On my third day of clinical course I had an African America patient age 72, female, a retired high school teacher who was admitted for an Acute Diverticulitis with Perforation. She is diabetic and had a medical and surgical history of diverticulitis, High Cholesterol, Non-Insulin-Dependent Diabetes Mellitus (NIDDM), Hysterectomy, and Scoliosis. She has been on clear liquid diet since she was admitted then she was Nothing by Mouth NPO for the CT scan for that day. When I got the assignment that I was going to be taking care of a patient with an acute diverticulitis, the first thing on my mind was that she will be in a severe abdominal pain, high fever due to infection because my aunty had same disease. To my surprise, she claimed a 0 /10 on a 0-10 pain scale. Her blood sugar and vital signs were normal except for respiratory that was 22. All her laboratory test results were normal including WBC. Patient concern was that she couldn’t have a bowel movement. She was medicated on Colace- a stool softener, morphine for pain, sulfran for nausea, and azactam an antibiotics.
Diverticulosis is a disease from the diverticulum. This is when the colon wall is been outpunched through the mucosa. These are small mucosal herniation bulging via smooth muscle and layers of the intestine along vasa recta formed opening in colon’s wall. Diverticulitis causes is still unknown but develop after a micro or macro perforation of diverticulum. Peritonitis is an end result from an intestinal rupture in the case of a large perforation. Clinically, diverticulosis could be asymptomatic or symptomatic, they are uncomplicated with no evidence of bleeding or inflammation. Signs and symptoms includes palpable mass and tenderness mostly i...
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...an seven 6-ounce of glasses of fluid each day most especially for patients on pharmaceutical fiber supplements.
Works Cited
Ferzoco, K.H. (2010). Small bowel diverticulitis. The New England Journal of Medicine. 327: 302-7
Juchems, A.A. (2010). Long-term management of diverticulitis in young patients. Diseases of the Colon & Rectum. 58:627-629.
Marinella, L.B. et al: (2010). Acute Diverticulitis. The New England Journal of Medicine. 327: 1521-1526
Painter, P.V. (2009). Diverticulitis. Gastroenterology Clinics of North America. 18:357-385.
Spivak, W.K., & deSouza, J.M. (2008). Diverticulitis of the right colon. Digestive diseases and sciences. 49: 350-358
Wilcox, C.V. (2009). Limitation in the CT diagnosis of acute diverticulitis: Comparison of CT, contrast enema, pathologic findings in 16 patients. American Journal of Roentgenology. 201:381-385.
Meckel’s diverticulum is a common congenital anomaly of the small intestine occurring in up to 3% of the population, typically 55 cm from the ileocecal valve. Surgical resection is indicated for complicated Meckel’s diverticulum (MD). Most reported
The laparoscope was inserted and the remaining ports were placed visualizing their placement with a laparoscope. An 11 mm port was placed in the subxiphoid location, and two 5 mm ports were placed laterally under the right subcostal (rib) margin. The gallbladder was identified. It was edematous, acutely inflamed. It was grasped with the fundus and retracted in a (cephalad) direction. There were no omental adhesions adherent to the gallbladder that were taken down sharply. The neck was then grasped along the lateral most ports and retracted in a lateral direction. The cone bile duct was identified and care taken to avoid injury to this structure. The cystic artery and cystic duct were identified, mobilized, doubly ligated with endoclips and then divided. The gallbladder was dissected free from the liver with the electrocautery. The specimen was placed in an (Endo Catch) (sac), and was removed through the umbilical incision with no difficulty. The Hassan trocar was reinserted into the abdomen, reinflated the suprahepatic lymphatic space was irrigated copiously with normal saline. Adequate hemostasis was obtained in the gallbladder fossa with the electrocautery. The 360 degree
Walker, H. (1990). Chapter 93Inspection, Auscultation, Palpation, and Percussion of the Abdomen. In Clinical methods: The history, physical, and laboratory examinations (3rd ed.). Boston:
•The specialist Richard should go visit to have an evaluation due to the predicaments he encounters with his colon & rectum is a proctologist generally diagnosing such areas also identifying symptoms occurring in the following organs: colon, rectum, & anus.
Explain your reasoning for each. The primary diagnosis is ovarian torsion. The patient present with classical signs and symptoms of RLQ abdominal pain the worsen with any movement, nausea, tachycardia, RLQ tenderness, guarding, and rebound on examination as well as right adnexal tenderness and right adnexal mass (I-Human Patients, 2017). Differential diagnosis include; pelvic inflammatory disease (PID), appendicitis, and renal colic. Clinical features that favor the diagnosis of PID are non-migratory pain, bilateral pelvic tenderness and absence of nausea or vomiting. Appendicitis typically presents with poorly localized colicky central abdominal pain associated with anorexia and vomiting. Renal colic typically presents with sudden onset of severe unilateral colicky pain radiating from the loin to the groin, which comes in waves, very similar to torsion (Krishnan, Kaur, Bali, & Rao,
Patients with ulcerative colitis if usually referred to a gastroenterologist. This is a specialist who manages patients with gastrointestinal diseases. The physicians will need to assess the severity of the condition. The questions he or she is likely to ask include how many times are you passing stool? Is the stool bloody? Do you have nonspecific symptoms such as a high temperature, tachycardia and shortness of breath? The patient should be examined and investigated to rule out differential diseases.
All of my patients outcomes were met today. He ate the majority of his breakfast, which was being monitored. He also took all of his medications, nasal sprays, and inhaler. The Patient was determined fit to go home and was to be discharged today. So I removed the patients IV, and helped secure his ankle bag for him before he was to start getting ready to pack up for home.
Ulcerative colitis begins in the rectum and spreads throughout the colon. The disease directly affects the mucosa. As with many diseases, the appearance varies with the severity of the disease. In the mildest form, the mucosal surface is usually wet due to blood and mucus with multiple petechial hemorrhages. In addition to this, ulcers of various sizes may form. Lesions also may form along the mucosa if one is affected by ulcerative colitis. Normally, the lesions are separated by normal mucosa. On rare occasions, the wall of the colon may thicken significantly.
The patient was transferred into my care via the Emergency Assessment Unit for Surgical Patients (EAUS). I was given handover by the charge nurse who has already pre-a...
He is admitted to the ward with the chief complain of pain at right lower quadrant of the abdomen for 8 hours prior to his admission.
On the second week of my placement, I was asked to bed-bath an 85 year male old patient in my bay, in the ward and get him ready for breakfast. This patient had, had a bowel surgery and as a result he had a stoma bag on. This patient was diagnosed with Inflammatory Bowel Disease (IBD) IN 2010, but his condition had grown worse over the years. IBD mainly refers to Ulcerative Colitis (UC) and Crohns disease (CD). However, this patient had Crohns disease. I was asked to bed-bath him by my mentor while she was observing me as she had taught me how to assist patients with their Activities of Daily Living (ADL) which are considered to be important.
Gastroenteritis, sometimes referred to as infectious diarrhoea is a common disease that affects millions of people annually. It is a disease caused by viruses, bacteria or parasites that enter the human body and spread, which induce symptoms such as vomiting, diarrhoea, abdominal pain and nausea. Although it is a common occurrence in society and is usually not harmful, cases of gastroenteritis in less developed countries may have more fatal repercussions due to their inability to access ample means of treatment. Over time, as more research was conducted into the disease, scientific developments were made to aid those affected by gastroenteritis and reduce the number of fatalities by educating people regarding preventative methods.
Irritable Bowel Syndrome. Mayo Foundation for Medical Education and Research, 2014. Web. 20 May 2014.
Duodenal ulcers are the most common, occurring on the inside of the upper portion of the small intestine called the duodenum. This results when the acid chyme, a semifluid mass of partially digested food, is expelled by the stomach into the duodenum. This chime is not completely neutralized when entering through the pyloric sphincter, thus producing erosions a...