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PYOMYOSITIS

PRESENTED BY:

LEA PEARL D. SUBA

PYOMYOSITIS
y Is a deep bacterial infection of the skeletal

muscle. y Usually occurs in the large skeletal muscle of the lower extremities

PYOMYOSITIS
y Most often, pyomyositis occurs due to both prior muscle

injury (can be minor muscle injury) and bacteremia y RARE disease y More common in males. y Staphylococcus aureus.

Signs and Symptoms


y Stage 1 y Insidious onset of dull muscle pain and fever. y Stage II y Abscess is present, skin in the affected appears

erythematous and warm y Stage III y Septic shock

Treatment
y IV antibiotic y Incision and Drainage

Nursing Care Plans


Cues/clues Nursing Diagnosis Acute pain related to infection of the skeletal muscle. Objectives Interventions Rationale Flushed skin, facial grimace, guarding behavior, pain scale of 5/10 at the end of a 5 hour shift the patient will be able to: 1. Verbalize that pain is controlled. 2. Demonstrate use of relaxation techniques and diversional activities Perform a comprehensive assessment of pain to include location, characteristics, onset, duration, frequency, quality, intensity or severity, and precipitating factors of pain. Pain is a subjective experience and must be described by the client in order to plan effective treatment

Reduce or eliminate factors that precipitate or increase the patients pain experience Teach the use of nonpharmacolog ic techniques (e.g., relaxation, guided imagery, music therapy, distraction, and massage) before, after, and if possible during painful activities; before pain occurs or increases; and along with other pain relief measures.

to enhance the overall pain management program

The use of noninvasive pain relief measures can increase the re-lease of endorphins and enhance the therapeutic effects of painrelief medications.

Elicit behaviors that are conditioned to produce relaxation, such as deep breathing, yawning, abdominal breathing, or peaceful imaging Evaluate the effectiveness of the pain control measures used through ongoing assessment of the patients pain experience.

Relaxation techniques help reduce skeletal muscle tension, which will reduce the intensity of the pain

Research shows that the most common reason for unrelieved pain is failure to routinely assess pain and pain relief. Many clients silently tolerate pain if not specifically asked about it.

Cues/clues

Nursing Diagnosis

Objectives

Interventions

Rationale

Presence of deformity in the lower extremity, localized erythema, + pain,

Impaired skin integrity related to infection of the skeletal muscle

At the end of a 5 hour shift, the patient will be able to: 1. Demonstrate understandin g of plans to heal skin and prevent injury 2. Demonstrate measure to help retain skin integrity Long term 1. Regains integrity of skin 2. Demonstrate lifestyle changes.

Assess site of skin impairment and determine etiology (e.g., acute or chronic wound, burn, dermatological lesion, pressure ulcer, skin tear) Monitor site of skin impairment at least once a day for color changes, redness, swelling, warmth, pain, or other signs of infection

Prior assessment of wound etiology is critical for proper identification of nursing interventions

Systematic inspection can identify impending problems early.

Avoid massaging Massage may around the site lead to deepof skin tissue trauma impairment and over bony prominences. Inadequate nutritional intake Assess client's nutritional status places individuals at risk for skin breakdown and compromises healing Individualize plan according to client's skin condition, needs, and preferences. Avo id harsh cleansing agents, hot water, extreme friction or force, or cleansing too This helps prevent further trauma to the skin of the patient.

Cues/clues

Nursing Diagnosis

Objectives

Interventions

Rationale

Presence of deformity in the lower extremity, localized erythema, + pain, facial grimace when moving from side to side

Impaired physical mobility related to deformity in the lower extremity secondary to infection of the skeletal muscle.

At the end of a 5 hour shift, the patient will be able to: 1. Long term 1. Maintain or increase strength and function of the affected body part.

Assisted/have To decrease client numbness and reposition self on pain in the a regular affected area schedule from side to side. Used side rails of To prevent the bed. patient from possible fall or accident that might happen Encouraged patient to move the affected part from time to time. To help ease the pain and numbness of said part.

Encouraged patient to do ROM exercises

This will help the patient to mobilize and recover faster.