PYOMYOSITIS

PYOMYOSITIS
Is a deep bacterial infection of the
skeletal muscle.
Usually occurs in the large skeletal
muscle of the lower extremities
PYOMYOSITIS
Most often, pyomyositis occurs due to both
prior muscle injury (can be minor muscle
injury) and bacteremia
RARE disease
More common in males.
Staphylococcus aureus.

Signs and Symptoms
Stage 1
Insidious onset of dull muscle pain and
fever.
Stage II
Abscess is present, skin in the affected
appears erythematous and warm
Stage III
Septic shock


Treatment
IV antibiotic
Incision and Drainage

Nursing Care Plans
Cues/clues Nursing
Diagnosis
Objectives Interventions Rationale
Flushed skin,
facial grimace,
guarding
behavior, pain
scale of 5/10
Acute pain
related to
infection of the
skeletal muscle.
at the end of a 5
hour shift the
patient will be
able to:
1. Verbalize
that pain is
controlled.
2. Demonstrate
use of
relaxation
techniques
and
diversional
activities
Perform a
comprehensive
assessment of
pain to include
location,
characteristics,
onset, duration,
frequency,
quality, intensity
or
severity, and
precipitating
factors of pain.

Pain is a
subjective
experience and
must be
described by the
client in order to
plan effective
treatment

Reduce or
eliminate factors
that precipitate
or increase the
patients
pain experience

Teach the use of
nonpharmacolog
ic techniques
(e.g., relaxation,
guided imagery,
music therapy,
distraction, and
massage)
before,
after, and if
possible during
painful activities;
before pain
occurs or
increases; and
along with other
pain relief
measures.
to enhance the
overall pain
management
program



The use of
noninvasive pain
relief measures
can increase the
re-lease of
endorphins and
enhance the
therapeutic
effects of
painrelief
medications.
Elicit behaviors
that are
conditioned to
produce
relaxation, such
as
deep breathing,
yawning,
abdominal
breathing, or
peaceful imaging

Evaluate the
effectiveness of
the pain control
measures used
through ongoing
assessment of
the patients pain
experience.

Relaxation
techniques help
reduce skeletal
muscle tension,
which
will reduce the
intensity of the
pain




Research shows
that the most
common reason
for unrelieved
pain is failure to
routinely assess
pain and pain
relief. Many
clients silently
tolerate pain if
not specifically
asked about it.
Cues/clues Nursing
Diagnosis
Objectives Interventions Rationale
Presence of
deformity in the
lower extremity,
localized
erythema,
+ pain,
Impaired skin
integrity related
to infection of the
skeletal muscle
At the end of a 5
hour shift, the
patient will be
able to:
1. Demonstrate
understandin
g of plans to
heal skin and
prevent injury
2. Demonstrate
measure to
help retain
skin integrity
Long term
1. Regains
integrity of
skin
2. Demonstrate
lifestyle
changes.
Assess site of
skin impairment
and determine
etiology (e.g.,
acute or chronic
wound, burn,
dermatological
lesion, pressure
ulcer, skin tear)

Monitor site of
skin impairment
at least once a
day for color
changes,
redness,
swelling, warmth,
pain, or other
signs of infection


Prior
assessment of
wound etiology is
critical for proper
identification
of nursing
interventions



Systematic
inspection can
identify
impending
problems early.
Avoid massaging
around the site
of skin
impairment and
over bony
prominences.

Assess client's
nutritional status






Individualize
plan according to
client's skin
condition, needs,
and
preferences. Avo
id harsh
cleansing
agents, hot
water, extreme
friction or force,
or cleansing too
frequently
Massage may
lead to deep-
tissue trauma



Inadequate
nutritional intake
places
individuals at risk
for skin
breakdown and
compromises
healing

This helps
prevent further
trauma to the
skin of the
patient.
Cues/clues Nursing
Diagnosis
Objectives Interventions Rationale
Presence of
deformity in the
lower extremity,
localized
erythema,
+ pain, facial
grimace when
moving from side
to side
Impaired
physical mobility
related to
deformity in the
lower extremity
secondary to
infection of the
skeletal muscle.
At the end of a 5
hour shift, the
patient will be
able to:
1.

Long term
1. Maintain or
increase
strength and
function of
the affected
body part.
Assisted/have
client
reposition self on
a regular
schedule
from side to side.

Used side rails of
bed.





Encouraged
patient
to move the
affected part
from time to
time.




To decrease
numbness and
pain in the
affected area



To prevent the
patient from
possible
fall or accident
that
might happen

To help ease the
pain and
numbness
of said part.
Encouraged
patient
to do ROM
exercises


This will help
the
patient to
mobilize
and recover
faster.