Diabetes, LE amputations Flashcards
Diabetes
chronic disease with progressive course
Type 1 diabetes
insulin deficiency
no longer produced by pancreas
Type 2 diabetes
Insulin resistance
insulin is produced, but no longer able to perform its function
Insulin
Hormone for glucose going out of blood
Diabetic Neuropathy
loss of sensation
unsteady gait
Effects of diabetes on body
Diabetic neuropathy
retinopathy
decreased circulation
Retinopathy
damage to blood vessels in retina
Decreased circulation
leads to diabetic ulcers, slower healing of wounds and sometimes amputation
Diabetes impacts individual’s
personal
environmental
social
spiritual
physical wellbeing
promoting successful prevention and management
healthy eating routines
physical activity routine
education on monitoring blood sugar and BP
Education on medication management
Education on physical activity - diabetes
Helps decrease glucose levels down and out of blood stream
muscles use glucose when exercising
Monitoring blood sugar and BP
daily
Mirror inspection
everywhere on body for pressure sores
foot examination and offloading
Diabetes and lower limb amputations
diabetes is leading cause of non-traumatic lower extremity amputations
other word for amputated leg
residual limb
causes of lower LE amputations
vascular disease
cancer
trauma
congenital - born with missing limb
Major limb amputations
above knee
below knee
any amputation below knee
Above knee amputation
Transfemoral
Below knee amputation
transtibial
minor amputations
at or below ankle level
toe amputation
foot amputation
2 main phases of rehab
pre-prosthetic phase
prosthetic phase
Pre-prosthetic
phase 1
wound is still healing
important phase
Phase 1 - main goals
prevention of contractures
swelling control
shaping of residual limb
desensitizing techniques
swelling control
compression socks
shaping of residual limb by…
bandaging
desensitizing techniques
rubbing
massage
circular motions
proper caring of residual limb
regular inspections
ADLs: washing/drying
at night, everyday
mild soap
pat dry with towel
moisture
Prosthetic phase
receiving prosthesis
gait re-education
center of gravity reorientation
personal hygiene and prosthetic care
positioning do’s and don’ts - Wheelchair
No crossing leg
no flexion for long amounts of time
swelling control
Positioning do’s and don’ts - Bed
No pillows
no leg dangling
straight leg
legs together
Dressing and bathing
training for LE dressing
Important to grade ADLs
ADL assistive devices and training
ADL assistive devices and training
balance and bending
sock aid
long handled shoehorn
ADL grading - low to high functioning
Dress in bed, not on edge (bridging technique)
ADL grading - highest
standing while dressing
Amputations - Transfers early in therapy
transfer toward unaffected side
Transfer progression - amputation
transferring toward both directions
Phantom limb pain interventions
mirror therapy
exercise for circulation
distraction
soaking in warm bath
massage limb
pain diary
relaxation techniques
Mirror therapy
tricking brain into thinking lost limb is there
Pain diary
what’s causing pain
when it is causing pain
can determine what is causing pain
