Medical-surgical Nursing Demystified

(^274) Medical-Surgical Nursing Demystified

• Bone scan shows area of increased cellular activity—detects site of infection.


• Culture and sensitivity tests to determine the infecting organism and anti-
  biotic—may be difficult to determine infecting organism.


• Bone biopsy to identify organism.

TREATMENT

Removal of necrotic bone tissue and local pus or drainage is often necessary to

speed healing. Typically, patients need antibiotics for several weeks to properly

treat the infection.

• Debridement of the area to remove necrotic tissue.


• Drain the infected site.


• Immobilize or stabilize the bone if necessary.


• Administer antibiotics parenterally for 4 to 6 weeks or orally for 6 to 8
  weeks:
  
  
  • nafcillin, vancomycin, penicillin G, piperacillin, ticarcillin/clavulanate,
    ampicillin/sulbactam, pipercillin/tazobactam, clindamycin, cefazolin, line-
    zolid,ceftazidime, ciprofloxacin
  
  
  
  


• Administer analgesic to relieve discomfort as needed:
  
  
  • ibuprofen, naproxen, acetaminophen
  
  
  • oxycodone, hydrocodone
  
  
  
  


• If there is vascular insufficiency or gangrene, amputation may be needed.

NURSING DIAGNOSES

• Impaired mobility


• Activity intolerance

NURSING INTERVENTION

• Monitor vital signs, changes in blood pressure, elevated pulse, elevated tem-
  perature and respiratory rate.


• Monitor wound site for redness, drainage, and odor.


• Monitor IV access site for patency.