Osteomyelitis: 7 Flashcards
What is osteomyelitis?
What bacteria is mostly involved?
Osteomyelitis is a severe infection of the:
Bone
Bone marrow
Surrounding soft tissue
Staph aureus
What is Indirect entry?
Usually associated with?
Blood carries infection from another area of the body to the bones (also called hematogenous)
infection of 1 microorganism.
Direct entry
bone infection that occurs when bacteria are directly introduced into the bone
An open wound allows microorganisms to enter the body.
What is sequestrum?
a piece of deadbone that has been separated from the surrounding bone during necrosis
What is involucrum?
a layer of new bone that forms around the piece of dead bone.
local symptoms of Acute osteomyelitis?
<1 month
4
Bone pain that worsens with activity and unrelieved by rest.
Swelling, Tenderness, Warmth
Restricted movement of the affected part.
Later signs include drainage from cutaneous sinus tracts or the fracture site
What is Chronic Osteomyelitis?
Chronic osteomyelitis may be?
Bone infection that lasts longer than 1 month or an infection that did not respond to initial antibiotic treatment.
Chronic osteomyelitis may be:
-Continuous (a result of inadequate acute treatment) OR
-A process of exacerbations and remissions
What changes would you see in the CRP and ESR? Why?
Both are elavated because of inflammation
What diagnostic test would be able to make the definitive diagnosis for osteomyelitits?
Bone or soft tissue biopsy!!!!!
What is the disadvantage of the doctor depending on an x-ray in diagnosing osteomyelitis?
What tests to do in Acute phase?
MRI may be more?
Signs dont appear on x-rays until 2-4 weeks after initial symptoms. By this time disease will progress.
CT and MRI can be done in acute phase
MRI may be more sensitive than CT in
detecting bone marrow edema, an early sign of osteomyelitis
What would you teach the patient about IV therapy and the length of time they will be on antibiotic therapy
AGGRESSIVE, long IV antibiotic therapy if bone ischemia has not occurred yet
Starts in the hospital and continues at home.
Some people will require IV antibiotics for 3 to 6 months.
Patients may be discharged to home care or a nursing facility so the antibiotics can be given through PICC line, IJ, or subclavian line.
TEST QUESTION!!!
Make sure you look at the information about gentamicin (aminoglycoside)
Can cause?
Assess for?
Ensure what test is done before?
Notify provider if?
Nephrotoxicity and Ototoxicity
Assess patient for dehydration before starting therapy.
Ensure renal function testing is done before starting therapy, especially in older patients.
Teach the patient to notify provider if hearing or urinary problems occur
How does hyperbaric O2 therapy help in the treatment of osteomyelitis?
What is a very important question you should ask the questions before this therapy is given…why?
It stimulates new blood growth and healing in the infected tissue.
Patient breathe pure O2!!!
Are you claustraphobic?????
Do you get anxious in closed spaces????
Review the nursing implications.
People at risk for osteomyelitis are those who are immunocompromised or have diabetes, orthopedic prosthetic implants, or vascular insufficiency
Some immobilization of the affected limb (e.g., splint, traction) is usually needed to decrease pain and reduce risk of further injury
