MR LOURDE OSTEOMYELITIS CASE STUDY
Order ID 53563633773 Type Essay Writer Level Masters Style APA Sources/References 4 Perfect Number of Pages To Order 5-10 Pages Description/Paper Instructions
Mr. Lourde
GENDER Male
AGE 73
SOCIOECONOMIC
SETTING Hospital
ETHNICITY White American
CULTURAL CONSIDERATIONS
PREEXISTING CONDITIONS
Left hip replacement two years ago; septic shock with left hip osteomyelitis last year with subsequent removal of the hip replacement prosthesis; allergies to meperidine hydrochloride (Demerol), morphine sulfate (MS Contin), and vancomycin hydrochloride (Vancocin)
COEXISTING CONDITION
COMMUNICATION
SPIRITUAL/RELIGIOUS
PHARMACOLOGIC
Linezolid (Zyvox); fondaparinux (Arixtra); hydrocodone bitartrate/ acetaminophen (Vicodin); acetaminophen (Tylenol); docusate sodium (Colace)
LEGAL
ETHICAL
ALTERNATIVE THERAPY
PRIORITIZATION
DELEGATION
Overview: This case requires that the nurse understand the risk associated with postoperative wound infection following a hip replacement. The manifestations characteristic of osteomyelitis are discussed. The nurse must care for the surgical incision site with a daily dressing change and maintenance of a HemoVac drainage system. The client’s prescribed medications are reviewed for purpose and potential adverse effects. The purpose and potential complications of a peripherally inserted central catheter (PICC) are explained.
Client Profile
Mr. Lourde is a 73-year-old man whose wife noticed a lump on his left hip that has increased in size over the past two weeks. The skin around the lump is red and swollen. Mr. Lourde complains of increasing discomfort in his left hip. His wife became concerned when he felt warm and his temperature was 101ºF (38.3ºC) so she brought him to the hospital. Mr. Lourde is diagnosed with an abscess of his left hip. A needle aspiration of the abscess reveals 30 mL of purulent exudate. Mr. Lourde is admitted for surgical incision and drainage of a suspected recurrence of osteomyelitis and for intravenous antibiotic therapy.
Case Study
A surgical incision and drainage is performed to remove necrotic tissue, sequestrum, and surrounding granulation tissue. A bacterial infection is identified as Enterococcus faecalis. The nurse reviews the client’s kardex and notes the dressing change pre-scribed is a dry sterile dressing to the left hip daily with reinforcement as needed.
The nurse medicates Mr. Lourde with hydrocodone/acetaminophen (Vicodin) thirty minutes prior to the dressing change. While changing the hip dressing, the nurse notes there are seven intact sutures along the incision line, and a HemoVac drain is in place. Minimal drainage is noted at the incision site. The site is slightly swollen, but there are no signs of infection. The HemoVac has drained 30 mL of dark red blood. Mr. Lourde tolerates the dressing change with minimal discomfort. He is afebrile at 98ºF (36.7ºC).
Questions
- Discuss the time frame within which signs of an infection at the site of a hip replacement usually occur. What possible complications are of concern when a client develops an infection at the site of a hip replacement?
- Discuss the pathophysiology of osteomyelitis.
- Include an explanation of a sequestrum, involucrum, and Brodie’s abscess.
- Discuss the clinical manifestations of osteomyelitis.
- The health care provider suspects a recurrence of Mr. Lourde’s osteomyelitis. How will the health care provider confirm this diagnosis?
- Discuss the treatment options if Mr. Lourde has osteomyelitis of his left hip.
- Lourde will require at least three to eight weeks of high-dose intravenous antibiotic therapy. The health care provider has requested that a PICC be inserted. Explain what a PICC is and the poten-tial complications associated with this device.
- What information should be included in the nurse’s documentation of the dressing change?
- Explain why the nurse does not document the stage of the left hip wound.Write two expected outcomes for the duration of time that a HemoVac drainage reservoir system is in place. How often should the nurse empty the drain and how will the nurse ensure that the system is working correctly to drain the incision site?
- Each of the medications below is prescribed for Mr. Lourde. For each, provide the therapeutic drug classification and discuss the purpose of the medication for Mr. Lourde and potential adverse effect(s) that the nurse should monitor.
Linezolid
Fondaparinux
Hydrocodone bitartrate/acetaminophen
Acetaminophen
- Help the nurse generate three appropriate nursing diagnoses for Mr. Lourde.
RUBRIC
QUALITY OF RESPONSE NO RESPONSE POOR / UNSATISFACTORY SATISFACTORY GOOD EXCELLENT Content (worth a maximum of 50% of the total points) Zero points: Student failed to submit the final paper. 20 points out of 50: The essay illustrates poor understanding of the relevant material by failing to address or incorrectly addressing the relevant content; failing to identify or inaccurately explaining/defining key concepts/ideas; ignoring or incorrectly explaining key points/claims and the reasoning behind them; and/or incorrectly or inappropriately using terminology; and elements of the response are lacking. 30 points out of 50: The essay illustrates a rudimentary understanding of the relevant material by mentioning but not full explaining the relevant content; identifying some of the key concepts/ideas though failing to fully or accurately explain many of them; using terminology, though sometimes inaccurately or inappropriately; and/or incorporating some key claims/points but failing to explain the reasoning behind them or doing so inaccurately. Elements of the required response may also be lacking. 40 points out of 50: The essay illustrates solid understanding of the relevant material by correctly addressing most of the relevant content; identifying and explaining most of the key concepts/ideas; using correct terminology; explaining the reasoning behind most of the key points/claims; and/or where necessary or useful, substantiating some points with accurate examples. The answer is complete. 50 points: The essay illustrates exemplary understanding of the relevant material by thoroughly and correctly addressing the relevant content; identifying and explaining all of the key concepts/ideas; using correct terminology explaining the reasoning behind key points/claims and substantiating, as necessary/useful, points with several accurate and illuminating examples. No aspects of the required answer are missing. Use of Sources (worth a maximum of 20% of the total points). Zero points: Student failed to include citations and/or references. Or the student failed to submit a final paper. 5 out 20 points: Sources are seldom cited to support statements and/or format of citations are not recognizable as APA 6th Edition format. There are major errors in the formation of the references and citations. And/or there is a major reliance on highly questionable. The Student fails to provide an adequate synthesis of research collected for the paper. 10 out 20 points: References to scholarly sources are occasionally given; many statements seem unsubstantiated. Frequent errors in APA 6th Edition format, leaving the reader confused about the source of the information. There are significant errors of the formation in the references and citations. And/or there is a significant use of highly questionable sources. 15 out 20 points: Credible Scholarly sources are used effectively support claims and are, for the most part, clear and fairly represented. APA 6th Edition is used with only a few minor errors. There are minor errors in reference and/or citations. And/or there is some use of questionable sources. 20 points: Credible scholarly sources are used to give compelling evidence to support claims and are clearly and fairly represented. APA 6th Edition format is used accurately and consistently. The student uses above the maximum required references in the development of the assignment. Grammar (worth maximum of 20% of total points) Zero points: Student failed to submit the final paper. 5 points out of 20: The paper does not communicate ideas/points clearly due to inappropriate use of terminology and vague language; thoughts and sentences are disjointed or incomprehensible; organization lacking; and/or numerous grammatical, spelling/punctuation errors 10 points out 20: The paper is often unclear and difficult to follow due to some inappropriate terminology and/or vague language; ideas may be fragmented, wandering and/or repetitive; poor organization; and/or some grammatical, spelling, punctuation errors 15 points out of 20: The paper is mostly clear as a result of appropriate use of terminology and minimal vagueness; no tangents and no repetition; fairly good organization; almost perfect grammar, spelling, punctuation, and word usage. 20 points: The paper is clear, concise, and a pleasure to read as a result of appropriate and precise use of terminology; total coherence of thoughts and presentation and logical organization; and the essay is error free. Structure of the Paper (worth 10% of total points) Zero points: Student failed to submit the final paper. 3 points out of 10: Student needs to develop better formatting skills. The paper omits significant structural elements required for and APA 6th edition paper. Formatting of the paper has major flaws. The paper does not conform to APA 6th edition requirements whatsoever. 5 points out of 10: Appearance of final paper demonstrates the student’s limited ability to format the paper. There are significant errors in formatting and/or the total omission of major components of an APA 6th edition paper. The can include the omission of the cover page, abstract, and page numbers. Additionally the page has major formatting issues with spacing or paragraph formation. Font size might not conform to size requirements. The student also significantly writes too large or too short of and paper 7 points out of 10: Research paper presents an above-average use of formatting skills. The paper has slight errors within the paper. This can include small errors or omissions with the cover page, abstract, page number, and headers. There could be also slight formatting issues with the document spacing or the font Additionally the paper might slightly exceed or undershoot the specific number of required written pages for the assignment. 10 points: Student provides a high-caliber, formatted paper. This includes an APA 6th edition cover page, abstract, page number, headers and is double spaced in 12’ Times Roman Font. Additionally the paper conforms to the specific number of required written pages and neither goes over or under the specified length of the paper. GET THIS PROJECT NOW BY CLICKING ON THIS LINK TO PLACE THE ORDER
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