Amputation

  1. General information
    1. Surgical procedure done for peripheral vascular disease if medical management is ineffective and the symptoms become worse.
    2. The level of amputation is determined by the extent of the disease process.
      1. Above knee (AK): performed between the lower third to the middle of the thigh
      2. Below knee (BK): usually done in middle third of leg, leaving a stump of 12.5-17.5 cm
  2. Nursing interventions: preoperative
    1. Provide routine pre-op care.
    2. Offer support/encouragement and accept client's response of anger/grief.
    3. Discuss
      1. Rehabilitation program and use of prosthesis
      2. Upper extremity exercises such as push-ups in bed
      3. Crutch walking
      4. Amputation dressings/cast
      5. Phantom limb sensation as a normal occurrence
  3. Nursing interventions: postoperative
    1. Provide routine post-op care.
    2. Prevent hip/knee contractures
    3. Avoid letting client sit in chair with hips flexed for long periods of time.
    4. Have client assume prone position several times a day and position hip in extension (unless otherwise ordered).
    5. Avoid elevation of the stump after 12-24 hours.
    6. Observe stump dressing for signs of hemorrhage and mark outside of dressing so rate of bleeding can be assessed.
    7. Administer pain medication as ordered.
    8. Ensure that stump bandages fit tightly and are applied properly to enhance prosthesis fitting.
    9. Initiate active ROM exercises of all joints (when medically advised), crutch walking, and arm/shoulder exercises.
    10. Provide stump care.
      1. Inspect daily for signs of skin irritation.
      2. Wash thoroughly daily with warm water and bacteriostatic soap; rinse and dry thoroughly.

Avoid use of irritating substances such as lotions, alcohol, powders.

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