Exam 3 - Amputation Flashcards
causes of amputation
poor blood flow (most common) trauma (2nd most common) infection bone cancer congenital disorders
types of amputation
Guillotine
closed
complications of amputation
hemorrhage infection pain phantom limb pain joint contracture
amputation goal
nontender residual limb with healthy skin for prosthetic
how to control edema s/p amputation
pressure dressings (wraps)
rigid dressings
wound vacs
prosthetic training, fitting
how often to change a rigid dressing
every 5-7 days
how long to use a rigid dressing before to removable temporary prothesis if no skin complications
after 3-4 weeks
when can a prosthesis be given
after 2-3 months
pre-op nursing interventions r/t optimal health
address underlying conditions
–ex: maintaining BGL for DM
nutrition
pre-op nursing intervention r/t psychosocial needs
body image
anticipatory grieving
pre-op nursing intervention r/t education
regular pre-op info
care of residual limb
causes of amputation pain
incisional inflammation pressure hematoma muscle spasm phantom limb pain
meds given for phantom limb pain
anti-seizure (Gabapentin)
anti-depressants (Lyrica)
beta-blockers
other meds given for pain s/p amputation
narcotics (best for incisional)
NSAIDS (reduce inflammation)
antispasmotics (reduce muscle spasms)
non-pharm measures to reduce pain
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)
should you place residual limb on pillows when in bed?
No
how often to prone a pt with an AKA
20-30 minutes TID
what to practice with pts an why
changing positions, standing d/t new center of gravity
this type of therapy is best for long term phantom limb pain
mirror therapy
which race is at highest risk for amputation?
African Americans
amputation is performed at the most ___ point
distal
which technique is used to handle amputation wound care?
aseptic
when are staples/sutures typically removed post-op?
3 weeks
what should the nurse encourage the pt to do re: body image
look at, feel, and care for residual limb
what type of atmosphere should a nurse create to help the pt and family share their feelings and work through the grief process?
accepting, supportive
pts description of phantom lamb pain
crushed cramped twisted numbness tingling burning, electric shock
how of to measure a limb for edema s/p amputation
q8-12 hours
pressure dressing to reduce edema
figure 8 wrap
rigid pressure dressing
what should the nurse establish with the pt to gain acceptance of the amputation
trust
the limb should be elevated for __ hours post surgery to promote ___ return and reduce ___.
24 hours
venous return
reduce edema
nursing interventions to prepare for prothesis
care to prevent complications (edema, contractions)
shape stump with elastic bandages
condition limb as Rx (push into pillow; massage; skin care; work with prothesis)
