Case Studies

Case 12: A male with osteomyelitis (Part 14 The musculoskeletal system)

Jeff Jackson is 17 years of age and lives with his parents and two sisters in a semi-detached house in small town. Jeff hurt his lower leg one day on piece of old metal in field. He went to the local accident and emergency department as the cut needed sutures; he was also given tetanus toxoid injection and was asked to return to the department in five days for suture removal. Two weeks after suture removal Jeff complains of increasing bone pain in his left leg, he is limping and is reluctant to weight bear and is in a lot of pain when the limb is moved.

Jeff's leg feels hot to touch and the wound has not healed fully and is now oozing pus. Jeff is now weak, pyrexial and nauseous. He is admitted to hospital.

• 1. List the investigations that may be performed on Jeff and give a rationale for your choice.

• 2. What is the nurse's role when these investigations are being carried and how do you assist Jeff?

• 3. Jeff is confined to bed. What are the complications of bed rest and how can the nurse prevent these?

• 4. What are the treatment options?

Consider the topical issue of antibiotic resistance and how this might relate to this case study. There are occasions when some patients do not complete the prescribed course of antibiotics; consider the ways in which you can encourage those patients to compete the prescribed course of antibiotics.