Limb Amputation
Limb Amputation
Limb Amputation
Surgical Interventions
Most postoperative nursing care priorities are the same as for any surgical patient:
assessing and maintaining the patient's airway, breathing, and circulation; monitoring
vital signs; managing pain; taking steps to prevent respiratory complications and venous
thromboembolism; and watching for signs and symptoms of hemorrhage.
Assessment:
1. Neurovascular status of involved extremity.
2. History to determine causative factors and health problems that can compromise recovery.
3. Client’s understanding of the extent of the surgery.
4. Client’s coping status.
5. Client’s support system.
Nursing Care:
After surgery, the patient will have a soft dressing or a rigid dressing made of fiberglass
or plaster. Assess the surgical dressing for integrity and drainage. Elevate the stump for
the first 24 to 48 hours to decrease edema.
Move and turn the patient gently and slowly to prevent severe muscle spasms. Reposition
the patient every 2 hours, turning the patient from side to side and prone, if possible.
Lying prone helps reduce hip flexion contractures. Avoid placing pillows between the
patient's legs or under the back.
Unwrap the stump dressing every 4 to 6 hours for the first 2 days postoperatively as
prescribed and then at least once daily. Assess the stump for signs and symptoms of
infection and skin irritation or breakdown. Assess the color, temperature, and most
proximal pulse on the stump before rewrapping it, comparing findings to the contralateral
extremity. Maintain elastic bandage to shrink and shape stump in preparation for
prosthesis
Before rewrapping the stump, provide periwound skin care as ordered, but avoid lotion.
Wrap the stump when it's elevated to prevent edema and vascular stasis. Follow your
facility's policy for replacing the bandage, such as every 2 to 4 days or sooner if it
becomes soiled.
When wound is healed, wash stump daily, avoiding the use of oils which may cause
maceration. Apply pressure to the end of the stump with progressively firmer surfaces to
toughen stump.
Encourage family to participate in care. Allow the client to express emotional reactions.
Submitted by:
Garcia, Micaella P.
Group 2, NR-43
Submitted to: