- Acute Pain elated to Inflammatory process as evidenced by reports of abdominal pain/tenderness and Facial grimacing
- Constipation related to Blockage of the colon and Insufficient fiber intake and Inadequate toileting habits as evidenced by Straining with defecation and Inability to defecate
- Diarrhoea related to Inflammatory process as evidenced by Bowel urgency and Hyperactive bowel sounds
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: -Verbal reports from the patient -Expressions of pain, such as crying -Unpleasant feeling (such as a prick, burn, or ache) Objective data: -Significant changes in vital signs -Changes in appetite or eating patterns -Changes in sleep patterns -Guarding or protective behaviors | Acute Pain elated to Inflammatory process as evidenced by reports of abdominal pain/tenderness and Facial grimacing | Patient will verbalize a significant reduction of pain as evidenced by stable vital signs and absence of restlessness and guarding behavior. | 1. Administer medications as needed. Antibiotics are prescribed for an infectious process while pain medications will treat the acute pain symptoms. 2. Provide a clear liquid or soft diet as indicated. If the patient is not NPO, provide a clear liquid diet or soft diet to enable the bowels to rest and reduce inflammation. 3. Encourage bed rest. Increased intraabdominal pressure can aggravate pain. Avoid activities that can increase intraabdominal pressure like vomiting, bending, wearing tight clothing, heavy lifting, and straining with bowel movements. 4. Provide nonpharmacological pain relief. Nonpharmacologic pain relief includes distraction, music therapy, imagery, and relaxation. Such techniques can be used to complement the pharmacological treatment of pain. 5. Prepare for surgical intervention as indicated. Surgical intervention may be indicated to improve the symptoms of diverticulitis. Prepare the patient preoperatively by providing patient education. | Patient verbalized significant reduction of pain as evidenced by stable vital signs and absence of restlessness and guarding behavior. |
| Subjective data: -Less than three bowel movements per week Hard, dry stool Lumpy stool -Difficulty/straining to pass stool, painful -Stomach pain, aches, or cramps -Sensation of feeling bloated or nauseous -Sensation that you have not fully emptied your bowel after a bowel movement Objective data: -Assess medical history related to potential constipation (history of constipation, activity level, medications used routinely for constipation) -Specific actions that improve or worsen pain -Assess stool characteristics per patient Color, consistency, amount – Use appropriate tools as needed (Bristol Stool Chart) | Constipation related to Blockage of the colon and Insufficient fiber intake and Inadequate toileting habits as evidenced by Straining with defecation and Inability to defecate | Patient will report passing stool without straining. Patient will report at least one bowel movement every 3 days. | 1. Encourage the patient to keep a diary of their bowel habits. A diary of bowel habits should include time, length of time in the toilet, consistency, amount and frequency of stool, and straining. This information can help the patient and healthcare team monitor progress. 2. Encourage the patient to eat a high-fiber diet. Provide patients with high-fiber foods to prevent constipation: apples, pears, peas, beans, potatoes, whole grains, bran cereal, and nuts. 3. Encourage adequate fluid intake. Encourage the patient to drink at least 1.5 liters per day (unless contraindicated). Water intake promotes the formation of soft stools and makes them easier to pass. 4. Encourage physical activity as tolerated. Physical activity stimulates peristalsis in the colon and encourages the movement of feces for elimination. 5. Educate on bowel training. Poor bathroom habits can cause constipation. Ensure the patient is not suppressing the urge to defecate. The patient should be provided with adequate time and privacy to complete defecation. 6. Consider stool softeners or laxatives. Chronic constipation may require the use of stool softeners or laxatives to prevent worsening diverticulitis. | Patient reported passing stool without straining. Patient reported at least one bowel movement every 3 days. |
| Subjective data: -Abdominal pain -Gas, bloating -Urgency and frequency Objective data: -Hyperactive bowel sounds -Three or more loose stools per day -Blood or mucus in the stool | Diarrhoea related to Inflammatory process as evidenced by Bowel urgency and Hyperactive bowel sounds | Patient will exhibit formed stools without experiencing bowel urgency. Patient will verbalize two strategies to prevent dehydration with diarrhoea. | 1. Administer medications as ordered. Antidiarrheals and antibiotics are indicated to help treat patients with signs of infection and symptoms of diarrhoea related to diverticulitis. 2. Place the patient on a liquid diet. A liquid diet is often prescribed for a few days to help the bowel rest, recover, and heal. Once the signs and symptoms of diverticulitis have improved, solid foods may be gradually added to the patient’s diet. 3. Instruct on high-fiber and low-fiber diets. When experiencing diarrhoea, fiber should be decreased so stools don’t pass as quickly through the GI tract. Once diarrhoea resolves, the patient can resume a high-fiber diet to prevent constipation and inflammation common with diverticulitis. 4. Monitor the patient’s fluid and electrolytes. Since diarrhoea can cause dehydration and electrolyte imbalances, strict monitoring of the patient’s intake and output, fluid status, and electrolyte levels is essential. 5. Encourage PO or IV fluid intake. The patient with diverticulitis may be on strict NPO status. If so, administer IV fluids to support hydration. | Patient exhibited formed stools without experiencing bowel urgency. Patient verbalized two strategies to prevent dehydration with diarrhoea. |