1. The client/caregiver can list measures to promote comfort.
   1. Pain medications as ordered
   2. Compression dressing to stump as instructed
   3. Massage therapy when allowed
   4. Relaxation methods
2. The client/caregiver can state measures for postoperative care of the residual limb.
   1. Daily hygiene to prevent infection and skin breakdown. Cleanse residual limb daily with soap and water. Dry well, and expose to air for 20 minutes.
   2. Inspect skin daily. If needed, use a hand-held mirror to check the site.
   3. Signs of infection to report to physician or nurse are
      • Fever or chills
      • Increased discomfort of the extremity
      • Redness, swelling around incision
      • Drainage increase or foul odor of drainage from the incision line
   4. Avoid use of powder, creams, or lotion on the incision site.
   5. Apply compression dressing as instructed to prevent swelling and aid in molding the shape of the residual limb.
   6. Review concept of phantom pain in the missing limb.
3. The client/caregiver can state measures to manage the use of the prosthesis limb.
   1. Explain the use of elastic sleeves or socks after molding is complete.
      • Change and wash daily.
      • Assure a smooth fit and avoid wrinkles.
   2. Wash the socket of the prosthesis with mild soap and water. Dry completely before use.
   3. Follow complete instructions from the prosthetist and have contact numbers in the event of problems.
   4. Discontinue use of prosthesis if skin becomes irritated, and contact physician.
   5. See a prosthetist if experiencing any problems with the prosthesis.
   6. Monitor for signs of bleeding, irritation, pressure areas, or infection.
4. The client follows exercises and the activity as prescribed.
   1. Attends rehabilitation program for
      • Physical and occupational therapy
      • Conditioning
      • Residual limb exercises
      • Exercise to unaffected joints and extremities
   2. Evaluate the need for assistive devices for bathing, toileting, or dressing.
   3. Review safe transfer techniques and the use of mobility aids, such as cane, walker, crutches, and so forth.
   4. Evaluate the home environment for safety.
5. The client/caregiver can list possible complications of amputation.
   1. Wound infection
   2. Skin breakdown from prosthesis irritation
   3. Phantom pain
   4. Contracture of the limb
   5. Abduction deformity

Resources

National Amputation Foundation
212-767-0596
www.nationalamputation.org

Physical and occupational therapy

Support groups

Clergy/counseling

Vocational counseling

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. St. Louis: Mosby Inc.
Canobbio, M. M. (2006). Mosby’s handbook of patient teaching. St. Louis: Mosby Inc.
Perry, A., & Potter, P. (2006). Clinical nursing skills & technique. St. Louis: Mosby Inc.
Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. LippincottWilliams & Wilkins.