Prosthetics Exam 2: Postoperative and Preoperative Care

Question 1

Examination in the acute care setting focuses on four priorities

1. Initial healing of the ___ ___
2. ___ management and ___ control of the residual limb
3. Bed mobility and transfers
4. Readiness for ____-___ ambulation

Answer 1

surgical site
pain volume
single limb

Question 2

Why is it important to teach a patient to use their upper body and walker to do the work in early ambulation

Answer 2

Because they are at risk of losing their other limb, so as little impact on the sound limb as possible is best

Question 3

Why is important to be aware of a patient’s cognitive status throughout the day

Answer 3

Because of the meds are going to be extremely strong and their mood can drastically change throughout the day

Question 4

What are the 5 body systems that need to be checked during systems review

Answer 4

cardio vascular
cardiopulmonary
integumentary
musculoskeletal
neuromuscular

Question 5

Adaptions of performing MMT post surgery can make data collecting, reliability, and validity (more/less) precise

Answer 5

less

Question 6

True or False:

We must document modifications to testing procedures post op

Answer 6

true

Question 7

Patients will experience high amounts of pain and have phantom limb sensation. If a patient reports these feelings, we need to document the ___, ____ and ___ of the pain as well as pain management strategies

Answer 7

nature, location, intensity

Question 8

___-___% of patients feel phantom sensations after recent amputation

Answer 8

54-99

Question 9

List the 6 types of phantom sensations that a patient may feel

Answer 9

numbness
tingling
tickling
pressure
itiching
mild muscle cramping

Question 10

Do we want all phantom sensation to go away? Why or why not

Answer 10

no because it can help the pt control the prosthesis better.

Question 11

When does phantom sensation become a safety problem

Answer 11

When a patient feels like their leg is there and goes to get up and walk and it isn’t there so they fall

Question 12

___-___% of patients experience phantom pain

Answer 12

46-63

Question 13

How can phantom pain be described as

Answer 13

shooting pain, severe cramping, distressing burning

Question 14

Is there a way to treat phantom pain

Answer 14

not really

Question 15

What are the two ways that limb length is measured

Answer 15

1. actual length of the tibia or femur

2. Total length of residual limb including soft tissue

Question 16

What are the bony landmarks for TT and TF length measurements

Answer 16

TT: medial joint line to end of bone/tissue
TF: greater trochanter to end of bone/tissue

Question 17

What types of blood color should be reported to the surgeon for further assessment

Answer 17

bright red arterial blood or darker venous blood

Question 18

There is a higher risk for infection along the incision. What are the signs of infection to look for

Answer 18

increased drainage, thickening, and discolored exudate

Question 19

True or false:

Circulation is only necessary to check in the residual limb

Answer 19

false, also check in sound limb bc it is vulnerable to be lost due to increased stress

Question 20

What are a few ways to assess circulation in both the residual limb and sound limb

Answer 20

skin temp and turgor
color at rest/position change
palpation of pedal/popliteal pulses
ABI

Question 21

Amputees are at high risk of developing contractures, what types of contractures are most likely to occur

Answer 21

hip and knee flexion

Question 22

what test is used to assess hip flexor length

Answer 22

thomas test

Question 23

TT amputees will need to have the (knee/hip) joint mobility and integrity assessed

Answer 23

knee

Question 24

How can we assess the integrity of the residual’s limb’s knee

Answer 24

varus/valgus stress test and lachmans

Question 25

We expect that an amputee with a short limb should (be able/not be able) to hold for a MMT, if they (can/cannot) this means that individual is really (weak/strong)

Answer 25

be able cannot weak

Question 26

When can active movement and MMT tests be taken

Answer 26

active movement and antigravity can be taken right away, but wait for surgical sites to heal before MMT. If it's too early to assess MMT, assess the next most proximal joint

Question 27

What two muscle groups are super important to strengthen before and after surgery

Answer 27

hip extensors and abductors

Question 28

How can we assess aerobic capacity and endurance during PT

Answer 28

resting vitals change in vitals with transfers and mobility training RPE

Question 29

Most amputees are at risk for ___ ____, so know the signs!

Answer 29

myocardial infarction

Question 30

When we start to do early mobility training ____ ____ should be a main factor to consider

Answer 30

orthostatic hypotension

Question 31

A score of ___ on the mini mental state exam may indicate some sort of cognitive impairment. ______ may also interfere with the ability to learn

Answer 31

24; depression

Question 32

Cognitive impairments are only seen in ____ ____ ____ amputees

Answer 32

peripheral vascular disease

Question 33

which movements are usually harder than anticipated for amputees

Answer 33

bed mobility, supine to sit, and sit to stand

Question 34

____ health is important as ambulation with a prosthesis can be challenin

Answer 34

back

Question 35

assess pelvic alignment against (vertical/horizontal)

Answer 35

horizontal