Osteomyelitis

2. Activity intolerance related to severe left leg pain. Based on the data given, the most appropriate nursing diagnosis is Activity intolerance related to severe left leg pain. The other diagnoses are not supported by the data presented.

A 24-year-old client has been diagnosed with acute osteomyelitis in the left leg. He complains of acute pain in the leg that intensifi es when he moves it. The client has a temperature of 101° F (38.3° C) and a reddened, warm area in the midcalf region over the shaft of the tibia. Based on this information, which of the following nursing diagnoses would be most appropriate for this client? 1. Grieving related to possible left lower leg amputation. 2. Activity intolerance related to severe left leg pain. 3. Disturbed body image related to left leg swelling and inflammation. 4. Deficient fluid volume related to elevated temperature of 101° F (38.3° C).

1. Sore mouth. 4. Stomach upset. 5. Fever. Common adverse effects of nafcillin include vomiting, diarrhea, sore mouth, fever, and gastritis. Pain with urination and headache are not associated with this drug.

A child diagnosed with osteomyelitis will be discharged on I.V. nafcillin (Unipen). After teaching the parents about adverse effects that are important to report, which effects as stated by the parents indicate that they understand the teaching? Select all that apply. 1. Sore mouth. 2. Pain with urination. 3. Headache. 4. Stomach upset. 5. Fever.

2. Culture. Cultures are used to determine exactly what organism is causing the inflammation. From the culture, sensitivities to various antibiotics may be determined.

A child is to receive I.V. antibiotics for osteomyelitis. Before the initial dose of antibiotics can be given, the nurse confirms that a blood sample for which of the following tests has been drawn? 1. Creatinine. 2. Culture. 3. Hemoglobin. 4. White blood count.

1. "You can try them and see how he does." Some clients find ginger snaps help relieve nausea. The National Center for Complimentary and Alternative Medicine has determined that ginger, in small dose such as would be found in the cookies, has few side effects.

A child with newly diagnosed osteomyelitis has nausea and vomiting. The parent wishes to give the child ginger snaps to help control the nausea. The nurse should tell the parent: 1. "You can try them and see how he does." 2. "I will need to get an order." 3. "Your child needs medication for the vomiting." 4. "We discourage the use of home remedies in children."

1. Sudden onset of chills 2. Temperature 103°F (39.4°C) 4. Report by the client of a pulsating pain in the area that intensifies with movement 5. Painful, swollen area on the left shoulder A sudden onset of chills and a high fever suggest the infection is bloodborne. The pulsating pain is caused from the pressure of the collecting pus. The infected area becomes swollen, painful, and extremely tender.

A clinic nurse suspects that a client may have developed osteomyelitis 3 months following a left shoulder arthroplasty. Which findings on assessment prompted the nurse's conclusion? SELECT ALL THAT APPLY. 1. Sudden onset of chills 2. Temperature 103°F (39.4°C) 3. Bradycardia 4. Report by the client of a pulsating pain in the area that intensifies with movement 5. Painful, swollen area on the left shoulder

4. Begin teaching on self-administration of home IV antibiotics. The nurse should defer teaching. Pain and an elevated temperature are barriers to learning.

A diabetic client is admitted with a tentative diagnosis of osteomyelitis secondary to a wound on the ankle. The client's ankle is painful, red, swollen, and warm, and the wound is persistently draining. The client's temperature is 102.2°F (39°C). Based on the client's status, which written physician's order should a nurse plan to defer until later? 1. Obtain wound culture. 2. Administer ceftriaxone (Rocephin®) 1 g IV (intravenously) q12 hours. 3. Apply splint to immobilize ankle. 4. Begin teaching on self-administration of home IV antibiotics.

1. Osteomyelitis Osteomyelitis is an infection that might have long term sequelae; however, the cause is not genetic.

A nurse has been asked to continue teaching with a group of parents of children with neurological and musculoskeletal conditions. For which condition should a nurse tell the parents that there is no genetic basis to the condition? 1. Osteomyelitis 2. Muscular dystrophy 3. Spina bifida 4. Tourette's Syndrome

3. Increased warmth. Findings associated with osteomyelitis commonly include pain over the area, increased warmth, localized tenderness, and diffuse swelling over the involved bone.

During the initial assessment of a child admitted to the pediatric unit with osteomyelitis of the left tibia, when assessing the area over the tibia, which is an expected finding? 1. Diffuse tenderness. 2. Decreased pain. 3. Increased warmth. 4. Localized edema.

4. Urine specific gravity Long-term, high-dose antibiotic therapy can adversely affect renal, hepatic, and hematopoietic function. Urine specifi c gravity would provide valuable information about the kidneys' ability to concentrate or dilute urine, thereby suggesting renal impairment.

The nurse is caring for a child with osteomyelitis who will be receiving high-dose intravenous antibiotic therapy for 3 to 4 weeks. What should the nurse plan to monitor? 1. Blood glucose level. 2. Thrombin times. 3. Urine glucose level. 4. Urine specific gravity

2. Eat a diet high in protein and vitamins C and D. The goal of care for this client is healing and tissue growth while the client continues on long-term antibiotic therapy to clear the infection. A diet high in protein and vitamins C and D promotes healing.

The nurse is planning care for a client with osteomyelitis. The client is taking an antibiotic, but the infection has not resolved. The nurse should advise the client to do which of the following? 1. Use herbal supplements. 2. Eat a diet high in protein and vitamins C and D. 3. Ask the health care provider for a change of antibiotics. 4. Encourage frequent passive range-of-motion to the affected extremity.

4. Risk for injury. The priority nursing diagnosis for this client is Risk for injury. The goal in this situation is to prevent falling. Impaired physical mobility contributes to the risk of injury and is an applicable diagnosis but does not address the client's safety needs, which are the priority.

The nursing assessment of a client with osteomyelitis of the left great toe reveals pain with partial weight-bearing, unsteady gait, and complaints of general weakness. Based on these data, the priority nursing diagnosis for the client is: 1. Impaired physical mobility. 2. Impaired skin integrity. 3. Ineffective coping. 4. Risk for injury.

1. Encouraging the child to communicate with schoolmates. Encouraging contact with schoolmates allows the school-age child to maintain and develop socialization with peers, an important developmental task of this age-group.

To meet the developmental needs of an 8-year-old child who is confined to home with osteomyelitis, what should the nurse include in the care plan? 1. Encouraging the child to communicate with schoolmates. 2. Encouraging the parents to stay with the child. 3. Allowing siblings to visit freely throughout the day. 4. Talking to the child about his interests twice daily.

1. Beef and bean burrito with cheese, carrot and celery sticks, and an orange. Children with osteomyelitis need a diet that is high in protein and calories. Milk, eggs, cheese, meat, fish, and beans are the best sources of these nutrients.

Which of the following meals would be appropriate for the child with osteomyelitis to choose? 1. Beef and bean burrito with cheese, carrot and celery sticks, and an orange. 2. Buttered wheat bread, cream of broccoli soup, tossed salad with dressing, and an apple. 3. Potato soup; bacon, lettuce, and tomato sandwich; and an orange. 4. Tomato soup, grilled cheese sandwich, and banana.