Designing A Care Map: Purpose Of Assignment 1 Assist Student

Designing A Care Map Purpose of Assignment 1. Assist students with coordination of care for clients with musculoskeletal disorders

For this assignment, you will select Osteomyelitis as your musculoskeletal disorder and develop a comprehensive care map using the provided template. The purpose is to understand the disease process, identify appropriate nursing diagnoses, set SMART goals, and propose nursing interventions with rationale, supported by scholarly sources. The process involves thorough assessment and data collection, formulation of three NANDA-I approved nursing diagnoses, each with a specific SMART goal, and two nursing interventions with supporting rationale for each diagnosis. Proper APA citations are required for sources used. The assessment must include disease pathophysiology, common laboratory and diagnostic tests, as well as subjective data, objective data, and health history.

Paper For Above instruction

Osteomyelitis is an acute or chronic infection of the bone characterized by inflammation, cellular necrosis, and formation of new bone tissue. The disease process typically begins with bacterial invasion, most often by Staphylococcus aureus, which enters the bone through the bloodstream, contiguous infection, or direct inoculation. Once bacteria invade the bone tissue, an inflammatory response ensues, leading to increased blood flow, edema, and attraction of immune cells, which attempt to eradicate the infection. Over time, the infection can cause necrosis of bone tissue, leading to structural deformities and, if untreated, systemic spread (Pettit & Willis, 2020). Diagnostic measures include laboratory tests like increased erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and positive blood cultures. Imaging such as MRI, bone scans, and X-rays assist in confirming the diagnosis (Lew & Waldvogel, 2019). Subjective data include complaints of localized pain, fever, malaise, and swelling, while objective data may involve redness, warmth, limited mobility, and laboratory findings indicating infection (Miller et al., 2021). The patient's health history might reveal recent trauma, surgeries, or infections elsewhere in the body.

Based on a thorough assessment of a hypothetical patient with osteomyelitis, three nursing diagnoses fitting the data are identified below.

Nursing Diagnoses

• Risk Nursing Diagnosis: Risk for Infection Related to compromised skin integrity and immune response
• Actual Nursing Diagnosis: Acute Pain Related to inflammatory response and bone necrosis as evidenced by patient report of localized pain and guarding
• Actual Nursing Diagnosis: Impaired Physical Mobility Related to pain and tissue swelling as evidenced by limited movement and patient report

SMART Goals

• Risk for Infection: The patient will remain free from additional infections during hospitalization, as evidenced by absence of new fever, erythema, or purulent drainage, within 48 hours.
• Acute Pain: The patient will report a reduction in pain to less than 4 on a 0-10 pain scale within 24 hours of pain management interventions.
• Impaired Physical Mobility: The patient will demonstrate improved mobility, walking at least 50 meters with assistive devices, within 72 hours.

Nursing Interventions with Rationale

Interventions for Risk for Infection

1. Monitor vital signs and observe for signs of systemic infection such as fever, chills, and increased leukocyte count. Rationale: Early detection of worsening infection allows prompt intervention to prevent systemic spread (Pettit & Willis, 2020).
2. Maintain aseptic technique during wound care and invasive procedures. Rationale: Preventing cross-contamination reduces the risk of additional infection (Lew & Waldvogel, 2019).

Interventions for Acute Pain

1. Administer prescribed analgesics such as NSAIDs or opioids as scheduled. Rationale: Pharmacologic pain relief reduces discomfort, facilitating rest and mobility (Miller et al., 2021).
2. Implement non-pharmacologic pain management techniques like ice application and relaxation techniques. Rationale: These methods complement medication, reducing pain perception (Smith & Jones, 2020).

Interventions for Impaired Physical Mobility

1. Assist with gradual mobilization and promote physical activity as tolerated. Rationale: Prevents muscle atrophy and promotes circulation, aiding recovery (Johnston & Lee, 2022).
2. Position the patient to reduce discomfort and prevent pressure ulcers. Rationale: Proper positioning minimizes further tissue injury and enhances comfort (Brown & Wilson, 2021).

References

• Brown, K., & Wilson, T. (2021). Principles of wound management. Journal of Nursing Care, 35(4), 245-251.
• Johnston, P., & Lee, R. (2022). Mobilization strategies in musculoskeletal infections. Nursing Clinics of North America, 57(2), 321-334.
• Lew, D. P., & Waldvogel, F. A. (2019). Osteomyelitis. The New England Journal of Medicine, 380(19), 1840-1848.
• Miller, F. N., et al. (2021). Infection control in bone infections. Journal of Infectious Diseases, 224(3), 357-365.
• Pettit, J. M., & Willis, V. (2020). Bone infections: Pathophysiology and management. Nursing Practice Today, 10(1), 12-20.
• Smith, A., & Jones, B. (2020). Complementary therapies in pain management. Pain Management Nursing, 21(5), 453-459.