ASSESSMENT

• Systemic

 Fever, night sweats, chills, restlessness, nausea

• Local

 Constant bone pain that worsens with activity

 Swelling, tenderness, warmth at infection site

 Restricted movement of affected part

 Later signs: drainage from sinus tracts

 Muscle spasm

 Local redness

 Local warmth

 Pain moving a nearby joint

DIAGNOSTIC TEST

DIAGNOSTIC/ Analysis and

Indications and Date Ordered and
POSSIBLE Results Normal Values Interpretation of
Purpose Date Released
PROCEDURE Results
Blood tests To determine the
presence of may reveal
infection. It was elevated levels of
also use to white blood cells
monitor the body’s and other factors
response to that may indicate
treatment and that your body is
monitor bone fighting an
marrow function infection.
and immune
response.

test that measures

ESR the rate at which
red blood cells
settle to the an elevated level
bottom of a test of C-reactive
tube containing protein (a protein
blood that circulates in
the blood and
dramatically
increases in level
when there is
inflammation)
usually occur.
A. HEMATOLOGY
Nursing Responsibilities
BEFORE:
 Check the doctor’s order.
 Identify the patient.
 Inform the patient and/or SO before doing the procedure and adequately explain the importance and
purpose of doing such procedure.
 Inform that there is no food/fluid restriction before the test.
 Inform that the test requires blood sample and that she may experience transient discomfort from needle
puncture.

DURING:

 Adhere to standard precautions which include:

 Applying sterile technique.
 Make sure to have patient’s pertinent information in the container.

AFTER:

 Apply direct pressure on the venipuncture site.

 Send the specimen immediately to the laboratory and fill-out laboratory forms properly and adequately.
 Chart all procedures done.
 DIAGNOSTIC/ Analysis and
Indications and Date Ordered and
POSSIBLE Results Normal Values Interpretation of
Purpose Date Released
PROCEDURE Results
used to diagnose almost always
Bone scan osteoporosis and appears
involves using x- abnormal, The
ray beams or tracer may
ultrasound to accumulate in
determine the certain areas of
solidity of the the bone,
bone. Bone scan: indicating one or
A bone scan is a more "hot" spots.
test that follows Hot spots may be
the decay of a caused by a
radioactive fracture that is
substance from healing, bone
the bone and cancer, a bone
measures infection
bone metabolism (osteomyelitis),
and can detect
early infection.

Nursing responsibilities
Before:

 You may be asked to sign a consent form before the test

 Check the patient’s name
 Check the doctors order.
 Inform the patient about the diagnostic test that will be ordered.
 Explain to the patient how this procedure works.

 tell your doctor if:

o You are or might be pregnant.
o You are breast-feeding. Use formula (discard your breast milk) for 1 to 2 days after the scan until the
radioactive tracer has been eliminated from your body.
o Within the past 4 days, you have had an X-ray test using barium contrast material (such as a barium enema)
or have taken a medicine (such as Pepto-Bismol) that contains bismuth. Barium and bismuth can interfere
with test results.
 You will need to remove any jewelry that might interfere with the scan.
 asked to empty your bladder to prevent any radioactive urine from blocking the view

During:

 Assist the patient in positioning.

 Comfort the vpatient
 Provide privacy
 asked to drink 4 to 6 glasses of water to help eliminate in your urine any of the radioactive substance that does not
collect in your bones.

After:

 Inform the patient about the result of the test

 Monitor patient for allergic reaction.
DIAGNOSTIC/ Analysis and
Indications and Date Ordered and
POSSIBLE Results Normal Values Interpretation of
Purpose Date Released
PROCEDURE Results

MRI . Using radio

waves and a
strong magnetic
field, MRIs can
produce
exceptionally
detailed images of
bones and the soft
tissues that
 Bone X-rays X-rays can reveal
surround them. damage to your
bone. However,
damage may not
be visible until
osteomyelitis has
been present for
several weeks.

Nursing responsibilities

Before:

 Inform the patient that The x-ray is used to detect fracturesfractures, tumors, or degenerative conditions of the joint.
 Inform the health care provider prior to the exam if you are pregnant, may be pregnant, or have an IUD inserted.
 If abdominal studies are planned and you have had a barium contrast study (such as a barium enema, upper GI
series, or barium swallow) or taken medications containing bismuth (such as Pepto-Bismol) in the last 4 days, the
test may be delayed until the contrast has fully passed.
 You will remove all jewelry and wear a hospital gown during the x-ray examination because metal and certain
clothing can obscure the images and require repeat studies.
During:

 Assist the patient in positioning

 Provide comfort to the patient

After:

 Inform the patient about the results of the test

 Give patient time to relax.

DIAGNOSTIC/ Analysis and

Indications and Date Ordered and
POSSIBLE Results Normal Values Interpretation of
Purpose Date Released
PROCEDURE Results
reveal what
Needle aspiration particular type of
Used to remove a germ has infected
bacteria sample your bone.
from the bone to
 help identify the
bacteria
responsible for the
infection.

Nursing responsibilities

Before:

 No use of aspirin or aspirin substitutes (e.g. ibuprofen, naproxen) for one week before the procedure;
 No food intake a few hours before the procedure;
 Routine blood tests (including clotting profile) must be completed two weeks before the biopsy;
 Suspension of blood anticoagulant medications;
 Antibiotic prophylaxis may be instituted.

 Before the procedure is started, vital signs (pulse, blood pressure, temperature, etc.) may be taken. Then,
depending on the nature of the biopsy, an intravenous line (I.V.) may be placed. Very anxious patients may want to
be given sedation through this line. For patients with less anxiety, oral medication (Valium) can be prescribed to be
taken before the procedure.

During:

 Position the patient

 Provide safety measures
After:

 Explain to the patient the results of the test

 Provide further management
 Emphasize to the patient the do’s and don’ts after the procedure.
 Monitor the patient’s vital sign.