Osteomyelitis

  1. General information
    1. Infection of the bone and surrounding soft tissues, most commonly caused by S. aureus.
    2. Infection may reach bone through open wound (compound fracture or surgery), through the blood stream, or by direct extension from infected adjacent structures.
    3. Infections can be acute or chronic; both cause bone destruction.
  2. Assessment findings
    1. Malaise, fever
    2. Pain and tenderness of bone, redness and swelling over bone, difficulty with weight bearing; drainage from wound site may be present
    3. Diagnostic tests
      1. CBC: WBC elevated
      2. Blood cultures may be positive
      3. ESR may be elevated
  3. Nursing interventions
    1. Administer analgesics and antibiotics as ordered.
    2. Use sterile technique during dressing changes.
    3. Maintain proper body alignment and change position frequently to prevent deformities.
    4. Provide immobilization of affected part as ordered.
    5. Provide psychologic support and diversional activities (depression may result from prolonged hospitalization).
    6. Prepare client for surgery if indicated.
      1. Incision and drainage of bone abscess
      2. Sequestrectomy: removal of dead, infected bone and cartilage
      3. Bone grafting after repeated infections
      4. Leg amputation
    7. Provide client teaching and discharge planning concerning
      1. Use of prescribed oral antibiotic therapy and side effects
      2. Importance of recognizing and reporting signs of complications (deformity, fracture) or recurrence

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