Pathophysiology

Nursing Intervention:

Osteomyelitis can occur as a result of

hematogenous seeding, contiguous spread of
infection to bone from adjacent soft tissues and
joints, or direct inoculation of infection into the
bone as a result of trauma or surgery.
Hematogenous osteomyelitis is usually
monomicrobial, while osteomyelitis due to
contiguous spread or direct inoculation is usually
polymicrobial.

Medical Diagnosis

A bone inflammation caused by

bacteria. The inflammation usually
originates in another part of the
body and is transported to the
bone via the blood

Medications
Tamsulosin 0.4mg
Atorvastatin 10mg
Hydrochlorothiazide 12.5 mg
Lisinopril 5mg
Insulin-Aspart 4-6 units SC
Insulin-Glargine 37units
Cyanocobalamin 500mg
Calcium Carbonate 500mg
Acetaminophen 650mg

Nursing Diagnosis
1. Imbalanced Nutrition R/T uncontrolled blood
sugars AEB elevated glucose levels
2. Risk for Infection R/T skin damage AEB diabetic
foot ulcers
3. Readiness for enhanced Self Health
Management R/T self-care AEB behaves congruent
with learning expressed knowledge.

1. Determine healthy body weight for age

and height. Refer to dietitian for complete
nutrition assessment if 10% under healthy
body weight or if rapidly losing weight.
2. Inspect clients feet, noting presence of
ulcers or infected ingrown toenails, or other
problems requiring medical or nursing
intervention.
Rationale: Foot injuries and impaired
circulation are associated with many
complications in diabetics, including cellulitis
and amputations
3. Negotiate a therapy plan client can
commit to. Include routines of awakening,
meals, work schedule, and medication side
effects.
Rationale: The more individualized the plan is
the greater probability of adherence. Note:
New dosing regimens are addressing the
issues of pill load or number of pills in each
dose, dosing frequency, dietary restrictions,
and adverse events, resulting in greater
individualization of the medication regimen.

Patient Education
1. Encourage adequate nutrition & hydration

Labs

No Labs reported

2. Reinforce the importance of mobility,

turning or ambulation
3. Provide books and videos that will help
the patients quest for enhanced knowledge.
Supplying some materials directly may be a
motivation for the patient to search further.

Subjective

Im happy to go back home

I have no pain in my foot
I ride the bike about 810miles/day
I dont hear very well
My appetite is good

A
S
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Objective
*G.V. 73yr old, DNR, WT 168.2 lbs.
*T97.9 P82 R18 Bp123/81 o2 94%
P 0/10
*Neuros: A & O x3, Pulses present, Lungs
clear bilateral
*MRSA Precaution/ wound
*Diabetic Ulcers- Toes/bottom of foot
Closed-open to air
*Diet: Consistent Carb.
*Blood Sugars: Elavated

Goals/Outcomes
1. Patient will verbalize understanding of
nutritional needs, by establishing a dietary
pattern with caloric intake adequate to regain
or maintain appropriate weight by discharge.
2. Patients skin will remain intact AEB no
redness over bony prominences & capillary
refill less than 6 seconds over areas of
redness.
3. The patient will begin practicing new
behaviors gleaned from enhanced knowledge
by discharge.