2 Med/surgical - Amputation

Front 1

the removal of a part of the body resulting in physical impairment.

a total or partial loss of an extremity

Back 1

amputation

Front 2

Rn diagnoses for an amputation

Back 2

Disturbed Body Image related to amputation and impaired mobility

Impaired skin integrity related to immobility and improper prothesis fitting

Chronic Pain - phantom limb sensation

Front 3

Causes of Amputation

Back 3

ischemia from arterioscloerosis, PVD, diabetes, cancer/tumors, trauma, congenital anomalies

Front 4

There is an increased incidence of amputation in young men in industrial and MVA
t/f

Back 4

true

Front 5

elective or emergency sx
performed in surgical environment by
a surgeon is called

Back 5

surgical amputation

Front 6

an unexpected severing of a body part or limb, usually associated with an accident is called

Back 6

traumatic amputation

Front 7

Your PT tells you he feels self conscious about his amputation - what do you say

Back 7

Ask PT to describe how he is feeling
NEVER say you know what he is going through!

Front 8

Name some indications for surgical amputation

Back 8

Cancer - Osteomyelitis - Peripheral Vascular Disease - Gangrene - Septicemia - Deformities, Traumatic Limb Injury

Front 9

A bone infection is called

Back 9

osteomyelitis

Front 10

Amputation used for clients at risk of infection. Wound remains OPEN and allows for drainage to exudate from the site until infection clears. Closed later

Back 10

Open/Guillotine Surgical Procedure

Front 11

Amputation where the wound is closed by a skin flap over the bone with sutures or staples applied to maintain closure. One or more drains are inserted.

Back 11

Closed or Flap Surgical Procedure

Front 12

In an open or closed method - the surgeon will preserve as much of extremity as possible to maintain what?

Back 12

Post Operative Mobility

Front 13

Expected outcomes of a surgical amputation are :

Back 13

To avoid or treat septicemia

treat or prevent disabiity

prevent death

treat infection

Front 14

referring to the presence of bacteria or their toxins in the blood

Back 14

Septicemia

Front 15

Your PT is having microsurgery as a surgical intervention - what does microsurgery deal with

Back 15

vessels and nerves

Front 16

Your PT accidently cut a digit off - what are the steps immediately taken for perservation?

Back 16

Wrap digit in cool dry cloth
and moisten with NSS or bottled water.

Place in sealed plastic bag.

Place bag in ICE WATER.

Front 17

Your patient is at risk for infection, what type of amputation would best suit him

Back 17

Open or Guillotene Surgical Procedure

Front 18

NEVER DO THESE 3 THINGS IN RESPONSE TO LIMB PRESERVATION

Back 18

NEVER put digit directly on ICE

NEVER plage digit directly in H20

NEVER remove semi-detached
limbs - secure limb - go to ER

Front 19

A FORM OF DISARTICULATION AT THE ankle (metatarsal level) is called

Back 19

Symes amputation

Front 20

medical condition characterized by a whole-body inflammatory state (called a systemic inflammatory response syndrome or SIRS) caused by infection

Back 20

sepsis

Front 21

most lower limb amputation result from

Back 21

PVD
Periopheral Vascular Disease

Front 22

most uopper limb amputations result from

Back 22

severe trauma

Front 23

is a high level pelvic amputation. Along with hip-disarticulations(hip removal)
these are the rarest of lower extremity amputations.

Back 23

hemipelvectomy

Front 24

what is performed more frequently - loss of any or all extremity parts presenting disability.

Back 24

Lower Extremity Amputation

ex) AKA - BKA - Transmetatarsal - Transphalangeal and SYMES (metatarsal)

Front 25

great toes affect what

Back 25

balance
gait
push off during walking

Front 26

what is the most common amputation for treatment of Peripheral Vascular Disease (Lisfranc or Chopart Procedure)

Back 26

Mid-Foot Amputation
(LISFRANC./CHOPART)

Front 27

The higher the level of amputation the more energy needed for ambulation

Back 27

true

Front 28

fewer than 10% of all amputations are ____________. . These amputations are more incapicitating.

Back 28

upper extremity

Front 29

Hip-Disarticulation and Hemipelvectomy are done most often on

Back 29

younger population

Front 30

a complication from aputation that occurs either by surgical intervention or trauma when major blood vessels are severed

WILL CAUSE PT RISK OF HYPOVELEMIC SHOCK OR DEATH!

Back 30

Hemmorage

Front 31

How do you treat Infection due to amputation

Back 31

Maintain ASEPTIC technique wound care

prophylactic and post injury antibiotics

Front 32

what helps cut out infection

Back 32

prophalactic

Front 33

Severe post operative pain described as burning, crushing or craming.. Feels as if the removed part is in a distorted position with numbness and tingling, described in 80% of all amputees

Back 33

phantom limb pain PLP

Front 34

the highest riskof PLP is with what kind of amputation

Back 34

ABOVE THE KNEE AMPUTATION\
With chronic pain pre-operatively.

rarely with s/p traumatic amputation

Front 35

A theory of PLP - stating peripheral sensation remains after limb is removed

Back 35

Peripheral Nervous System Theory

Front 36

Your PT is experiencing shaking, dropped BP, heart rate UP, Respiration UP... what is happening

Back 36

Shock

Front 37

A theory of PLP - the loss of the inhibitory signals which are normally generated by teh afferent impulse - thus repetitive neural activity causing pain

Back 37

CNS Theory

central nervous system

Front 38

A theory of PLP - associated with stress, anxiety and depression

Back 38

Psychological THeory

Front 39

a sensitive tumor consisting of nerve cells found at the severed nerve endings.

Back 39

Neuroma

Front 40

Neuroma is most commonly found in what kind of amputaiton

Back 40

Upper Extemity Amputations

Front 41

Your PT after amputation surgery is having problems with immobility - name some of them

Back 41

Atelactasis with pneumonia

THrombophlebitis/embolism

constipation

skin breakdown

renal calculi (kidney stones)

disorientation

Front 42

Your PT is experining infection with increased temperature, confusion and delirium - what most likely has just happened

Back 42

pre-operative care for a surgical amputation

Front 43

what occurs with decrease movement, no Physical therapy, no proper positioingof extremity and faultyor no use of positional devices

Back 43

Flexion Contracture

Front 44

Most common flexion contractures are

Back 44

hip and LE amputations or
Upper Elbow

Front 45

prophylactic treatments to prevent amputation are :

Back 45

antibiotics, dietary supplements, IV and fluid replacement, pain management, teaching

Front 46

procedure whose purpose is to prevent, rather than treat or cure a disease

Back 46

prophylactic

Front 47

a non invasive diagnostic study for pre-operative teaching of amputationis called

Back 47

doppler ultrasonography

Front 48

an invasive diagnostic study , xray of the arteries

Back 48

angiography

Front 49

Your PT can be fitted for a prosthesis pre-operative - However, a prostehsis may be contra indicated

Back 49

Chronic or progressive mental deterioration
Advancing neurological problems
COPD
Cardiac Disease, CHF, Angina

Front 50

Your PT prostehsis is prolonged, most likely due to

Back 50

type of amputation
infection
or
elderly

Front 51

when you monitor for signs of circulation to the area and assess for increase bleeding/hemorage - you are asessing what

Back 51

Tissue Perfusion

Front 52

Explain howyou would do a neurovascular asessment of your PT

Back 52

Temperature
Color
Sensation.pain
capilarry refill
distal pulses
edema/swelling

Front 53

collator for all diseases caused by the obstruction of large peripheral arteries, which can result from atherosclerosis, inflammatory processes leading to stenosis, an embolism or thrombus formation. It causes either acute or chronic ischemia (lack of blood supply), typically of the legs.

Back 53

peripheral vascular disease PVD

Front 54

What helps minimize effectiveness of PLP

Back 54

Opiods

Front 55

a statuspost surgery can reduce PLP for first week by

Back 55

IV CALCITONIN

Front 56

treatment for constant burning pain that is dull is best done with

Back 56

beta blocker

Front 57

treatment of knife like sharp pain of PLP is best with

Back 57

anticonvulsive

Front 58

treatment of musle spasms from PLP is known as

Back 58

antispasmodics

Front 59

What is the best way for your PT to promote ambulation

Back 59

collaborative treatment PT and occupation therapy

muscle strengthening excercies
ambulatory aids like crutches, wlakers, adl

ROM

Front 60

What is the best dressing to reduce swelling and promote circulation

Back 60

ACE WRAP

Front 61

what kind of dressing must be reapplioed every 4-6 hours

figure 8 wrapping to prevent restriction of blood flow, reduce swelling and shrinking of limb

Back 61

ACE WRAP

Front 62

a plastic inflatable device inflated to 20mmHG for 22 hours out of 24 hours

problem = air leakage

Back 62

air splint
(Jobst)

Front 63

a plastic dressing (bandage with a prosthetic pylon ankle and foot to assist with ambulation) - avoid excessive stump area pressure.

Back 63

Rigid Dressing

Front 64

Inspect Stump daily and assess for signs of redness, blisters and irritation - If found, discontinue prothestis use.

wash daily with warm water and bacteriostatic soap, rinse and dry well.

Back 64

stump care

Front 65

how long should you air dry before wrapping , putting on sock and prothesis

Back 65

20 minutes

Front 66

a patient with alzheimers may NOT be fitted with prostetic

t/f

Back 66

true

Front 67

what kind of dressing decreases edema/swelling to area, psychologically beneficial, can NOT be changed by nurse

Back 67

Rigid Dressing

Front 68

Your PT is having a surgical amputation - what is he at risk for
KNOWLEDGE DEFICIT
INCREASED RISK OF IMPAIRED SKIN INTEGRITY
BODY IMAGE
PAIN - PLP
ACTIVITY INTOLERANCE
RISK FOR INJURY
INNEFECTIVE COPING

Back 68

KNOWLEDGE DEFICIT
INCREASED RISK OF IMPAIRED SKIN INTEGRITY
BODY IMAGE
PAIN - PLP
ACTIVITY INTOLERANCE
RISK FOR INJURY
INNEFECTIVE COPING

Front 69

Client Coping Assessments require you to asess psycho -social feelings and atttidues , religious and cultural beliefs and depression,denial, anger

t.f

Back 69

true

Front 70

Your PT has an ABOVE THE ELBOW amputation and Below the elbow and one has HAND AND DISTAL DIGIT amputation - what kind are they

Back 70

Upper Level Amputations

Front 71

is a complication of necrosis (i.e., cell death) characterized by the decay of body tissues, which become black and malodorous. It is caused by infection or ischemia, such as from thrombosis (blocked blood vessel). It is usually the result of critically insufficient blood supply (e.g., peripheral vascular disease) and is often associated with diabetes and long-term smoking.

Back 71

gangrene

Front 72

is the technique of mechanically widening a narrowed or totally obstructed blood vessel; typically as a result of atherosclerosis.

Back 72

Angioplasty