1. The client/caregiver can define osteomyelitis.
   1. It is an acute or chronic infection of the bone.
   2. It can be difficult to cure because of limited blood supply and may persist for years.
2. The client/caregiver can list possible causes.
   1. Direct infection caused by surgery, penetrating wound, or compound fracture.
   2. Indirect infection caused by an infection elsewhere in the body.
3. The client/caregiver can list signs and symptoms.
   1. Fever
   2. Pain in the area of the infection
   3. Warmth
   4. Swelling and redness over the area of the infection
   5. Tiredness
   6. Drainage from an open wound near the area of the infection
4. The client/caregiver can list risk factors.
   1. Malnourishment
   2. Older
   3. Diseases that may cause decreased resistance (i.e., diabetes, kidney disease, liver cirrhosis, and rheumatoid arthritis)
   4. Situations that can create more risk for bone infections are as follows:
      • Illegally injectable drug use
      • Dialysis
      • Use of Foley catheters
      • Central lines for intravenous therapies
5. The client/caregiver can state measures for management of disease.
   1. Obtain adequate nutrition.
      1. Eat foods high in vitamin D, B vitamin complex, vitamin C, phosphorous, and magnesium.
      2. Take vitamin and mineral supplements as needed.
      3. Eat a well-balanced diet high in protein.
      4. Drink fluids to 3 liters per day unless contraindicated.
   2. Provide relief of pain.
      1. Take pain medication as needed.
      2. Splint or immobilize affected part as needed.
      3. Use a foot cradle to keep weight of blankets off extremity.
      4. Use good body alignment.
   3. Prevent infection.
      1. Avoid exposure to persons with infections.
      2. Change dressing with sterile technique as instructed.
      3. Use good hand-washing techniques.
   4. Take medications as ordered (long-term antibiotic therapy).
   5. Elevate extremity to decrease swelling.
   6. Follow limited weight-bearing ambulation as ordered. Use assistive devices as instructed.
   7. Plan frequent rest periods to promote healing.
   8. Keep follow-up appointments with physician as instructed.
   9. Report signs of infection’s getting worse (i.e., additional tender areas, increase in fever, or increase in drainage).
   10. Do not smoke. Smoking decreases blood flow to hands and feet.
6. The client/caregiver can list possible complications.
   1. Pathological fracture
   2. Bone deformity
   3. Sepsis
   4. Bone abscess

Resource

National Institute of Arthritis and Musculoskeletal and Skin Diseases
www.niams.nih.gov

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins. Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott
Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com