The nurse is caring for a patient who underwent a below-the-knee amputation. What is the primary purpose of positioning the residual limb in a flexed position?
To prevent contractures
To promote venous return
To reduce edema
To facilitate wound healing
The Correct Answer is A
The primary purpose of positioning the residual limb in a flexed position after a below-the-knee amputation is to prevent contractures. Contractures are abnormal shortening and tightening of muscles and tendons, leading to restricted joint movement. Maintaining the limb in a flexed position helps prevent contractures and ensures optimal prosthetic fitting and functional outcomes.
b. To promote venous return: While positioning the limb in a flexed position may have some impact on venous return, it is not the primary purpose of this positioning. Elevating the limb on a pillow is more effective for promoting venous return.
c. To reduce edema: Keeping the residual limb elevated on a pillow is the preferred method for reducing edema in the immediate post-operative period, not positioning it in a flexed position.
d. To facilitate wound healing: Facilitating wound healing is not the primary purpose of positioning the residual limb in a flexed position. Proper wound care, dressing changes, and monitoring for signs of infection are essential for wound healing.
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Correct Answer is B
Explanation
Delayed wound healing is a common complication that may occur in the immediate post-operative period after amputation. Factors such as poor circulation, infection, or underlying health conditions can contribute to delayed healing of the surgical wound.
a. Phantom limb pain: Phantom limb pain is a sensation of pain, discomfort, or other sensations in the absent limb, but it is not typically an immediate post-operative complication. It may develop later as the nerve endings undergo reorganization.
c. Hypertrophic scarring: Hypertrophic scarring refers to excessive and raised scar tissue formation at the surgical site. While it can occur after amputation, it is not typically an immediate post-operative complication.
d. Contractures: Contractures are abnormal shortening and tightening of muscles and tendons, leading to restricted joint movement. While contractures can develop in the post-operative period, they are not usually immediate complications.
Correct Answer is B
Explanation
Encouraging the patient to perform active range of motion exercises is important to promote muscle strength and flexibility in the residual limb after a below-the-elbow amputation. Active exercises engage the muscles and joints, preventing stiffness and maintaining function.
a. Lifting heavy weights with the residual limb: Lifting heavy weights with the residual limb may be contraindicated, especially in the immediate post-operative period, as it can strain the healing tissues and lead to injury.
c. Keeping the residual limb immobile: Keeping the residual limb immobile can lead to stiffness, weakness, and contractures. Active range of motion exercises are essential to maintain mobility and function.
d. Applying cold packs to the residual limb: Cold packs may be used for pain relief or to reduce swelling in the immediate post-operative period, but they are not specifically aimed at promoting muscle strength and flexibility in the residual limb. Active exercises are more appropriate for this purpose.
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