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31 Cards in this Set
- Front
- Back
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What are ways to prevent amputation?
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control causative factors
-PVD -DM -Chronic osteomyelitis -pressure ulcers -trauma |
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Clinical reasons for amputation are..
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-circulatory impairment
-traumatic events -malignant tumors -infection of extremity -congenital disorder |
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diagnostics are what?
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-H&P
-ABI -Arteriography (dye is injected) -transcutaneous doppler recording |
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What are two types of amputation?
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-elective
-emergency |
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elective is what?
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there is time to assess Pt's general health able to monitor other disease process, time to instruct and potential for successful rehab (DM)
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emergency is what?
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it must go then and therefor physical and emotionaly complicated (MVA)
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Symes amputation is what?
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cut at the ankel
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BK or transtibial is what?
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below the knee
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AK or transfemoral
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above the knee
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hemipelvectomy
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at the hip
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the goal of amputation is what?
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-preserve the length of extermity
-preserve function -remove pathologic tissue |
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Types of amputation include what?
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-closed
-open |
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closed allows for what?
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a wt-bearing residual limb
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open does what?
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leaves a surface on the limb that is not covered with skin, possible infection
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Pre Op nursing include
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-reason for amputation
-post op rehab -teach about prosthesis -teach upper-extremity exercise to increase upper body strength -explain phantom limb sensation |
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What things increase Phantom limb pain?
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-smoking
-urination -defication |
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What can be given to help with Phantom pain?
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-beta blockers, anticonvulsants, SSRI's
-have them touch the site -massage |
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Post op management includes
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-care for co-morbidities if present
-V/S -strict sterile tech. -watch for PE -Tourniquet @ bedside -no lotion until ordered |
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how can we avoid contractures?
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-need to move
-leg must be straight -avoid Pt in chair -elevate limb 1st 24 hr -then don't elevate (have Pt lay on stomach often daily) -keep legs together |
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prevention of contractions
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-prevent post-op hip flexion
-residual limb bandaging -avoid dangling -strict adherence to Wt-bearing orders -proper nut. -pain control -encourage verbal feelings of amputation |
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the compression stocking will be applied when?
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in surgery, and should be reapplied 3-4 times a day to decrease the edema
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Limb assessment includes
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-pain
-color -suture line -drainage -edema |
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What are the 2 types of prosthetic fittings?
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-immediate (applied in OR, cast like bandage)
-delayed (time of placement depends on the healing status of limb) |
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How much space should be left between limb and prosthetic?
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enough so that the tip of the stump doesn't touch base of the prosthetic
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What is applied to the limb?
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limb stocking (not to tight)
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what therapy is done?
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-transfer tech
-conditioning exercise -active ROM -crutch walking for lower limb Pt -referral to prothetist |
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What are 4 types of traumatic amputation?
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-complete (completely severed)
-partial (some bone/tissue) -cuillotine (slice, clean cut well defined edges) -crush (less likely for reattachment, more soft tissue damage) |
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care of fresh amputated limb
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-rinse and clean
-wrap in clean damp cloth -place in sealed bag & immerse in water and ice -don't allow it to touch ice -tag with name, date, time |
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ER care of ampuated Pt
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-stabilize Pt
-control bleeding -type & cross -Pain meds -Medical hx -X-rays -Assist MD with wound debridement |
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Post Op care of Pt
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-neuro checks
-assess for shock, comparment syndrome, DVT, PE, Fat Emb. -ROM -Teach how to avoid contractures -watch for DVT |
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Evaluation of amputation is..
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-acceptance of body image
-no skin break down -pain reduction/relief -satisfactory mobility |
