Osteomyelitis Presentation (1)
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Transcript of Osteomyelitis Presentation (1)
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DEFINITION(osteo-derived from the Greek
word osteon, meaning bone, myelo-
meaning marrow, and -itis meaninginflammation)
simply means an infection of thebone or bone marrow.
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OTHER TERMSBrodie abscess
Chronic recurrent multifocalosteomyelitis
SAPHO Syndrome
Garres sclerosing osteomyelitis
Hematogenous Osteomyelitis
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CAUSATIVE AGENTSAGE GROUP MOST COMMON ORGANISMS
Newborns (younger than 4months) S. aureus, Enterobacter species group
A and B Streptococcus species
Children (4 months to 4 years) S. aureus,
group A Streptococcus species, Haemophilus influenzae
Enterobacter species
Children, Adolescents (4 years to adult) S. aureus (80%) group
A Streptococcus species,
H. influenzae
Enterobacter species
Adult S. aureus
occasionally Enterobacter
Streptococcus species
Sickle cell anemia patients Salmonella species
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RISK FACTORS those who are poorly nourished
elderly
obese
other patient at risk include those with impaired
immune system, those with chronic illnesses
(diabetes, rheumatoid arthritis)
and those receiving long term corticosteroid therapy
or immunosuppressive agents
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TYPES OF OSTEOMYELITIS
Acute osteomyelitis
Sub-acute
osteomyelitis
Chronic osteomyelitis
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PATHOPHYSIOLOGYPredisposing factors:vascular insufficiency disorders genitourinary
infectionsrespiratory infections IV drug useImmune-compromising diseaseshistory of blood- stream infections
Indwelling prosthetic devices
Open wounds/fractures
Microorganisms lodge into an area where circulation slows
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PATHOPHYSIOLOGYMicroorganisms grow
Increase pressure
Vascular CompromiseIschemia
Infection through the bone cortex and marrow
Ischemia of the periosteum
Cortical devascularization
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PATHOPHYSIOLOGYNecrosis
Formation ofnew bone
sequestra Separation ofdevitalized
bone from living bone
Involucrum
Continuous to be aninfected island
Difficulty to reach byblood borne antibiotics
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PATHOPHYSIOLOGYEnlarged Sequestrum
Development of sinus tract
Turns to scar tissue
Site for continuedmicroorganism growth
Remission andexacerbation
Sequestrum move out tothe soft tissue
Revascularized
Removal by the normalimmune process
HEALING
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PATHOPHYSIOLOGY
Excessive vascular insifficiency
Loss of organ function
AMPUTATION
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Sign and Symptoms:
Diagnostic Finding:
Acute Osteomyelitis;
x-ray findings
Radioisotope bone scans , Isotope-labeled white blood cell
(WBC) scan, Magnetic Resonance ImagingWound and blood culture
Chronic Osteomyelitis;
X-ray findingsBone Scan
ESR
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Management:
Surgery if needed:
Incision ad Drainage of bone abscess.Sequestrectomy
Debridement
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Nursing Resposibilities for client with Osteomyelitis:
Monitors the neurovascular status of the affected extremity Elevation reduces swelling and associated discomfort Pain is controlled with prescribed analgesics and other pain-reducing
techniques The patient must understand the rationale of for the activity of
restriction Encourage patient to have a full participation in ADLs within the
physical limitationsMonitor the patients response to antibiotic therapyObserves the IV access
If surgery is necessary (take measures to ensure adequate circulation tothe affected area (wound suction to prevent accumulation, elevation ofthe area to promote venous drainage, avoidance of pressure on thegrafted area) to maintain needed immobility, and to ensure the patientsadherence of to weight bearing restrictions.
Changes dressings using aseptic technique
Diet high in protein and Vitamin C
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Thank you