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MS2 Exam 3 > Amputation > Flashcards

Flashcards in Amputation Deck (20)
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1

Amputation

partial or complete surgical removal of a limb

2

Difference between minor and major amputation

Prognosis is better for minor amputations.

3

Goal for amputation

preserve the extremity length and function while removing all infected, pathologic, or ischemic tissue

4

Risk Factors for Amputations

-65 or older
-DM
-heart dz
-smoking
-lack of exercise
-poor nutrition
-AA, Hispanics, Native Americans

5

Major causes of Amputations

-Medical: 70 percent DM, PVD, gangrene, and infection

-Trauma: 22 percent, crushing, burns, frost bite

-Congenital: 4 percent

-Tumors: 4 percent

6

Diagnostic Studies for Amputation

-WBC
-Arteriogram
-Venogram

7

Amputation Questions

-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

Closed Amputation

-used to create a weight bearing extremity

-skin flap with soft tissue covers the bony part of the residual limb or stump

9

Disarticulation

performed at the joint

10

Guillotine/Open Amputation

-leaves the bony end open

-generally used to control or prevent potential infection

-wound is closed later by second surgeon

11

Pre-op teaching

-discuss level of amputation
-discuss normal feelings grief/loss
-phantom limb sensations
-dressing process
-pain control
-rehab goals
-discharge plans

12

Post-op Care

-pain
-bleeding from site
-VS
-Stump elevation
-cast care

13

Post-op Teaching: Positioning

-elevate for 24-48 hours

-keep flat after 24 hours

-prone positioning at least 2x daily

14

Stump Care

-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

Stump Shrinker

-used in place of ACE wrap

-stump socket: casted

-weight change

-cleaning of socket

16

Phantom Limb Pain

-knifelike
-burning
-squeezing
-85 percent
-dorsi and plantar flexing the foot

17

Meds for Neuropathic Pain

-Amitriptyline (Elavil)

-Gabapentin (Neurontin)

-Pregablin (Lyrica)

18

Psychological Aspects

-fear
-denial
-bargaining
-death without funeral
-grief
-anger
-depression

19

What to do when patient has psychological worries?

-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

Prothesis

-mold of residual limb is taken

-wear all day to prevent swelling

-limb is covered with stocking

-learning to use is difficult