The practical nurse (PN) is caring for a client with type 1 diabetes mellitus. Which intervention should the PN implement immediately after a below-the-knee (BKA) amputation due to gangrene?

Choice A reason: Red meats are typically high in sodium, especially if they are processed or cured. Encouraging the consumption of red meats would not be appropriate for a client with low sodium levels.
Choice B reason: Salted crackers are high in sodium and should be avoided for a client with low sodium levels. Consuming salted crackers would further decrease the sodium level, which is not desirable in this case.
Choice C reason: Fresh fruits are naturally low in sodium and are a good choice for a client with low sodium levels. They provide essential vitamins and nutrients without adding excess sodium to the diet.
Choice D reason: Green vegetables are also low in sodium and are a healthy option for a client with low sodium levels. However, fresh fruits are often more palatable and easier to incorporate into the diet, making them a better choice for encouraging the client to eat.

Choice A reason: Positioning the client supine and flat is not specifically aimed at preventing phantom pain. Phantom pain is a common issue after amputations, and its management typically involves medications, therapies, and psychological support rather than positioning. Keeping the client supine and flat may not address the immediate concerns of bleeding and swelling, which are critical in the initial postoperative period.
Choice B reason: Turning the client prone every 2 hours to prevent hip flexion contractures is an important intervention to prevent contractures after a below-the-knee amputation. However, this is not the immediate priority immediately following surgery. The primary concern in the immediate postoperative period is to manage bleeding, swelling, and ensuring proper healing of the residual limb.
Choice C reason: Elevating the residual limb on pillows to prevent bleeding and swelling is the most crucial intervention immediately after a below-the-knee amputation. Elevation helps reduce edema, promote venous return, and minimize the risk of postoperative bleeding. Proper elevation also supports the healing process of the surgical site. This intervention addresses the immediate needs of the client and helps prevent complications in the critical early stages after surgery.
Choice D reason: Positioning the residual limb below the heart to promote healing for prosthetic fitting is not recommended in the immediate postoperative period. Keeping the limb elevated is more beneficial to reduce swelling and manage bleeding. The focus in the immediate phase is to ensure proper healing and prevent complications, with considerations for prosthetic fitting coming later in the rehabilitation process.