Prosthetics Exam 2: Postoperative and Preoperative Care Flashcards
Examination in the acute care setting focuses on four priorities
- Initial healing of the ___ ___
- ___ management and ___ control of the residual limb
- Bed mobility and transfers
- Readiness for ____-___ ambulation
surgical site
pain volume
single limb
Why is it important to teach a patient to use their upper body and walker to do the work in early ambulation
Because they are at risk of losing their other limb, so as little impact on the sound limb as possible is best
Why is important to be aware of a patient’s cognitive status throughout the day
Because of the meds are going to be extremely strong and their mood can drastically change throughout the day
What are the 5 body systems that need to be checked during systems review
cardio vascular cardiopulmonary integumentary musculoskeletal neuromuscular
Adaptions of performing MMT post surgery can make data collecting, reliability, and validity (more/less) precise
less
True or False:
We must document modifications to testing procedures post op
true
Patients will experience high amounts of pain and have phantom limb sensation. If a patient reports these feelings, we need to document the ___, ____ and ___ of the pain as well as pain management strategies
nature, location, intensity
___-___% of patients feel phantom sensations after recent amputation
54-99
List the 6 types of phantom sensations that a patient may feel
numbness tingling tickling pressure itiching mild muscle cramping
Do we want all phantom sensation to go away? Why or why not
no because it can help the pt control the prosthesis better.
When does phantom sensation become a safety problem
When a patient feels like their leg is there and goes to get up and walk and it isn’t there so they fall
___-___% of patients experience phantom pain
46-63
How can phantom pain be described as
shooting pain, severe cramping, distressing burning
Is there a way to treat phantom pain
not really
What are the two ways that limb length is measured
- actual length of the tibia or femur
2. Total length of residual limb including soft tissue
What are the bony landmarks for TT and TF length measurements
TT: medial joint line to end of bone/tissue
TF: greater trochanter to end of bone/tissue
What types of blood color should be reported to the surgeon for further assessment
bright red arterial blood or darker venous blood
There is a higher risk for infection along the incision. What are the signs of infection to look for
increased drainage, thickening, and discolored exudate
True or false:
Circulation is only necessary to check in the residual limb
false, also check in sound limb bc it is vulnerable to be lost due to increased stress
What are a few ways to assess circulation in both the residual limb and sound limb
skin temp and turgor
color at rest/position change
palpation of pedal/popliteal pulses
ABI
Amputees are at high risk of developing contractures, what types of contractures are most likely to occur
hip and knee flexion
what test is used to assess hip flexor length
thomas test
TT amputees will need to have the (knee/hip) joint mobility and integrity assessed
knee
How can we assess the integrity of the residual’s limb’s knee
varus/valgus stress test and lachmans
We expect that an amputee with a short limb should (be able/not be able) to hold for a MMT, if they (can/cannot) this means that individual is really (weak/strong)
be able
cannot
weak
When can active movement and MMT tests be taken
active movement and antigravity can be taken right away, but wait for surgical sites to heal before MMT. If it’s too early to assess MMT, assess the next most proximal joint
What two muscle groups are super important to strengthen before and after surgery
hip extensors and abductors
How can we assess aerobic capacity and endurance during PT
resting vitals
change in vitals with transfers and mobility training
RPE
Most amputees are at risk for ___ ____, so know the signs!
myocardial infarction
When we start to do early mobility training ____ ____ should be a main factor to consider
orthostatic hypotension
A score of ___ on the mini mental state exam may indicate some sort of cognitive impairment. ______ may also interfere with the ability to learn
24; depression
Cognitive impairments are only seen in ____ ____ ____ amputees
peripheral vascular disease
which movements are usually harder than anticipated for amputees
bed mobility, supine to sit, and sit to stand
____ health is important as ambulation with a prosthesis can be challenin
back
assess pelvic alignment against (vertical/horizontal)
horizontal
