DIVERTICULITIS HEALTH EDUCATION PLAN (HEP) Objectives: (at least 3) 1.

Within 1 hour of giving health teachings, inform the patient of what exacerbates diverticulitis and how to properly manage it on their own. 2. Within 2-3 hours of educating, stresses the importance of adequate fiber intake during non-acute phases, adequate water intake and foods that are contraindicated for diverticulitis. 3. Within 30-45 minutes, patient will verbalize the importance of having good bowel hygiene. Materials Needed: 1. Visual aid 2. Ballpen 3. Notebook General Health Teachings 1. 1. Hygiene Specific Health Teachings Good bowel hygiene. Getting plenty of dietary fiber to keep stools soft and bowel movements regular Drinking plenty of water and exercising regularly are also important.

2. 2. Diet

a. A. Clear liquid diet means no solid foods. Juices should have no pulp. b. Purposeto provide hydration to a post-op patient. During the clear liquid diet, you may consume:

> Broth > Clear juices such as apple, cranberry and grape. (Avoid orange juice) > Jell-O

> Popsicles

c. B. Full Liquid d. Purposeafter a post-op patient tolerates clear liquids, this is often ordered. Foods Allowedall foods that are liquid or are liquid at room temperature Foods Not Allowednuts, beans, solid food C. Soft Diet Purposefor post-op patients after full liquid or for patients with infections or GI problems Foods Allowedall foods that are soft, tender, minced, stewed, or creamed Foods Not Allowedcoarse or whole grain breads, meats, sharp cheeses, dried fruits and nuts d. D. When you're able to eat solid food, choose low fiber foods while healing. Low fiber foods include:

> Canned or cooked fruit without seeds or skin, such as applesauce and melon > Canned or well cooked vegetables without seeds and skin > Dairy products such as cheese, milk and yogurt > Eggs > Low-fiber cereal > Meat that is ground or tender and well cooked > Pasta > White bread and white rice

E. Bland Diet Purposeto eliminate irritating foods to allow the stomach lining to heal (ulcer patients) Foods Allowedmilk, custards, white bread, cooked cereals, creamed or pureed soups, baked or broiled potatoes Foods Not Allowedstrongly flavored and highly seasoned foods, coffee, tea, citrus fruits, raw fruits and vegetables, whole grains, very hot or cold beverages F. Low-Residue Diet Purposeto reduce fiber for patients with Crohns disease, colon or rectal surgery, esophagitis, diarrhea. Foods Allowedclear fluids, sugar, salt, meats, fats, eggs, some milk, refined cereals and white breads, peeled white potatoes Foods Not Allowedcheeses, fried foods, highly seasoned foods, and high fiber foods G. Sodium Restricted Purposefor patients with kidney, cardiovascular disease or hypertension to control the retention of sodium and water and thus lower blood pressure Foods Allowednatural foods without salt, milk, and meat in limited quantities Foods Not Allowedcanned prepared foods, table salt, most prepared

seasonings not labeled low sodium H. Gluten-Free Diet Purposeeliminates gluten, a protein found in wheat products. These are used for patients with malabsorption syndromes such as celiac disease. Foods Allowedrice, corn, soy flour, fruits, vegetables, meat, eggs, milk Foods Not Allowedall wheat, rye, barley, oats: many prepared foods such as creamed sauces or breaded foods (may contain thickeners and fillers) I. Lactose-Free Diet Purposeto reduce or eliminate foods with lactose, for patients who cannot metabolize it Foods Allowedmost meats, fruits and vegetables, cereals and grains Foods Not Allowedfoods containing lactose, such as milk, cheese and ice cream J. Low-Cholesterol Purposeto reduce the intake of cholesterol in order to lower blood cholesterol levels Foods Allowedfruits, vegetables, lean meats and fish, poultry without skin, skim milk Foods Not Allowedorgan meats, egg yolks, shrimp, beef, lamb, pork

K. Low-Purine Diet Purposeto reduce the amount of purine, which is a precursor of uric acid, in the diet. It is used with patients who have gout or uric acid kidney stones. Foods Allowedmost vegetables (except cauliflower), spinach, asparagus, peas, fruit juices, cereals, eggs, cottage cheese 3. Prevention Foods Not Allowedorgan meats, fish, poultry, lentils, dried peas, nuts beans, oatmeal, whole wheat.

1. Regular bowel movements and avoiding constipation and straining are most important to prevent diverticulitis. 2. Eat a high-fiber diet to maintain good bowel hygiene. The American Dietetic Association recommends 20 to 35 grams of fiber a day. High-fiber foods include whole grain breads, cereals and crackers; berries; fruit; vegetables, such as broccoli, cabbage, spinach, carrots, asparagus, squash, and beans; brown rice; bran products; and cooked dried peas and beans, among other foods. 3. Drinking eight 8-ounce glasses of water a day.