Osteomyelitis and Amputation Lecture Notes

Flashcards about Osteomyelitis and Amputation

Osteomyelitis

Severe infection of bone, bone marrow, and surrounding soft tissue.

Amputation

Traumatic or surgical removal of an extremity.

Indirect entry Osteomyelitis

Most often affects children less than 17 years old.

Direct entry Osteomyelitis

Affects adults most often through open wounds, foreign body presence, diabetic/vascular ulcers, or pressure injuries.

Local manifestations of acute osteomyelitis

Constant pain worsening with activity, unrelieved by rest; swelling, tenderness, warmth, restricted movement.

Systemic manifestations of acute osteomyelitis

Fever, night sweats, chills, restlessness, nausea, malaise, late drainage.

Chronic osteomyelitis

Infection lasting longer than 1 month or has failed to respond to initial antibiotic treatment; continuous/persistent or exacerbations/remissions.

Diagnostic Studies for Osteomyelitis

Bone or soft tissue biopsy, blood/wound cultures, WBC count, ESR, C-reactive protein, X-rays/MRI/CT scans, bone scans.

Acute Osteomyelitis Care

Cultures or bone biopsy before antibiotics; aggressive, prolonged IV antibiotic therapy (4-6 weeks); surgical debridement and drainage.

Chronic Osteomyelitis Care

Surgical removal, extended antibiotic use, intermittent/constant antibiotic irrigation, casts/braces, negative-pressure wound therapy, hyperbaric oxygen therapy, removal of prosthetic devices, muscle flaps/skin grafts/bone grafts, amputation.

Acute Care for Osteomyelitis

Immobilization, pain management (NSAIDs, opioids, muscle relaxants), sterile dressing care, proper positioning, prevent immobility complications, patient teaching on antibiotic adverse effects (hearing deficit, renal impairment, neurotoxicity).

Important information to include in discharge education for a patient who had wound debridement for osteomyelitis

Antibiotic therapy for 4-6 weeks.

Systemic manifestations of acute osteomyelitis

Malaise, Night Sweats, Fever

Surgical goal for Amputation

Preserve as much extremity length and function as possible while removing infected, pathologic, or ischemic tissue.

Nursing diagnoses related to amputation

Disturbed body image, impaired tissue integrity, chronic pain, impaired mobility.

Goals for the patient with an amputation

Adequate relief from underlying health problem, satisfactory pain management, reach maximum rehabilitation potential, cope with body image change, make satisfying lifestyle adjustments.

Postoperative care for Amputation

Monitor VS, hemorrhage, infection. Delayed prosthesis fitted after healing, temporary prosthesis for partial weight bearing, permanent prosthesis 3 months after amputation if no problems.

Treatment for Phantom Limb Sensation/Pain

Mirror therapy, massage, nerve stimulation, acupuncture, medications.

Patient & Caregiver Teaching for Lower Extremity Amputation

Inspect residual limb daily, stop using prosthesis if irritation develops, wash residual limb thoroughly each night, do not use lotions/alcohol/powders/oil unless prescribed, wear residual limb sock in good condition, change sock daily, pain management techniques, ROM exercises, do not elevate residual limb on a pillow, lay prone with hip in extension 3-4 times daily.

Reasoning for phantom limb pain after an above-the-knee amputation

Nerve endings of the limb are still intact and react to stimuli.