Week 5: Discussion

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  1. Read the case study below.
  2. In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference

Case Scenario:

An 84- year-old -female who has a history of diverticular disease presents to the clinic with left lower quadrant (LLQ) pain of the abdomen that is accompanied by with constipation, nausea, vomiting and a low-grade fever (100.20 F) for 1 day.

On physical exam the patient appears unwell. She has signs of dehydration (pale mucosa, poor skin turgor with mild hypotension [90/60 mm Hg] and tachycardia [101 bpm]). The remainder of her exam is normal except for her abdomen where the NP notes a distended, round contour. Bowel sounds a faint and very hypoactive. She is tender to light palpation of the LLQ but without rebound tenderness. There is hyper-resonance of her abdomen to percussion.  

The following diagnostics reveal:  

Stool for occult blood is positive.

Flat plate abdominal x-ray demonstrates a bowel-gas pattern consistent with an ileus. 

Abdominal CT scan with contrast shows no evidence of a mass or abscess. Small bowel in distended. 

Based on the clinical presentation, physical exam and diagnostic findings, the patient is diagnosed with acute diverticulitis and she is admitted to the hospital. She is prescribed intravenous antibiotics and fluids (IVF). Her symptoms improved and she could tolerate a regular diet before she was discharged to home.   

Discussion Questions:

  1. Compare and contrast the pathophysiology between diverticular disease (diverticulosis) and diverticulitis.
  2. Identify the clinical findings from the case that supports a diagnosis of acute diverticulitis.
  3. List 3 risk factors for acute diverticulitis.
  4. Discuss why antibiotics and IV fluids are indicated in this case.

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Week 5 discussion

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Need help with this discussion post

In preparing for this discussion, you took part in an interactive scenario called “The Graduate.” In the scenario, you got to experience different people presenting different arguments (some of which you may not have liked). We have learned a lot in this course about the meaning of an argument and what constitutes a good argument. This discussion allows us to discuss more positive things that we can learn from “arguing” in the right way. 

Prepare: To prepare for this discussion, watch the following video from Daniel H. Cohen [Link here to http://www.ted.com/talks/daniel_h_cohen_for_argument_s_sake.html] and review section 9.4 of Chapter 9 called “Confronting Disagreement by Seeking Truth.”  Take a look as well at the required resources from this week and make sure that you have completed “The Graduate” interactive scenario. 

Reflect: Think about experiences you have had that involved conflicts with others. What was the genesis of the conflict? Would it have been possible for the exchange to be more productive? Think about why disagreements often lead to fights rather than opportunities to learn from each other. 

Write: Answer the following questions: What is an area of life in which you have experienced people treating arguments as a kind of war? What were the consequences of that approach? What is an area of life in which you have experienced people treating arguments as a kind of performance? Was that approach effective? Why is it better to treat arguments as a venue for learning? What traits of character does it require to be able to live according to that approach? What benefits can it have in our lives to take that approach? (please give a specific example)

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