Podcast
Questions and Answers
Which of the following strategies is most important for a patient with diabetes mellitus to prevent the need for amputation?
Which of the following strategies is most important for a patient with diabetes mellitus to prevent the need for amputation?
- Strict adherence to a high-protein diet.
- Avoiding all forms of weight-bearing activities.
- Maintaining controlled blood glucose levels and practicing good foot care. (correct)
- Engaging in high-intensity exercise to improve circulation.
A patient reports burning pain after an amputation. Which medication would be most appropriate?
A patient reports burning pain after an amputation. Which medication would be most appropriate?
- Beta Blockers (correct)
- Opioid analgesics
- NSAIDs
- Muscle Relaxants
What is the primary purpose of using elastic or pressure bandages after an amputation?
What is the primary purpose of using elastic or pressure bandages after an amputation?
- To allow the wound to drain freely
- To increase blood flow to the residual limb.
- To prevent infection by creating a sterile barrier.
- To promote wound healing and shape the residual limb for prosthetic fitting. (correct)
A nurse is caring for a post-operative amputation patient. Which intervention is crucial in the first 24 hours?
A nurse is caring for a post-operative amputation patient. Which intervention is crucial in the first 24 hours?
A patient awaiting a below-knee amputation expresses significant anxiety. Which nursing intervention is most appropriate?
A patient awaiting a below-knee amputation expresses significant anxiety. Which nursing intervention is most appropriate?
A patient is diagnosed with a herniated disc. What is the underlying mechanism causing nerve irritation?
A patient is diagnosed with a herniated disc. What is the underlying mechanism causing nerve irritation?
A 45-year-old patient with a history of manual labor presents with symptoms of a herniated disc. Besides age, which factor most likely contributed?
A 45-year-old patient with a history of manual labor presents with symptoms of a herniated disc. Besides age, which factor most likely contributed?
Which treatment approach should be tried before surgical intervention for a patient with a herniated disc?
Which treatment approach should be tried before surgical intervention for a patient with a herniated disc?
A patient is scheduled for a discectomy. What is the primary goal of this surgical procedure?
A patient is scheduled for a discectomy. What is the primary goal of this surgical procedure?
Following a laminectomy, what is the most important nursing intervention?
Following a laminectomy, what is the most important nursing intervention?
Flashcards
Amputation
Amputation
Surgical removal of a limb or part of a limb due to injury, disease, or surgery.
Infection (Amputation)
Infection (Amputation)
Infection risk requiring prophylactic antibiotics and aseptic dressing changes post-amputation.
Phantom Pain
Phantom Pain
A type of pain felt in the area where a limb has been amputated.
Bleeding/Decreased Perfusion (Amputation)
Bleeding/Decreased Perfusion (Amputation)
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Contractures (Amputation)
Contractures (Amputation)
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Herniated Disc
Herniated Disc
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Herniated Disc Risk Factors
Herniated Disc Risk Factors
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Herniated Disc Prevention
Herniated Disc Prevention
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Herniated Disc Meds
Herniated Disc Meds
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Herniated Disc Surgery
Herniated Disc Surgery
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Study Notes
Amputations: Risk Factors
- Peripheral Vascular Disease, Diabetes Mellitus and Trauma may lead to amputation.
- Other causes include Thermal/Frostbite, Malignancies and Osteomyelitis
Health Promotion and Prevention for Amputations
- Maintaining controlled blood sugars can help prevent amputation
- Good foot care can help prevent amputation
- Taking care around heavy machinery
- Controlling infected wounds
Common Amputations
- Above Knee Amputation: AKA
- Below Knee Amputation: BKA
- Hip disarticulation
- Trans-metatarsal-Toe Amputation
Amputations: Collaborative Treatment & Complications
- The risk of infection can be mitigated with prophylactic antibiotics and aseptic dressing changes.
- Pain may be treated with pain medication and elastic/pressure bandages
- Beta Blockers can assist in decreasing phantom burning pain
- Antiepileptics like gabapentin decrease sharp, stabbing, burning phantom pain
- Validate the pain
- Encourage Massage and relaxation
- Monitor lab values and be aware of signs of decreased perfusion and bleeding
- Assess dressings and proximal pulses, and skin every 2 hours
- Reposition the patient but avoid elevation after the first 24 hours to prevent contractures
- Encourage Physical Therapy, particularly IPOP (Immediate Post-Op Prosthesis)
- IPOP promotes knee extension
- Prepare the site and patient for a prosthetic
- Allow patient to verbalize feelings, encourage Support groups, and Rehabilitation services like Prosthetics/Orthotics
- Most prosthetics will be fitted after the initial wound heals
Herniated Discs
- Spinal disk ruptures may allow fluid in the disk to leak out and irritate nearby nerves
Herniated Discs: Risk Factors
- Middle-age (Ages 30-50)
- Genetics
- Occupation
- Weight/obesity
Herniated Discs: Teaching to Decrease Risk
- Stretching exercises
- Proper ergonomics
- Weight loss
Herniated Discs: Treatment Options
- Acupuncture, Massage and Yoga may help resolve a herniated disk
- Chiropractic care and Heat and cold therapies are also helpful
- Medications might include: NSAIDs, Cortisone Injections and Neuropathic pain relievers like gabapentin and pregabalin
- Surgery, including Laminectomy, Discectomy, and Fusion, are options after lifestyle modifications have been tried
Herniated Discs: Post-operative Care
- Medicate with ordered pain medication
- Physical Therapy with Frequent ambulation aids recovery
- Log roll to turn in bed, do not twist back
- Do not pull self up in bed with side-rails
- Monitor for urinary retention or signs of spinal cord swelling
- Monitor for signs of Surgical site issues like hematoma, leaking CSF, and infection
- Watch for Skin breakdown and Respiratory complications
- Teach patients to Prevent heavy lifting and Prevent bending at the waist
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Description
Overview of amputation causes, including PVD, diabetes, and trauma. Preventative measures include blood sugar control and foot care. Collaborative treatments focus on infection control, pain management (pharmaceutical and non-pharmaceutical), and emotional support.
