Exam 3 - Amputation

Question 1

causes of amputation

Answer 1

poor blood flow (most common)
trauma (2nd most common)
infection
bone cancer
congenital disorders

Question 2

types of amputation

Answer 2

Guillotine

closed

Question 3

complications of amputation

Answer 3

hemorrhage
infection
pain
phantom limb pain
joint contracture

Question 4

amputation goal

Answer 4

nontender residual limb with healthy skin for prosthetic

Question 5

how to control edema s/p amputation

Answer 5

pressure dressings (wraps)
rigid dressings
wound vacs
prosthetic training, fitting

Question 6

how often to change a rigid dressing

Answer 6

every 5-7 days

Question 7

how long to use a rigid dressing before to removable temporary prothesis if no skin complications

Answer 7

after 3-4 weeks

Question 8

when can a prosthesis be given

Answer 8

after 2-3 months

Question 9

pre-op nursing interventions r/t optimal health

Answer 9

address underlying conditions
–ex: maintaining BGL for DM
nutrition

Question 10

pre-op nursing intervention r/t psychosocial needs

Answer 10

body image

anticipatory grieving

Question 11

pre-op nursing intervention r/t education

Answer 11

regular pre-op info

care of residual limb

Question 12

causes of amputation pain

Answer 12

incisional
inflammation
pressure
hematoma
muscle spasm
phantom limb pain

Question 13

meds given for phantom limb pain

Answer 13

anti-seizure (Gabapentin)
anti-depressants (Lyrica)
beta-blockers

Question 14

other meds given for pain s/p amputation

Answer 14

narcotics (best for incisional)
NSAIDS (reduce inflammation)
antispasmotics (reduce muscle spasms)

Question 15

non-pharm measures to reduce pain

Answer 15

reduce edema
--tight dressing, evacuate hematoma or other fluids
position change
light pressure to residual limb
--sandbag (reduce muscle spasm)
elevation (be aware of contraction)

Question 16

should you place residual limb on pillows when in bed?

Answer 16

No

Question 17

how often to prone a pt with an AKA

Answer 17

20-30 minutes TID

Question 18

what to practice with pts an why

Answer 18

changing positions, standing d/t new center of gravity

Question 19

this type of therapy is best for long term phantom limb pain

Answer 19

mirror therapy

Question 20

which race is at highest risk for amputation?

Answer 20

African Americans

Question 21

amputation is performed at the most ___ point

Answer 21

distal

Question 22

which technique is used to handle amputation wound care?

Answer 22

aseptic

Question 23

when are staples/sutures typically removed post-op?

Answer 23

3 weeks

Question 24

what should the nurse encourage the pt to do re: body image

Answer 24

look at, feel, and care for residual limb

Question 25

what type of atmosphere should a nurse create to help the pt and family share their feelings and work through the grief process?

Answer 25

accepting, supportive

Question 26

pts description of phantom lamb pain

Answer 26

crushed
cramped
twisted
numbness
tingling
burning, electric shock

Question 27

how of to measure a limb for edema s/p amputation

Answer 27

q8-12 hours

Question 28

pressure dressing to reduce edema

Answer 28

figure 8 wrap

rigid pressure dressing

Question 29

what should the nurse establish with the pt to gain acceptance of the amputation

Answer 29

trust

Question 30

the limb should be elevated for __ hours post surgery to promote ___ return and reduce ___.

Answer 30

24 hours
venous return
reduce edema

Question 31

nursing interventions to prepare for prothesis

Answer 31

care to prevent complications (edema, contractions)
shape stump with elastic bandages
condition limb as Rx (push into pillow; massage; skin care; work with prothesis)