2ND CASE SCENARIO.(Nursing)Osteomyelitis

A 48 years female was brought in by her husband to the Emergency room.

Diagnosis:Osteomyelitis of right foot. Her foot was red and swollen. Diabetic ulcer under the right foot.

Secondly Diagnosis: Diabetes type 2,hypertension. Patient was admitted to Medical/Surgical floor.

Full code

Room Air.

DIET :Diabetic heart health diet.

Blood sugar QAc +Qhs.

Voiding using bedpan.

Saline lock left forearm.

MEDICATIONS:

Zosyn 378gm iv Q8hrs

Vancomycin 1gm iv Q24hours.

Vasotec 20mg po 09am Daily.

Adalat 60mg po Qday.

Zorco 40mg po Qhs.

Tylenol 650mg po Q6hours prn temperature.

Seroquel 25mg 1tablet po Qpm.

Incentive Spirometry 10times while awake.

PLAN:

Discharge home in am.

If no temperature for 24hours.

Follow up with your doctor in 2 weeks.

Antibiotics by mouth for six weeks upon discharge.

Norco 5/325mg by mouth every 4hours as needed for pain.

Tylenol 650mg q6hours by mouth for fever.

While patient was admitted another man came to see her.She told the nurse that she will not like to go back to her husband. The Nurse called the doctor and Case manager and Social worker consulted to see the patient. (1)What are the signs and symptoms of Osteomyelitis?

(A)Pain,redness and swelling.

(B)Swelling of the foot.

(C )No pain but redness.

(D) All of the above.

Correct answer A.

A 47years old male came to the Emergency room hospital today. Chief Complaint Osteomyelitis right foot.

Diagnosis Osteomyelitis of right foot with redness, swelling and severe pain.Secondary diagnosis Diabetes, HLD,Hypertension. Full code, alert and oriented ×4

Weighs 1302lbs,height 5ft 5inches.

02 at 3liter nc.

General surgery Consultation done.

Allergy: NKDA.

Diet Carb control diet.

Glucerna shakes I can Bid.

Plan

Right BKA in one week. Intravenous treatment of infection with Vancomycin 1gm IVPB Q12hours.

Zosyn 3.375gm IV Q8hrs.

Blood sugar check QAC and QHS.

Procedures Right BKA by doctor None,Smileys .

Need to follow up orthopedic for splints, check wounds and remove sutures in two weeks.

Laboratory :CBC with differential and CHEM 7 in am.

Published by edochie99

A Registered Nurse with over twenty years of hospital experience, an author with Masters Degree in Nursing,also Bachelor Degree in Nursing,graduated in 1996 from USC,University of Southern California.MSN in 2009 University of Phoenix.

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