Osteomyelitis

what is osteomyelitis?

a severe infection of the:
Bone
Bone marrow
Surrounding soft tissue

acute osteomyelitis

the initial infection or an infection of less than 1
month in duration

chronic osteomyelitis

refers to a bone infection that lasts longer than 1 month or an infection that did not respond to initial antibiotic treatment

difference between direct and indirect entry

Indirect-blood carries infection from another area of the body to the bones

Direct- an open wound allows microorganisms to enter body

what is sequestrum?

dead bone that separates from the living bone

what is involucrum?

a layer of new bone that grows over the sequestrum

clinical manifestations associated with osteomyelitis (local)

bone pain that is unrelieved with rest

swelling

warmth

tenderness

restricted movements

fractures

changes you see in the CRP and ESR and why

they will be elevated due to inflammation

diagnostic test that would be able to make definitive diagnosis

bone and soft tissue biopsy

CT and MRI

what is the disadvantage of the HCP depending on an X-ray in diagnosing osteomyelitis?

you aren’t able to accurately diagnose because its hard to see (takes about 10-14 days)

teaching for patient about IV therapy and the length of time they will be on antibiotic therapy

you will be placed on aggressive IV antibiotics for about 4-6 weeks in the acute setting

• then about 3-6 months at home via a line

gentamicin

teach that this is nephrotoxic and ototoxic

• tell them to report hearing loss or decrease in hearing

• problems urinating or any pain

• check/do renal tests before adminisering

what is hyperbaric O2 therapy and how does it help in treatment?

its a pressured tube that produces 100% O2 to stimulate new blood growth and healing for infected tissues

what is the very important question you ask before this therapy is given and why?

make sure you ask if they are claustrophobic

nursing implications of osteomyelitis

control other infections

teach about signs and symptoms

immobilize limb and be gentle

assess pain and monitor

encourage to reach out to HCP about bone pain etc.

check vascularization of limb

wet-to-dry dressing