Patient With An Amputation
Is the removal of a body part, and most commonly a limb
(Cheever & Hinkle, 2013).
Used to relieve symptoms, improve functions and to save or
improve the patient’s quality of life (Cheever & Hinkle, 2013). Can be elective due to complications of the vascular disease often of diabetes. ex. Gangrene, trauma (burns, crushing
injury, electrical burns, frostbite, explosions)
Vascular disease accounts for 82% of all amputations with
97% results in lower limb amputations. This is called
Men and African-Americans are at a higher risk for dysvascular amputations and the risk increases with age
Upper limb amputations occurs less frequently compared to lower limb amputation and happens due to trauma or malignant tumors
Objective of the surgery is to conserve as much limb length as possible to function with or without prosthesis and preservation of knee and elbow joints are always desirable, if possible.
Two key components of the body that is significant in healing are muscle and tissue perfusion. Caregivers assess this by physical examination and diagnostic tools such as: Doppler flow studies with duplex ultrasound, segmental blood pressure determinations, and transcutaneous partial pressure of arterial oxygen.
It is also performed at the distal point of a limb that will heal successfully.
Levels of Amputation
The site of amputation is determined by two factors:
adequate blood supply for healing and functional
usefulness for prosthesis compatibility.
Amputations are described in regards to the extremity
and its location.
AE- above elbow BE- below elbow
AK/A- above knee BK/A- below knee
Syme- ankle disarticulation (amputation through the
Disarticulation- amputation through a joint
Hemorrhage or massive bleeding
Infection (always a risk with any surgical
Skin breakdown (irritation with prosthesis
Phantom limb pain due to severed
Joint contractures (cause by positioning
and protective flexion withdrawal pattern)
History and physical assessment
Assess the function & condition of the residual
limb if pt experienced a traumatic amputation
(ex. Motorcycle crash that resulted in
Assess the circulatory and function of the
Collection of culture and sensitivity samples to
determine the choice of antibiotic to use in case
if an infection occurs
Nursing Assessments and Actions cont.
Identification and treatment of any
concurrent health problems (ex. Anemia,
dehydration, diabetes) –for patient to
withstand surgical procedure.
Psychological and emotional assessment of
patient (if patient is aware and ready for the
Assess patient’s nutritional status (high
protein diet is essential for recovery and
Acute pain r/t amputation
Impaired skin integrity r/t surgical amputation
Distributed body image r/t amputation
Grieving and/or risk for complicated grieving
r/t loss of body part and resulting disability
Self-care deficit: feeding, bathing, dressing,
toileting, r/t amputation
Impaired physical mobility r/t amputation
Planning and Goals
Altered body image acceptance
Grieving process resolution
Physical mobility restoration
Absence of complications
Relieving pain (ex. Phantom pain)
Surgical pain can be effectively controlled by
Position change can improve client’s comfort
Medications: Opioid analgesics, beta blocker (for
dull & burning discomfort), anti-seizure
medications (for controlling stabbing and
cramping pain), Tricyclic antidepressants (for
Promoting Wound Healing
Residual limb must be handled gently to prevent infection and...
Please join StudyMode to read the full document