The nurse is caring for a patient who underwent a below-the-knee amputation. What is the primary purpose of positioning the residual limb in a flexed position?
To prevent contractures
To promote venous return
To reduce edema
To facilitate wound healing
The Correct Answer is A
The primary purpose of positioning the residual limb in a flexed position after a below-the-knee amputation is to prevent contractures. Contractures are abnormal shortening and tightening of muscles and tendons, leading to restricted joint movement. Maintaining the limb in a flexed position helps prevent contractures and ensures optimal prosthetic fitting and functional outcomes.
b. To promote venous return: While positioning the limb in a flexed position may have some impact on venous return, it is not the primary purpose of this positioning. Elevating the limb on a pillow is more effective for promoting venous return.
c. To reduce edema: Keeping the residual limb elevated on a pillow is the preferred method for reducing edema in the immediate post-operative period, not positioning it in a flexed position.
d. To facilitate wound healing: Facilitating wound healing is not the primary purpose of positioning the residual limb in a flexed position. Proper wound care, dressing changes, and monitoring for signs of infection are essential for wound healing.
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Correct Answer is D
Explanation
The priority nursing intervention in the immediate post-operative period after an upper extremity amputation is to assess the surgical incision for infection. Early detection of signs of infection, such as redness, swelling, warmth, or drainage, is crucial to prevent complications and promote healing.
a. Managing phantom limb pain: While managing phantom limb pain is important, it may not be the priority nursing intervention immediately after the surgery. Assessing the surgical incision for infection and monitoring for any complications take precedence.
b. Ensuring proper prosthetic fitting: Prosthetic fitting is essential for functional outcomes, but it may not be the priority in the immediate post-operative period. It is addressed during the rehabilitation phase.
c. Elevating the residual limb on a pillow: Elevating the residual limb on a pillow is typically recommended for lower extremity amputations to reduce edema and promote venous return, not for upper extremity amputations.
Correct Answer is C
Explanation
Peripheral vascular disease, which involves decreased blood flow to the extremities, is a common indication for amputation. In severe cases, where blood flow cannot be restored, amputation may be necessary to prevent further complications.
a. Chronic low back pain: Chronic low back pain is not an indication for amputation. It is usually managed through conservative treatments such as physical therapy, medications, or injections.
b. Osteoarthritis of the knee: Osteoarthritis of the knee may cause pain and mobility issues, but it does not typically lead to amputation. Treatment for osteoarthritis includes pain management, physical therapy, and, in some cases, joint replacement surgery.
d. Minor soft tissue injury: Minor soft tissue injuries do not require amputation. They are usually treated with wound care, rest, and possibly antibiotics if there is an infection.
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