marcus josiah m. reyes, sn-ust batch 2010 section 8 rle 4
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Marcus Josiah M. Reyes, SN-UST
Batch 2010 Section 8 RLE 4
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A severe infection of the bone and surrounding tissues (Maher, Salmond, & Pellino, 2002).
Can occur in any age, but common to children younger than 12 years of age. Males have higher incidence than females (Maher, et al, 2002).
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HematogenousThrough the bloodstream
Contiguous focusExtension from adjacent tissue infection
Direct infection into the bone
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Predominantly occur in children, middle-aged, and older adults (Maher, et al, 2002).
There is usually a single organism that enters a bone via the bloodstream from a site of infection (most commonly S. aureus) (Maher, et al, 2002).
Common sources of infection: UTI, skin infection, URTI, and acute otitis media (Maher, et al, 2002).
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Involves rich red marrow (Maher, et al, 2002).In children and infants: the long bones
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Onset is insidious (Maher, et al, 2002).Infection spreads to adjacent bone through
the soft tissue (Maher, et al, 2002).Greater risk for clients with Diabetes Mellitus
and severe atherosclerosis (Maher, et al, 2002).
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Microbes gain entry to the bone through open fractures, penetrating wounds, or contamination in a surgical procedure (Maher, et al, 2002).
Implanted items may also cause infection (Maher, et al, 2002).
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If hematogenous, common sepsis manifestations:ChillsHigh feverRapid pulseGeneral Malaise
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At first, systemic sx may overshadow the local signs
Constant, pulsating pain that intensifies with movement
Swollen and tender area of infectionChronic Osteomyelitis presents continuously
draining sinus or recurrent inflammation
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CBCESRBlood CulturesSuperficial CulturesBiopsyX-RaysRadionuclide Bone ScansMRI
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If with current infection, postpone orthopaedic surgery
Strict aseptic technique during orthopaedic surgery
Prophylactic antibioticsUrinary catheters and drains are removes as
soon as possible
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PharmacologicIV Antibiotic Therapy for 3-6 weeksThen, oral ATB for 3 monthsDirect application
SurgicalSurgical DebridementSequestrectomySaucerizationInternal fixation or external supportive devices
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InfectionIN ATBs, as orderedHand WashingStrict AsepsisMonitoring of ATB complianceHealth Education
Infection ControlInfection PreventionATB administration
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PainDeep Breathing ExercisesSplintingAnalgesics, as ordered
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Impaired Physical Mobility and Activity ToleranceComplete Bed RestDiversional ActivitiesActive ROM exercises to unaffected areasPassive ROM exercise to affected area,
approved by the MDAssistive Devices
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AnxietyActive ListeningStress Reduction (relaxation, guided imagery)Diversional ActivitiesHealth Education regarding illness
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Knowledge Deficit: Disease and MedicationHealth Education to the patient and family
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Maher, A., Salmond, S., & Pellino, T. (2002). Orthopaedic Nursing 3rd Ed. PA: W.B. Saunders Company
Smeltzer, S., Bare, B., Hinkle, J., & Chever, K. (2008). Brunner & Suddarth’s Textbook
of Medical-Surgical Nursing 11th Ed. PA: Lippincott Williams & Wilkins