Interprofessional Care
What is the care of osteomyelitis?
Aggressive IV antibiotic therapy if bone ischemia hasn't occurred. ABX ordered depends on sensitivity to bacteria.
CVAD (picc)
What are the diagnostics for MD?
What is the nursing management for osteomyelitis?
Immobolize affected limb, nonmed forms of relation, prevent contractures (foot drop), educate about rxns to long term ABX use (hearing deficit, impaired renal fxn, neurotoxicity)
What are adverse effects of cephlasporins?
Hives, watery diarrhea, blood in stools, mouth sores
What are the complications of MD?
spinal collapse (so wear orthotic jacket)
cardiomyopathy
resp depression (support airway, tracheostomy)
what is the Treatment for chronic osteomyelitis?
surgical removal of poorly perfused tissue and dead bone and extended use of ABX (ABX beads). negative pressue wound therapy and hyperbaric O2. if orthopedic device is determined to be cause, REMOVE it. muscle flaps and skin graft. bone grafts (if infection is still present don't do)
What are the diagnostics for acute low back pain?
straight leg test
avoid sleeping in prone position (lumbar lordosis). encourage side lying or supine position. consider job change or change in how job is done
What are considerations for fluroquinolones?
Peak and trough levels, candida, CDIFF, emotional support
What are the risk factors of low back pain?
smoking, stress, poor posture, obesity, heavy lifting, jackhammering, sitting too long, health care workers
Care of intervertebral disc disease?
limit movement
TENS therapy
when pain subsides do back strengthening exercised twice daily
What are the diags for invertebral disc disease?
myelogram (eval nerves)
epidural venogram (diskogram) X-ray of spine after contrast is injected into disc
EMG (determine nerve damage)
What is the management for chronic low back pain?
antidepressants to help pain and sleep probelms.
antiseizure meds to improve walking and relieve leg sx.
avoid cold damp weather
back school website
What disease are associated with osteoporosis?
IBD, kidney disease, RA, hyperthyroid, alcoholism, hypogonadism, diabetes
Multiple nerve root compressions from herniated disc may cause
severe low back pain and bowel and bladder incontinence
What is the treatment for osteomalacia?
Vitamin d3- chloecalciferol
vitamin d2- ergocalciferol
calcium/phosphorus supplements
add dairy, eggs, meat, oily fish, and breakfast cereal
exposure to sunlight
weight bearing exercise
Diags for osteomalacia?
decreased serum calcium, phospohorus, and vitamin D
elevated serum alkaline phosphate
Management of vertebral disc surgery?
maintain proper alignmnet of the spine until its healed
during lumbar fusion, place pillows under things when supine, and between legs when side lying
monitor for CSF leak (will appear clear/yellow w high glucose) and immediately report if they complain of headache
neuro assessment q2-4 hrs for 2 days
encourage OOB to bathroom and if incontinent report to surgeon (nerve damage)
logrolling
Diags for pagets?
serum alkaline phosphatase elevated
bone scan
Risks of osteomalacia?
limited sun exposure, GI malabsorption, extensive burns, chronic diarrhea, pregnancy, kidney disease, certain meds, long term care patients, dark skin people, obesity
What is the treatment for osteoporosis?
calcium and vitamin D supplements
sun exposure
exercise
biphosphonates
vertebroplasty- cement injection
kyphoplasty- balloon then cement injection
Diags for osteoporosis?
calcium, phosphorus, and alkaline phosphate may be elevated
bone mineral density
DXA is gold standard
what is some management for foot disorders?
shockwave therapy, stretching, orthotics.
elavate foot
daily foot care and wear clean socks
trim toenails
educate diabetes patients
Care for pagets?
Braces, biphosphonates to slow resorption, zoledronic acid to build bone, calcium and vitamin D, calcitonin (if can't tolerate biphosphonate), firm mattress, prevent falls, no heavy lifting or twisting
Women over 65 that smoke, have low weight, or prior fractures should get what test?
bone density test