Examination of Patient at Risk for Amputation or with Amputation Flashcards
When performing the Pallor with Elevation, what does pallor within 30-45 seconds indicate?
Moderate arterial insufficiency
When performing the Pallor with Elevation, what does pallor within 45-60 seconds indicate?
Mild arterial insufficiency
When performing the Pallor with Elevation, what does pallor greater than 1 minute indicate?
WNL
When performing the Rubor of dependency what does it indicate if the feet turn bright red?
Ischemia
When performing Rubor of dependency when does blood flow return if a patient has normal blood flow?
15-20 second
When performing Rubor of dependency what indicates severe arterial insuffiency?
Pallor with elevation (in less than 25 seconds) followed by bright red appearance with dependency
When performing Venous Filling time what time frame is normal?
Refill in 5-15 seconds
When performing Venous Filling time what time frame indicates arterial insufficiency?
> 20 seconds for refill
When performing Venous Filling time what time frame indicates venous insufficiency?
Immediate refill
What should occur when testing capillary refill if there is no issue?
- Area should briefly blanche
- White & refill immediately
What is the pitting edema scale?
- 0 = non pitting
- 1+ = barely perceptible
- 2+ = skin rebounds <15 seconds
- 3+ = skin rebounds 15-30 seconds
- 4+ = skin rebounds >30 seconds
What is the ankle brachial index a ratio of?
systolic ankle / systolic brachium
What is the scale for the ankle brachial index?
- Normal: 1-1.29
- Borderline: .91-.99
- Mild PAD: .71-.90
- Medium Severe PAD: .41-.7
- Severe PAD: < .4
What is the ideal limb shape?
cylindrical
Describe the ideal residual limb
- Durable
- Well vascularized
- Tolerates pressure in weight bearing areas
- Tolerates friction in areas covered by the prosthetic socket
What bony landmarks are used to take girth measurements of the lower limb?
Tibial tubercle/ ischial tuberosity/ greater trochanter
What are the bony landmarks for measuring length of lower extremity?
Tibial tubercle/ Ischial tuberosity/ greater trochanter to distal aspect of limb
What are the bony landmarks for measuring girth of upper extremity?
Tip of acromion/ olecranon
What is the bony landmark for measuring length of upper extremity?
From tip of acromion/olecranon to distal aspect of limb
What education should be given to a patient on preventive foot care?
- Wash feet daily, dry them well, especially between toes
- Apply a thin coat of moisturizer to feet daily, avoid between toes
- Trim nails after washing & drying feet
- Cut nails straight across, smooth any sharp edges
- Have podiatrist assist with thickened nailed or ingrown nails
- Thin, thick corn or callouses by gently using a purnice stone or professional care
- Check water temp with thermometer or elbow before bathing
- Wear socks at night if feet are cold
- Use sunscreen on the tops
- Ask health care provider to check feet each visit
What should you tell a patient not to do for preventive foot care?
- Soak feet
- Use moisturizer between toes
- Cut corns or calluses
- Use chemical agents, corn plasters, strong antiseptics, or adhesive tape on feet
- Use hot water or heating pads
What should be done when considering footwear?
- Wear shoes that fit the size & shape of foot & leave room for any necessary insoles
- Ask health care provider to recommend correct type of shoe
- Break in new shoes slowly
- Keep shoes & insoles in good repair
- Check feet
What should not be done when considering footwear?
- Walk barefoot
- Wear socks that are too baggy or have hole
- Wear socks to stocking that constricting at the tip
- Wear sandals with thongs between toes
