👤 By the CinnaRN Clinical Content Team🕐 Updated 2026-08-23🏷️ Physiological Adaptation🔖 Free to read, print, and share
Also known as: inflamed pouches in the colon · infected colon pockets
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Use this quick-reference guide to spot, treat, and prevent Diverticulitis on the NCLEX. Keep it handy during review and on exam day!
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📒 The 1-minute cheat sheet
🩺 Signs
LLQ pain, fever, ↑WBC
N/V, bloating, altered bowels
✅ Do
Acute: NPO/clear liquids, bowel rest
Antibiotics, IV fluids
Recovery: ↑fiber, ↑fluids
📌 Avoid
No fiber during acute flare
No enemas/laxatives → perforation
🚩 Report
Rigid abdomen, ↑fever → rupture
Peritonitis = surgical emergency
📚 Diverticulitis — full study notes
The cheat sheet above is your quick recall card. These notes go deeper — what it is, what to do first, what must be reported, and what to teach.
Diverticula are small outpouchings of the colon wall (most often the sigmoid colon); diverticulosis is their presence, and diverticulitis is when one becomes inflamed or infected, usually after stool/food trapping. It classically causes left lower quadrant pain, fever, and altered bowel habits. A low-fiber diet and chronic constipation are major contributors.
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Key points
Understand these first
Hallmark presentation is left lower quadrant abdominal pain, fever, leukocytosis, and often a palpable LLQ mass.
Acute diverticulitis is managed with bowel rest (NPO or clear liquids), IV antibiotics, and IV fluids; the bowel is rested then advanced slowly.
Long-term prevention uses a HIGH-fiber diet and adequate fluids once the acute episode resolves.
Complications include perforation, peritonitis, abscess, fistula, and bowel obstruction.
Barium enema and colonoscopy are AVOIDED during the acute phase because of perforation risk and are deferred 4-6 weeks until inflammation subsides.
Older adults and patients on corticosteroids may have blunted symptoms, masking a serious infection or perforation.
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Nursing priorities
What to do, in order
Keep the patient NPO or on clear liquids during the acute attack to rest the bowel, then advance the diet gradually as ordered.
Administer prescribed IV antibiotics and IV fluids and monitor temperature and WBC trend.
Assess pain and abdomen frequently for rigidity, rebound tenderness, or distention signaling perforation.
Monitor for signs of peritonitis or sepsis (rising fever, tachycardia, hypotension, board-like abdomen).
Teach a high-fiber, high-fluid lifestyle for prevention once recovered.
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Red flags — report now
Escalate immediately
Report sudden severe abdominal pain with a rigid board-like abdomen, rebound tenderness, fever, and tachycardia (perforation/peritonitis).
Never give laxatives, enemas, or perform a colonoscopy/barium study during the acute inflamed phase due to perforation risk.
Report bright red rectal bleeding or signs of shock.
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Labs & values
Numbers to know
WBC: 5,000-10,000/mm3 (elevated in active diverticulitis)
CRP elevated in active inflammation
Hgb may fall with bleeding (male 13.5-17.5 g/dL, female 12-16 g/dL)
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Patient teaching
What patients must know
Eat a high-fiber diet (20-35 g/day) with plenty of fluids to keep stool soft and prevent recurrence, but only after the acute attack resolves.
Older 'avoid nuts and seeds' advice is no longer broadly required; follow your provider's guidance.
Avoid increasing intra-abdominal pressure with straining; prevent constipation.
Return for fever, worsening pain, or rectal bleeding.
❓ Diverticulitis: NCLEX FAQs
What are the priority nursing interventions for Diverticulitis?
Keep the patient NPO or on clear liquids during the acute attack to rest the bowel, then advance the diet gradually as ordered. Administer prescribed IV antibiotics and IV fluids and monitor temperature and WBC trend. Assess pain and abdomen frequently for rigidity, rebound tenderness, or distention signaling perforation. Monitor for signs of peritonitis or sepsis (rising fever, tachycardia, hypotension, board-like abdomen).
What are the warning signs of Diverticulitis a nurse must report?
Report sudden severe abdominal pain with a rigid board-like abdomen, rebound tenderness, fever, and tachycardia (perforation/peritonitis). Never give laxatives, enemas, or perform a colonoscopy/barium study during the acute inflamed phase due to perforation risk. Report bright red rectal bleeding or signs of shock.
What do I need to know about Diverticulitis for the NCLEX?
Hallmark presentation is left lower quadrant abdominal pain, fever, leukocytosis, and often a palpable LLQ mass. Acute diverticulitis is managed with bowel rest (NPO or clear liquids), IV antibiotics, and IV fluids; the bowel is rested then advanced slowly. Long-term prevention uses a HIGH-fiber diet and adequate fluids once the acute episode resolves. Complications include perforation, peritonitis, abscess, fistula, and bowel obstruction.
What patient teaching is important for Diverticulitis?
Eat a high-fiber diet (20-35 g/day) with plenty of fluids to keep stool soft and prevent recurrence, but only after the acute attack resolves. Older 'avoid nuts and seeds' advice is no longer broadly required; follow your provider's guidance. Avoid increasing intra-abdominal pressure with straining; prevent constipation. Return for fever, worsening pain, or rectal bleeding.
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Quick Tip
Hallmark presentation is left lower quadrant abdominal pain, fever, leukocytosis, and often a palpable LLQ mass.