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Y2 Finals > OM > Flashcards

OM Flashcards

1
Q

What is the duration of acute OM

A

<1mth

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2
Q

What is the duration of chronic OM

A

> 1mth

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3
Q

What microorganisms are most commonly seen in OM

A

Staph A* & mycobacterium TB

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4
Q

Risk factors of OM

A
  1. Trauma/injury
  2. Surgical procedures
  3. Open wound
  4. Bloodstream/haemtogenous spread (*most common)
  5. Infection from other parts of the body (ear, tonsil, teeth, sinus & genitourinary)
  6. Weak immunity (HIV)
  7. Poor circulation (DM/cellulitis)
  8. IV drug use
  9. Periodontal disease
  10. Indwelling central catheter
  11. Prosthetic joint
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5
Q

Where do OM usually occur in ADULTS

A

Vertebrae, sternocalvicular, sacroiliac joint, symphysis pubis

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6
Q

Where do OM occur in CHILDREN

A

Long bones of appendicular skeleton

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7
Q

What can OM cause at site of infection

A

Septic arthritis & pathologic fracture

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8
Q

What is the SS of OM

A
  1. Bone pain
  2. Redness
  3. Swelling
  4. Warmth
  5. Fever
  6. Malaise
  7. Nausea
  8. Restless
  9. Night sweats/chill
  10. Bacteraemia
  11. Pain on movement of affected extremity
  12. Loss of movement
  13. Local tenderness
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9
Q

What test can be done for OM

A
  1. MCS
  2. Hx & PE
  3. X-ray
  4. Conventional radiology
  5. Nuclear imaging studies
  6. CT scan
  7. MRI
  8. Radionuclide bone scan
  9. Bone biopsy
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10
Q

What treatment is done for ACUTE OM

A
  1. IV abx (abx for 4 wks, 1-2 wk on IV, rest on PO)
  2. Surgical debridement
  3. Abx irrigation
  4. Acrylic bead chains containing abx
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11
Q

What is the tx of CHRONIC OM

A
  1. Incision & drainage
  2. Wound debridement
  3. Sequestectomy
  4. Hyperbaric O2
  5. IV abx
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12
Q

Which part of the body does OM TB affect the most

A

Spine because its closest to the vertebrae/leg
(*more difficult to control & more destructive)

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13
Q

What are the SS of OM TB

A

Local: pain, immobility, muscle atrophy, swelling
Systemic: Fever/night sweat, Leukocytosis, Cough, manifestations to pulmonary TB

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14
Q

What is the goal of tx for OM

A
  1. Eradicate infection
  2. Monitor complication & pt discomfort & pain
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15
Q

What are the nursing management for OM

A
  1. Establish contact precaution
  2. Assess VS (bp) & lvl of pain
  3. Administer pain meds
  4. Help with non-pharmacological pain mgt techniques
  5. Administer fluid & abx
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16
Q

What are the pre-surgical debridement care to be done for OM

A
  1. Standard pre-opt care
  2. Perform focused NV assessment of affected extremity
    • to report if
      A. Decreased/absent pulse
      B. Prolonged cap refill of more than 3 seconds
      C. Dusky, pale skin - cool to touch
      D. Numbness, tingling/decreased sensation
      E. Pain that does not improve with meds
17
Q

What are the post-surgical debridement care for OM

A
  1. Monitor for systemic infection (VS & lab result)
    • report if
      I. Increased WBC + left shift
      II. Increased serum lactate
      III. Increased procalcitonin
      IV. Altered LOC
      V. Hypotension
      VI. Tachycardia
      VII. Tachypnoea
      VIII. Fever
  2. Protein rich diet to support healing
  3. Coordinate ongoing care after discharge
    • IV abx
    • Dressing change (*sign of wound healing: decreased size, exudate & contraction of wound edge)
18
Q

How does Jackson Pratt/JP drain work

A

Prevent extra fluid from building up after surgery/have infection by sucking fluid through squeezable bulb

19
Q

How does Hemovac drain work

A

Prevent extra fluid from building up after surgery/have infection by sucking fluid into flat container with spring

20
Q

Factors affecting wound healing

A
  1. Clean/uncontaminated
  2. Moist wound bed for continuous granulation
  3. Blood flow (remove dead tissue/necrotic/escahr)
  4. Pressure
  5. Location of wound (joint/movement area which are further away from circulation)
  6. Diet (increased protein, decreased sugar & salt to prevent dehydration)
  7. Med (chemo & blood thinners)
21
Q

What is MEASURE

A

Measure wound; Exudate quality & amt; Appearance of wound bed; Suffering; Undermining, Re-evaluation every 2-4wk; Edge of wound

22
Q

What is the discharge plan for OM

A
  1. Knowledge on OM
  2. Refer to home nurse to assess surgical wound, administer IV abx & monitor process
  3. Teach how to care for central venous access if have
  4. Eat diet rich in protein, vitamin & mineral
  5. Manage chronic condition (DM/PVD - inspection leg daily and take measures to prevent injury)
23
Q

What is to be reported to the HCP for OM

A
  1. Develop other wound/ulcer/break in skin
  2. Fever, chill
  3. Increased redness, swelling, numbness/pain

Y2 Finals (10 decks)

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