Eric Osteomyelitis
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Transcript of 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