Med Surg Ch 64
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a severe infection of the bone, bone marrow, and surrounding soft tissue.
(hematogenous) microorganisms in osteomyelitis most frequently affects growing boys less than 12yrs associated with higher incidence of blunt trauma.
can occur at any age when there is an open wound (penetrating wounds, fractures). May also occur due to the presence of a foreign object (prosthesis)
Once ischemia occurs, the bone dies. The area of devitalized bone eventually separates from the living surrounding living bone, forming sequestra.
is the part of the periosteum that continues to have a blood supply forms new bone called involucrum.
Drug Alert (Gentamicin-Garamycin)
instruct pt to notify physician if any visual, hearing or urinary problems develop. Assess pt for dehydration before starting therapy.
in adult pts with chronic osteomyelitis oral therapy with a fluoroquinolone for 6 to 8 wks may be prescribed instead of IV antibiotics.
- saturated in saline or antibiotic solution
- wet to dry
- *when the dressing is changed, sterile technique is essential*
The pt should avoid
- heat application that increase circulation and swelling and serve as stimuli to the spread of infection.
Potential adverse and toxic reactions associated with prolonged and high-dose antibiotic therapy
- hearing deficit
- fluid retention
- overgrowth of Candida albicans (thrush)in genitals or oral cavity
Benign bone tumors
Malignant bone tumors
- Osteogenic sarcoma
- Ewing's sarcoma
overgrowth of cartilage & bone near the end of the bone at the growth plate. Most commonly found in long bones of the leg, pelvis or scapula.
Clinical manifestations for Osteochondroma
painless, hard, and immobile mass, lower than normal height for age, soreness of muscles in close proximity to the tumor, one leg or arm longer than the other, and pressure or irritation with exercise.
is extremely aggressive & rapidly metastasizes to distant sites. Associated with Paget's disease.
metastatic bone cancer
high serum calcium levels result as calcium is released from damaged bones.
- assess for locations & severity of pain
- swelling at the involved site
- decreased joint function
- weakness due to anemia
Types of muscular dystrophy
DDD (degenerative disk disease)
intervertebral disks losing their elasticity, flexibility and shock-absorbing capabilities. Thinning of the disks occurs as the nucleus pulposus(gelatinous center of the disk) starts to dry out & shrink.
Herniated intervertebral disk
slipped disk. The result of natural degeneration with age or repeated stress & trauma to the spine.
(intradiscal electrothermoplasty) minimally invasive outpatient procedure that involves the insertion of a needle into the affected disk with guidance of an xray, the wire is then heated.
CSF (cerebrospinal fluid)
severe headache or leakage of CSF on the dressing should be reported immediately. CSF appears as clear or slightly yellow drainage on the dressing & will test positive for glucose on dipstick.
Loss of sphincter tone or bladder
may mean nerve damage, incontinence or difficulty evacuating the bowel or bladder must be monitored closely reported to the surgeon.
involves the surgical excision of part of the posterior arch or the vertebra to gain access to part or the entire protruding disk to remove it.
Hallux valgus (bunion)
painful deformity of great toe consisting of lateral angulation of great toe toward 2nd toe, bony enlargement of medial side of 1st metatarsal head & formation of bursa or callus over bony enlargement.
complaints related to hammer toe include burning on bottom of foot, and pain and difficult in walking when wearing shoes.
The foot should be elevated with the heel off the bed to help reduce discomfort and prevent edema.
is a rare condition of adult bone associated with vitamin D deficiency resulting in decalcification & softenin of the bone.
or porous bone (fragile bone disease) is a chronic, progressive & structural deterioration of bone tissue, leading to increased bone fragility.
is a skeletal bone disorder in which there is excessive bone resorption followed by replacement of normal marrow by vascular, fibrous connective tissue.
is a subcutaneous or IM injection for treating Paget's disease.
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