A 67 y.o. (year old) female presents to the ER with increasing Llower abdominal pain for 3 days. She has had a fever of 102F forthe past 2 days, nausea and 3 episodes of bloody diarrhea sinceyesterday. Her past history is significant for diverticular diseaseand HTN (hypertension). She has been admitted 2 times previouslyfor diverticulitis, the last one being approximately 1 ½ yearsago. On examination the patient is in moderate distressand febrile at 102.5F and her BP is 140/90. Her abdomenis slightly distended and appreciably tender throughout the L lowerabdomen. The decision is made to admit her with diagnosis of acutediverticulitis.
- Before beginning drug therapy, what 2 factors related to thehistory not present above must be known?
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- Name two bacteria (not just “gram-neg rods”) that you arefamiliar with that could possibly be causing this infection
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- Before starting an antibiotic, name 4 factors that need to betaken into consideration with regard to the drug itself and thepatient.
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- Based on your answers to #3, what would be the BEST CHOICE foran antibiotic at this time?________________________________________________
- What type of “diet order” should be given for thispatient?_______________________
- What “activity level” should be assigned for this patient atthis time? (take into consideration the history above, patient age,elimination needs; Ex; bed rest, bed rest with bedside commode,etc.)
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On day 2 of admission during the night, the patients feverspikes to 104F. Her skin is ‘cool and moist’ and her BPdrops to 90/60. On exam, her abdomen is now “rigid” andacutely tender in the LLQ (left lower quadrant).
- Given the above information, what has the patient developedsecondary to herinfection?___________________________________________________________
- What has most likely occurred related to her initial diagnosisand “disease location” that has produced the change in her status?___________________________________________________________
- The “rigid abdomen” is a likely indicator that she isdeveloping or hasdeveloped________________________________secondary to your answerin #8.
- Given the above changes, where should this patient betransferred to in the hospital at thistime?_______________________________________________________________
