Amputation

Question 1

Amputation

Answer 1

• May be congenital or traumatic (medical) or caused by conditions such as:
  > peripheral vascular disease
  > diabetes
  > infection
  > malignant tumor
• Used to relieve symptoms, improve func, & improve quality of life

Question 2

Amputation - Goal

Answer 2

• Preserve as much functional length as possible
• Regain function (if possible): prosthesis
• Improve quality of life
• Most common: above or below knee
  > transfemoral
  > transtibial

Question 3

Amputation - Complications

Answer 3

• Hemorrhage
• Infection
• Phantom limb pain
• Flexion contracture
• Loss of strength

Question 4

Amputation - Nursing Care

Answer 4

• Assess: perfusion, edema, pulses, color, temp, suture line
  > wound begin to heal 4-8wks
• Pain control
  > phantom/absent limb pain
• No pillows under stump
  > contractures: scare tissue developing that affects ROM
• Overhead trapeze; exercise
• Pt out of bed 12-24hrs after surgery

Question 5

Amputation - Rehab

Answer 5

• Psychological support
• Prostheses fitting & use
• PT
• Vocational or occupational training & counseling
• Use a multidisciplinary team approach
• Pt teaching

Question 6

Amputation - Nursing Diagnosis

Answer 6

• Acute pain
• Impaired skin integrity
• Disturbed body image
• Grieving
• Self-care deficit
• Impaired physical mobility

Question 7

Amputation - Nursing Goals

Answer 7

• Relief of pain
• Absence of altered sensory perceptions
• Wound healing
• Acceptance of altered body image
• Resolution of grieving processes
• Restoration of physical mobility
• Absence of complications

Question 8

Amputation - Nursing Interventions: Relief of Pain

Answer 8

• Admin analgesic or other meds as prescribed
• Changing position
• Putting a light sand bag on residual limb
• Alternative methods of pain relief: distraction, TENS unit

Question 9

Amputation - Nursing Interventions: Promoting Wound Healing

Answer 9

• Handle limb gently
• Residual limb shaping

Question 10

Amputation - Nursing Interventions: Resolving Grief/Enhancing Body Image

Answer 10

• Encourage communication & expression of feelings
• Accepting, supportive atmosphere
• Provide support & listen
• Encourage pt to look at, feel, & care for residual limb
• Help pt set realistic goals
• resume self-care & independence
• Referral to counselors/support groups

Question 11

Amputation - Nursing Interventions: Achieving Physical Mobility

Answer 11

• Proper positioning of limb; avoid abduction, external rotation & flexion
• Turn frequently; prone positioning if possible
• Use of assistive devices
• ROM exercises
• Muscle strengthening exercises
• “Preprosthetic care”; proper bandaging, massage, & “toughening” of the residual limb

Question 12

Amputation - Self-Care Home

Answer 12

• Encourage active participation in care
• Continue support in rehabilitation facility or at home
• Focus on safety & mobility