1
Q
Amputation
A
partial or complete surgical removal of a limb
2
Q
Difference between minor and major amputation
A
Prognosis is better for minor amputations.
3
Q
Goal for amputation
A
preserve the extremity length and function while removing all infected, pathologic, or ischemic tissue
4
Q
Risk Factors for Amputations
A
- 65 or older
- DM
- heart dz
- smoking
- lack of exercise
- poor nutrition
- AA, Hispanics, Native Americans
5
Q
Major causes of Amputations
A
- Medical: 70 percent DM, PVD, gangrene, and infection
- Trauma: 22 percent, crushing, burns, frost bite
- Congenital: 4 percent
- Tumors: 4 percent
6
Q
Diagnostic Studies for Amputation
A
- WBC
- Arteriogram
- Venogram
7
Q
Amputation Questions
A
- Is there complete separation?
- Can the segments be reconnected or salvaged?
- What will be the function of the salvaged limb versus amputations?
- Is there time for other tx options?
8
Q
Closed Amputation
A
- used to create a weight bearing extremity
- skin flap with soft tissue covers the bony part of the residual limb or stump
9
Q
Disarticulation
A
performed at the joint
10
Q
Guillotine/Open Amputation
A
- leaves the bony end open
- generally used to control or prevent potential infection
- wound is closed later by second surgeon
11
Q
Pre-op teaching
A
- discuss level of amputation
- discuss normal feelings grief/loss
- phantom limb sensations
- dressing process
- pain control
- rehab goals
- discharge plans
12
Q
Post-op Care
A
- pain
- bleeding from site
- VS
- Stump elevation
- cast care
13
Q
Post-op Teaching: Positioning
A
- elevate for 24-48 hours
- keep flat after 24 hours
- prone positioning at least 2x daily
14
Q
Stump Care
A
- inspect for discoloration and breaks
- wash with soapy water and dry
- stump wrapping, edema up to 4 months
- reapply up to 3 times per day
- no alcohol
- no lotion
15
Q
Stump Shrinker
A
- used in place of ACE wrap
- stump socket: casted
- weight change
- cleaning of socket
16
Q
Phantom Limb Pain
A
- knifelike
- burning
- squeezing
- 85 percent
- dorsi and plantar flexing the foot
17
Q
Meds for Neuropathic Pain
A
- Amitriptyline (Elavil)
- Gabapentin (Neurontin)
- Pregablin (Lyrica)
18
Q
Psychological Aspects
A
- fear
- denial
- bargaining
- death without funeral
- grief
- anger
- depression
19
Q
What to do when patient has psychological worries?
A
- listen
- open communication
- realistic encouragement
- education at the appropriate level
- allow time to vent feelings
- support groups
- be aware of where you are and how you act
20
Q
Prothesis
A
- mold of residual limb is taken
- wear all day to prevent swelling
- limb is covered with stocking
- learning to use is difficult
