Exam (elaborations)
N308 Exam 3 questions with correct answers.
- Course
- Nurs 308
- Institution
- Liberty University
N308 Exam 3 questions with correct answers.
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N308 Exam 3 questions with correct answersosteomyelitis Correct Answer-inflammation of bone and bone marrow,
usually caused by infection
Direct Entry Osteomyelitis Correct Answer-microorganisms gain entry
ot the body form the outside - foreign body or open wound
Indirect Entry Osteomyelitis Correct Answer-Hematogenous
-blunt trauma, vascular insufficienty, other infections
acute osteomyelitis Correct Answer-inflammation of the bone lasting 1
month with both local and systemic manifestations
chronic osteomyelitis Correct Answer-inflammation of the bone lasting
greater than 1 month, lingers after treatment, or periods of remission and
exacerbation - sometimes systemic manifestations subside
osteomyelitis: pathophisiology Correct Answer--severe infeciton of
bone, bone marrow, and the surrounding soft tissue
-after gaining entry, the microorganism grows
---results in rpessure dur to the non-expanding nature of bone
---leads to ischemia and vascular compromise of the periosteum
---bone death due to ischemia - separation from surrounding living bone
(sequestra)
,-bacteria (staphylococcus aureus) is a common cause of infection
local osteomyelitis: clinical manifestations Correct Answer--constant
bone pain
---worse with activity, unrelieved with rest
-swelling, warmth, tenderness at infection site
-restricted movement at infeciton site
-drainage from cuteneous sinus tracts of fx site
systemic osteomyelitis: clinical manifestations Correct Answer--fever,
night sweats, chills
-restlessness, nausea, malaise
-drainage from a cutaneous sinus tract or from the fracture wound site
-elevated WBC
complications of osteomyelitis Correct Answer--spread of infeciton to
surrounding tissues or the bloodstream
,-reduced limb or joint funciton reducing mobility
-septicemia: spread to blood - can lead to death
-septic arthritis
-pathologic fractures
-amyloidosis: abnormal protein deposits from destroyed bone into
tissues
-osteonecrosis: bone death
---amputation may be required
-chronic osteomyelitis: symptoms that come and go for years
osteomyelitis: diagnosis Correct Answer--blood cultures and/or wound
cultures
-bone biopsy: definitive way to determine the caustative organism
-bone x-ray, CT scan, MRI, gallium scan
-CBC, CRP, ESR
osteomyelitis: Interprofessional Care Correct Answer-Treatment:
-cultures if possible prior to antibiotics
-prolonged IV antibiotic treatment if bone ischemia has not occurred
---may be started in hospital then continued at home 4-6 weeks; may
take as long as 3-6 monhs for treatment
---monitor for fungus, c.diff. infection
, -if treatment is delayed, surgical drbridement and/or amputation may be
necessary
-HBO treatment
-if the problem is with hardware, it should be removed
-dressing changes if open wound
-various antibiotics may be used depending on the ID microorganism:
---penicillin, nafcillin, neomyucin, vancomycin, cephalexin, cefazolin,
cefoxitin, gentamicin, tobramycin
-response to drug therapy should be monitored
-bed rest in early stages, correct body alignment
-prevention of "food drop"
-dressing, drains if open wound
-teaching: risks of long term antibiotic therapy
-psychological and emotional support
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