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INFECTIONS OF MUSCULOSKELETAL SYSTEM AND INFLAMMATORY & DEGENERATIVE…
INFECTIONS OF MUSCULOSKELETAL SYSTEM AND INFLAMMATORY & DEGENERATIVE JOINT DISORDERS
Oesteomyelitis:is the inflammation of bone and bone marrow,"osteo" means bone. "myelo" means bone marrow
causes and risk factors: caused by a bacteria called staphylococcus, recent injuries or orthopaedic surgery, circulation disorders
PATHOPHYSIOLOGY: Oesteomyelitis tends to occlude local blood vessels which causes bone necrosis and local spread of infection, infection may expand through the bone cortex and spread under the periosteum, with formation of subcutenous abscesses that may drain spontaneously through the skin
MEDICAL MANAGEMENT: drainage- if the is an open wound or abscess, it may be drained through procedure called needle aspiration.
Antibiotic medication prescribing antibiotics is the first step in treating osteomyelitis. the dosage and type of antibiotic prescribed depends on the type of bacteria present and extend of infection
Blood and wound cultures are performed to identify organisms and select the antibiotic.
Affected area is immobilized, warm saline, soak are provided for 2 minutes several times a day.
NURSING MANAGEMENT protect the affected extremity from further injury and pain by supporting the limb above and below the affected area
prepare client for surgical treatment such as debridement, bone grafting and amputation
Administer prescribed medication, which may include opoid and non-opoid analgesics and antibiotics
promote healing and tissue growth.
SURGICAL MANAGEMENT: Debridement, dead space management, illizarow technique, vascularized reconstruction
HEALTH EDUCATION: teach the client not to injure the area where you have the infection, careful follow all the instruction for taking care of wounds and do follow up care
MYOSITIS-inflammation of the muscles that you use to move your body or any condition that will cause inflammation in muscles.
CAUSES injury, drugs such as statins, colchicine, cocaine, alcohol, inflammatory conditions such as lupus scleroderma
SYMPTOMS rash, fatigue, thickening of the skin on the hands, difficulty swallowing, difficulty breathing
MEDICAL MANAGEMENT inflammatory conditions causing myositis may require treatment that may supress the immune system, including, prednisone, azathioprine, methotrexate,
NURSING MANAGEMENT passive range of motion and mobilization, help the patients with exercise, do extracorporeal shock wave therapy to the inured wound, helping it heal more quickly
PATHOPHYSIOLOGY single or multiple muscle groups in the limbs can be involved, a notable exception being trichinosis, which commonly involves orbital muscles, in most instances, involvement of proximal muscle is predominant
HEALTH EDUCATION patient will be teached about doing exercises to avoid muscle stiffness, to comply on medication and not to carry heavy loads or do straneous activities
SEPTIC BURSITIS inflammation of bursa that becomes infected with bacteria
CAUSES it can be caused by overuse and repeated movements,, these include using tools, cooking, gardening, aging, long period of pressure on an area such as roofers
SYMPTOMS tenderness and stiffness near the affected bursa, swelling, pain and redness
PATHOPHYSIOLOGY inflammation of the bursa causes synovial cells to multiply and thereby increases collagen formation and fluid production, local inflammation occurs and the synovial fluid is thickened, and movement becomes painful as the result
HEALTH EDUCATION, focuses on relieving the inflammation and pain, maintaining range of motions, prevent complications and future recurrence, pain-relief medication, to teach patients about all the above mentioned topics
MANAGEMENT it should be treated with antibiotics while awaiting culture results, superficial bursitis can be treated with oral outpatient therapy, those with systemic symptoms or who are immunocompromised may require intravenous antibiotic therapy, nursing management should be needed in pain, to administer analgesia for pain and promote comfort and help patient co[ping with situation
SEPTIC ARTHRITIS inflammation in the joint caused by bacterial infection
CAUSES can be caused by bacteria, can develop when infection, such as skin infection, urinary tract infection, spread through a blood stream to a joint, skin fragility, weak immune system, joint trauma
PATHOPHYSIOLOGY pathogenic invasion, previously damaged joints, especially those damaged by rheumatoid arthritis, are the most susceptible to infection, the synovial membranes of these joints exhibit neovascularization and increases adhesion factors, both conditions increase the chance of bacteremia, resulting in a joint infection
COMMON FINDINGS AND SYMPTOMS fever, fatigue and generalised weakness, swelling, inability to move the limb with the infected joint
HEALTH EDUCATION exercise, as tolerated initially, joint immobilization and physical therapy should be encouraged
MEDICAL INTERVENTION analgesics such as nonsteroidal anti-inflammatory drugs for pain management
parenteral antibiotics, ceftriaxone,ciprofloxacin
SURGICAL MANAGEMENT reconstructive surgery for severe joint damage, possible open surgical drainage, arthroscopy for fluid accumulation that can not be drained, surgical removal of prosthetic joint
NURSING MANAGEMENT express feelings of increased comfort and decreased pain , identify measures to reduce axiety, adhere to strict aseptic technique, provide wound care, assist with immobilization, check splints or traction daily
INFLAMMATORY AND DEGENERATIVE JOINT DISORDERS
DEGENERATIVE JOINT DISORDER
OSTEOARTHRITIS
DEFINATION also known as osteoarthrosis or degenerative joint disorder, progressive disorder of the joints caused by gradual loss of cartilage and resulting in development of bony spurs and cysts at the margins of the joint
CAUSES trauma, including sports injuries, repeates episodes of gout, poor posture or bone alignment
HEALTH EDUCATION patient should get a diet high in vitamin c and D, compliance in medication should be emphasised, the patient family should be involved in discussions of coping, household reorganization
SURGICAL MANAGEMENT it may include replacement of a damaged joint with an artificial part, surgical fusion of spinal bones, scraping or removal of damaged bone from the joint
MEDICAL MANAGEMENT acetaminophen, non-steroid anti-inflammatory drugs, corticosteroids injected directly into the joint to reduce inflammation
PATHOPHYSIOLOGY it changes the tissue homeostasis of articular cartilage and subchondral bone, determine the predominance of destructive process
INFLAMMATORY JOINT DISORDER
RHEUMATOID ARTHRITIS
DEFINATION autoimmune disease that can cause joint and damage throughout the bodyt pain
CAUSES it is an autoimmune which means it caused by immune system attacking healthy body tissue
PATHOPHYSIOLOGY a systemic inflammatory disease characterised by synovitis and joint destruction, causing swelling of the synovial joint, lead to destruction of both cartilaginous and bony element of the joint resulting in pain and disability
HEALTH EDUCATION teaches about diet suitable for condition, exercises and complying with medication
COMMON FINDINGS AND SYMPTOMS joint pain and swelling,, extreme fatigue, persistence cough, chest pain or shortness of breath, skin rash,
MANAGEMENT managing pain, after surgery, alley anxiety to patient give medication as prescribed
References:
(Healthline, 2018) (Mogotlane, 2013) (Smeltzer, 2010)