Eric Osteomyelitis

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    Osteomyelitis

    Eric

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    Anatomy and Physiology

    The Skeleton

    he adult human skeleton has a total of 2xcluding the sesamoid bones (1). The apkeleton has 126 bones, axial skeleton 60 uditory ossicles six bones. Each bone

    undergoes modeling during life to help ithanging biomechanical forces, as well as remremove old, microdamaged bone and replace itmechanically stronger bone to help prestrength.

    http://cjasn.asnjournals.org/content/3/Supplement_3/S131.fullhttp://cjasn.asnjournals.org/content/3/Supplement_3/S131.full
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    Four general categories bones:

    1. Long bones (clavicle, humerus, radius, etc.)

    2. Short bones (carpal, tarsal bone)3. Flat bones (skull, mandible, scapulae)

    4. Irregular bones (sacrum, coccyx)

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    Function of Bone-the bones of the skeleton provide structural suppor

    of the body

    -permit movement and locomotion by providing lemuscles

    -protect vital internal organs and structures

    -provide maintenance of mineral homeostasis an

    balance-serve as a reservoir of growth factors and cyt

    provide the environment for hematopoiesis within

    spaces

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    The long bones are composed of a hollow shaft

    diaphysis; flared, cone-shaped metaphyses belo

    growth plates; and rounded epiphyses above th

    plates. The diaphysis is composed primarily of dcortical bone, whereas the metaphysis and epip

    composed of trabecular meshwork bone surrou

    relatively thin shell of dense cortical bone.

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    Osteomyelitis

    osteo-derived from the Gree

    osteon, meaning bone myelo- means marrow

    itis- means inflammation

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    Simply means an infection of the bone

    marrow. It can be usefully sub classifie

    basis of the causative organism

    bacteria or mycobacteria ) the route,

    and anatomic location of the infection

    It is an acute or chronic inflammator

    f the bone and its structures seco

    infection with pyogenic organisms.

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    The bones becomes infcted by one the th

    modes:

    1. Extension of the soft tissue infection (in

    infection or vascular ulcer)

    2. Direct bone contamination from bone su

    open fracture, or traumatic injury

    3. Hematogenous (blood borne) spread forsites of infection

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    Osteomyelitis resulting from hematogenous spre

    occurs in a bone area of trauma or lowered resista

    from subclinical (non apparent) trauma. Patient

    for osteomyelitis include those who are poorly

    elderly or obese. Also at risk are patient with impasystem, those with chronic illness and those re

    term corticosteroid therapy. Postoperative sur

    infections occur within 30 days after surgery

    classified as incisional or deep .

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    Bone infections are more diff

    eradicate than soft tissue i

    because the infected bone walled off. Natural body

    responses are blocked, and ther

    penetration by antibiotics . Osteomay become chronic and may af

    patient's quality of life.

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    l

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    Etiology

    Bacteria Staphylococcus Aureus

    Streptococcus

    Gonococcus

    Cocciloides Treponema

    k

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    Risk Factor Long term use of corticosteroids

    Obese

    Elderly

    Poorly nourished

    Postoperative surgical wound

    Trauma

    Weak immune system

    Immunocompromised patient

    Diabetes

    Poor blood supply

    C

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    Causes

    Direct or indirect invasion of an organism into the bone

    Break in the skin (break make cause abrasion, open fractu

    Trauma to the bone

    Category of Osteomyelitis

    Exogenous- infectious organism enter from the outside of the

    Endogenous- organism carried by a blood circulation from otthe infection in the body

    Contigious- results from the skin infection of adjacent tissue

    Si d S t

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    Sign and Symptoms:

    Elevated WBC

    Limited ROM

    Bone pain on affected site

    Irritability

    Elevated ESR

    Swelling Redness

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    Modifiable Factor:Lifestyle

    Punctured wound

    Non- ModifiabFactor:

    AgeGender

    Bacterial invasionor infection on thewound

    Hematogenousspread of infection

    to the bone

    Organism invadethe bone tissue

    and initiate andinflammation

    response

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    Fever, Leukocytosis, Inflammation, and Pusformation

    VasculEngorgemeto inflamm

    Exudatescontribute to grow

    Pressure developsat the site causing

    painCompromise

    flow

    Exudates extends intothe medullary cavity and

    under the periosteum

    Sequestrum thenosteoblastic response Involucrum

    Diagnostic Test:

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    Diagnostic Test:

    1. Bone biopsy

    2. MRI3. CT-scan

    4. Ultrasound

    5. Culture and sensitivity

    6. CBC7. X-ray

    M di l I i

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    Medical Intervention:

    1. IVF (D5 0.3NaCl)2. Laboratory Test

    3. Medication (Paracetamol)

    4. Diet and Nutrition5. Debridement

    S i l M t

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    Surgical Management:

    1. Sequestrectomy

    2. Bone graft

    3. Muscle Flap

    4. Amputation

    Nursing Management:

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    Nursing Management:

    1. Prevention for deformity or injury

    2. Increasing clients comfort

    3. Avoids complication of impaired mobility

    4. Maintain cool and clean environment

    5. Encourage on relaxation and distractive tech

    6. Provide information regarding to the disease

    7. Open draining wounds8. Administering oral antibiotics

    9. Proper disposal of drainage

    10. Emphasize importance of clean wound acco

    disease Nursing Diagnosis

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    Nursing Diagnosis

    1. Risk for peripheral neurovascular dysfunction

    2. Risk for Infection

    3. Acute pain

    4. Impaired physical mobility

    5. Impaired skin integrity