Chapter 64: Musculoskeletal Problems, ch 62 musculoskeletal trauma and orthopedic surgery, Chronic Exam III

Chapter 64: Musculoskeletal Problems, ch 62 musculoskeletal trauma and orthopedic surgery, Chronic Exam III A patient with chronic osteomyelitis has been hospitalized for a surgical debridement procedure. What does the nurse explain to the patient as the rationale for the surgical treatment? a. Removal of the infection prevents the need for bone and skin grafting. b. Formation of scar tissue has led to a protected area of bacterial growth. c. The process of depositing new bone blocks the vascular supply to the bone. d. Antibiotics are not effective against microorganisms that cause chronic osteomyelitis. Chronic infection of the bone leads to formation of scar tissue from the granulation tissue. This avascular scar tissue provides an ideal site for continued microorganism growth and is impenetrable to antibiotics. Surgical debridement is often necessary to remove the poorly vascularized tissue and dead bone and to instill antibiotics directly to the area. Involucrum is new bone laid down at the infection site, which seals off areas of sequestra. Antibiotics can be effective during acute osteomyelitis and prevention of chronic osteomyelitis requires early antibiotic treatment. Bone and skin grafting may be necessary following surgical removal of infection if destruction is extensive. A patient with osteomyelitis has a nursing diagnosis of risk for injury. What is an appropriate nursing intervention for this patient? a. Use careful and appropriate disposal of soiled dressings. b. Gently handle the involved extremity during movement. c. Measure the circumference of the affected extremity daily. d. Provide range-of-motion (ROM) exercise q4hr to the involved extremity. {{Correct Ans- b. Gently handle the involved extremity during movement. The patient with osteomyelitis is at risk for pathologic fractures at the site of the infection because of weakened, devitalized bone and careful handling of the extremity isnecessary. Careful handling of dressings is necessary to prevent the spread of infection to others but is not related to preventing injury to this patient. Splints may be used to immobilize the limb, range-of-motion (ROM) exercises will be limited because of the possibility of spreading infection, and edema is not a common finding in osteomyelitis.