A nurse is caring for a client who reports abdominal pain.

Exhibits

The nurse is caring for a client who has abdominal pain. Which of the following actions should the nurse take? Select all that apply.

Rationale:

A. Administer a laxative to prevent constipation: Laxatives are contraindicated in the acute phase of diverticulitis, as they can worsen symptoms by increasing bowel motility. The priority is to allow the bowel to rest, not stimulate it.

B. Ensure the client is on bed rest: Bed rest is often recommended for patients with diverticulitis to reduce abdominal strain and decrease the risk of perforation or worsening of the condition.

C. Ensure the client is NPO: The client’s CT scan shows thickening of the bowel in the left lower quadrant, suggesting diverticulitis. In the acute phase, the client should be NPO to rest the bowel and prevent further irritation, allowing the gastrointestinal system to recover.

D. Prepare to insert a nasogastric tube: In acute diverticulitis, particularly when there is abdominal distention and vomiting, a nasogastric (NG) tube may be needed to decompress the stomach. This will help relieve pressure, prevent aspiration, and remove gastric contents in case of bowel obstruction or ileus.

E. Position client in high-Fowler's position: High-Fowler’s position is not appropriate for this client, as it could increase intra-abdominal pressure. A position that reduces strain on the abdomen (such as low or semi-Fowler’s) is more beneficial.

F. Provide the client with foods that are high in fiber: High-fiber foods are generally advised for managing diverticular disease in the chronic phase, but they should be avoided during acute diverticulitis. Inflammation of the diverticula requires a low-residue diet to prevent irritation of the bowel.

G. Administer an enema to promote bowel evacuation: Administering an enema is contraindicated in diverticulitis because it can cause bowel perforation, particularly if the diverticula are inflamed. The focus should be on resting the bowel.