A patient is recovering from a below-the-knee amputation. For ...

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A patient is recovering from a below-the-knee amputation. For which complications should the nurse assess this patient?
 
  Select all that apply.
  1. diabetes mellitus
  2. phantom pain
  3. infection
  4. chronic stump pain
  5. contractures

Question 2

The nurse has identified that a patient recovering from an above-the-knee amputation has a problem with pain control. Which nursing interventions would be beneficial for this patient?
 
  Select all that apply.
  1. administering analgesics before pain reaches a higher level
  2. splinting and supporting the injured area
  3. elevating the stump on three pillows
  4. encouraging deep breathing and relaxation exercises
  5. repositioning the patient every 8 hours

[Moriaki]

Answer to Question 1

Correct Answer: 2, 3, 4, 5

Phantom limb pain more frequently affects people who had pain in the amputated limb prior to its removal than those who did not. A patient who experiences a traumatic amputation has a greater risk of infection than the person who has a planned amputation. However, even planned amputations carry a risk of infection. Chronic stump pain is the result of neuroma formation. A contracture is an abnormal flexion and fixation of a joint caused by muscle atrophy and shortening. Contracture of the joint above the amputation is a common complication. Diabetes mellitus is not a complication of a below-the-knee amputation.

Answer to Question 2

Correct Answer: 1, 2, 4

Analgesics alleviate pain by stimulating opiate receptor sites. Giving pain medication when the pain is rated at a lower level allows for more effective pain management. Splinting prevents additional injury by immobilizing the stump and reducing edema while molding the stump for a good prosthetic fit. Deep breathing and relaxation will increase the effectiveness of analgesics and modify the pain experience. Elevating the stump can increase the risk for hip contractures. The patient should be repositioned every 2 hours to prevent muscle cramping and prolonged pressure on any area.