Amputation Flashcards

1
Q

Amputation

A

partial or complete surgical removal of a limb

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2
Q

Difference between minor and major amputation

A

Prognosis is better for minor amputations.

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3
Q

Goal for amputation

A

preserve the extremity length and function while removing all infected, pathologic, or ischemic tissue

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4
Q

Risk Factors for Amputations

A
  • 65 or older
  • DM
  • heart dz
  • smoking
  • lack of exercise
  • poor nutrition
  • AA, Hispanics, Native Americans
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5
Q

Major causes of Amputations

A
  • Medical: 70 percent DM, PVD, gangrene, and infection
  • Trauma: 22 percent, crushing, burns, frost bite
  • Congenital: 4 percent
  • Tumors: 4 percent
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6
Q

Diagnostic Studies for Amputation

A
  • WBC
  • Arteriogram
  • Venogram
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7
Q

Amputation Questions

A
  • Is there complete separation?
  • Can the segments be reconnected or salvaged?
  • What will be the function of the salvaged limb versus amputations?
  • Is there time for other tx options?
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8
Q

Closed Amputation

A
  • used to create a weight bearing extremity

- skin flap with soft tissue covers the bony part of the residual limb or stump

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9
Q

Disarticulation

A

performed at the joint

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10
Q

Guillotine/Open Amputation

A
  • leaves the bony end open
  • generally used to control or prevent potential infection
  • wound is closed later by second surgeon
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11
Q

Pre-op teaching

A
  • discuss level of amputation
  • discuss normal feelings grief/loss
  • phantom limb sensations
  • dressing process
  • pain control
  • rehab goals
  • discharge plans
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12
Q

Post-op Care

A
  • pain
  • bleeding from site
  • VS
  • Stump elevation
  • cast care
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13
Q

Post-op Teaching: Positioning

A
  • elevate for 24-48 hours
  • keep flat after 24 hours
  • prone positioning at least 2x daily
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14
Q

Stump Care

A
  • inspect for discoloration and breaks
  • wash with soapy water and dry
  • stump wrapping, edema up to 4 months
  • reapply up to 3 times per day
  • no alcohol
  • no lotion
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15
Q

Stump Shrinker

A
  • used in place of ACE wrap
  • stump socket: casted
  • weight change
  • cleaning of socket
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16
Q

Phantom Limb Pain

A
  • knifelike
  • burning
  • squeezing
  • 85 percent
  • dorsi and plantar flexing the foot
17
Q

Meds for Neuropathic Pain

A
  • Amitriptyline (Elavil)
  • Gabapentin (Neurontin)
  • Pregablin (Lyrica)
18
Q

Psychological Aspects

A
  • fear
  • denial
  • bargaining
  • death without funeral
  • grief
  • anger
  • depression
19
Q

What to do when patient has psychological worries?

A
  • listen
  • open communication
  • realistic encouragement
  • education at the appropriate level
  • allow time to vent feelings
  • support groups
  • be aware of where you are and how you act
20
Q

Prothesis

A
  • mold of residual limb is taken
  • wear all day to prevent swelling
  • limb is covered with stocking
  • learning to use is difficult