The nurse is caring for a client experiencing an acute flare-up of diverticular disease. Which interventions by the nurse are appropriate for this client?

Select all that apply.
  1. encourage a diet high in fiber
  2. insert a nasogastric (NG) tube
  3. administer enemas as ordered
  4. administer IV fluids as ordered
  5. encourage coughing and deep breathing
  6. check stools for frank or occult bleeding
Numbers 2, 4, and 6 are correct.
Rationale: An NG tube is placed to avoid complications from nausea, vomiting, and abdominal distention. IV fluids correct dehydration. Monitoring stools for bleeding is important because blood loss may lead to a drop in blood pressure or, in severe cases, progress to hypovolemic shock. A client in the acute phase of diverticular disease should have a low-fiber diet if she is able to eat. A high-fiber diet should be introduced gradually once the acute phase has resolved. Enemas are contraindicated because they cause an increase in intestinal motility. Coughing should be avoided because it increases intra-abdominal pressure.