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Prosthetic Final > Rehab w/ Limb Loss (2) > Flashcards

Rehab w/ Limb Loss (2) Flashcards

1
Q

acute post surgical phase

A

from surgery to wound closure

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2
Q

how long is the acute post surgical phase

A

12-14 days

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3
Q

what could the acute post surgical phase be delayed by

A

meds (like steroids)

trauma

compromised circulation

infection

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4
Q

goals of acute post surgical

A

early mobilization

encourages wound healing

pain management

reduce post op complication

optimize ROM and motor control

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5
Q

what is the primary goal of APSP

A

encourage wound healing

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6
Q

pain management –> goals

A

facilitate rehab process

critical to prevent opioid complications

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7
Q

what if complications occur

A

phase is prolonged

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8
Q

complications of APSP

A

contractures

muscle atrophy

skin breakdown

trauma

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9
Q

contractures –> complications

A

pre existing

d/t mobility

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10
Q

muscle atrophy –> complications

A

deconditioning

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11
Q

skin breakdown –> complications

A

comorbidities like diabetes

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12
Q

pain control –> APSP

A

RL pain

phantom limb pain

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13
Q

RL pain –> pain control

A

pain medication during PT

non opioid

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14
Q

phantom limb pain –> pain control

A

education/medication etc.

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15
Q

APSP includes

A

assessment

systems review

girth and length measurements

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16
Q

assessment

A

general

subjective

observation

cognitive/mental status

systems review

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17
Q

general –> assessment

A

medical history

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18
Q

subjective –> assessment

A

pt’s goals

psychological well being

pain level

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19
Q

psychological well being –> subjective

A

how is the pt dealing w/ the amputation

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20
Q

pain level –> subjective

A

0-10

pain control critical to facilitate rehab and non-opioid use recommended

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21
Q

observation –> assessment

A

position of RL

position in bed

fit of immobilizer/rigid dressing or ace bandage

overall skin assessment

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22
Q

cognitive/mental status –> assessment

A

alertness, orientation, etc

mini mental state

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23
Q

systems review –> assessment

A

CP

vascular

NM

MSK

integ

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24
Q

CP –> systems review

A

vital signs

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25
Q

vascular –> systems review

A

pulses

capillary refill

temp

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26
Q

NM –> systems review

A

light touch

proprioception

*semmes weinstein

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27
Q

MSK –> SR

A

passive ROM

active ROM

muscle strength

muscle/tendon length

A/P ROM, MMT of UE and uninvolved extremity

28
Q

passive ROM –> MSK

A

of amputated extremity

pre-existing contractures

29
Q

muscle strength –> MSK

A

no resistance to any muscle involved in the amputation

TF, TT

30
Q

muscle/tendon length –> MSK

31
Q

integ –> SR

A

texture, hair, nail beds

hemosiderin staining, color

RL and sound limb

pitting edema

32
Q

pitting edema

33
Q

0 –> pitting edema

34
Q

1+ –> pitting edema

35
Q

2+ –> pitting edema

A

skin rebound < 15 s

36
Q

3+ –> pitting edema

A

skin rebound 15-30 s

37
Q

4+ –> pitting edema

A

skin rebound in > 30s

38
Q

Observation

A

abrasions, bruising, blisters

is the incision healing

shape of the RL

39
Q

shape of the RL –> observation

A

bulbous

conical

dog ears

bone spurs

40
Q

girth and length measurements are

A

easily palpable

bony –> not moving

41
Q

the length measurements is the

A

most distal intact joint

42
Q

how are length and girth measurements taken

A

position to eliminate external forces

straight line

43
Q

where do we record length and girth measurement

A

note in chart

44
Q

girth measurement

A

consistent distances

every 2-3”

45
Q

length measurement

A

fxnal

actual

2x and average

46
Q

fxnal length measurement

A

bone lenggth

47
Q

actual soft tissue length

A

soft tissue length

48
Q

subcutaneous tissue

A

punch

< 1/2 “ = light

> 1/2 “ = heavy

49
Q

muscle firmness

A

palpate contracted muscle (subjective)

soft, average, firm

50
Q

APSP intervention

A

prevent contracture

compression methods will continue

51
Q

most common contractures for TF

A

flexion

ABD

ER

52
Q

most common TT contractures

A

knee flexion

hip flexion, ABD, ER

53
Q

how long does someone stay in one position

A

1-2 hrs day prone

54
Q

TT position to prevent contracture

55
Q

TF position to prevent contracture

56
Q

compression methods

A

removable rigid dressing

elastic wrapping (ace bandage)

elastic shrinker

57
Q

elastic shrinker

A

difficult to use while healing

pulling on incision

58
Q

purpose of ACE

A

shrinkage

shaping

healing

59
Q

TT ACE

A

2/4” ace bandages

60
Q

TF ACE

A

2/6” ace bandage

1/4” and 1/6”

61
Q

when is an ACE used

A

immediately after surgery

62
Q

how to put on ace

A

no wrinkles

pressure greater distal

63
Q

what do we use ace for

A

shape

good ace

64
Q

what do we instruct the pt with

A

washing the ace

65
Q

when do we change ace

A

every 2-3 hrs

66
Q

no… –> ace

A

clips or tape on skin

67
Q

when do we stop ace

A

when wearing prosthesis all day

Prosthetic Final (13 decks)

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