Amputation

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Question 1:

Which of the following statements best describes amputation?

Explanation

: Amputation is the surgical removal of a limb or body part due to injury, disease, or medical necessity. It involves cutting through bones, muscles, and other tissues to remove the affected limb or body part.

a. A surgical procedure to repair damaged bones and tissues: This statement is incorrect. Amputation involves the removal of a limb or body part rather than repairing damaged bones and tissues.

c. A procedure to treat joint diseases and improve mobility: While amputation may improve mobility in certain cases, it is not primarily used to treat joint diseases. Joint diseases are usually managed through other treatment modalities.

d. The transplantation of a healthy limb from one person to another: This statement is incorrect. Amputation does not involve the transplantation of a healthy limb from one person to another. It is the removal of an affected limb or body part from the same individual.


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Question 2:

Which of the following is a common indication for amputation?

Explanation

Peripheral vascular disease, which involves decreased blood flow to the extremities, is a common indication for amputation. In severe cases, where blood flow cannot be restored, amputation may be necessary to prevent further complications.

a. Chronic low back pain: Chronic low back pain is not an indication for amputation. It is usually managed through conservative treatments such as physical therapy, medications, or injections.

b. Osteoarthritis of the knee: Osteoarthritis of the knee may cause pain and mobility issues, but it does not typically lead to amputation. Treatment for osteoarthritis includes pain management, physical therapy, and, in some cases, joint replacement surgery.

d. Minor soft tissue injury: Minor soft tissue injuries do not require amputation. They are usually treated with wound care, rest, and possibly antibiotics if there is an infection.


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Question 3:

What is an essential consideration in the decision-making process for amputation?

Explanation

The decision for amputation is complex and takes into account the patient's overall health status, goals, and preferences. Factors such as the extent of the disease or injury, the potential for rehabilitation, and the impact on the patient's quality of life are considered when determining the most appropriate treatment plan.

a. Patient's age and gender: While age and gender may be factors in the decision-making process, they are not the primary consideration for amputation. Each patient's case is evaluated individually based on their specific circumstances.

b. Healthcare provider's preference: The healthcare provider's preference alone does not dictate the decision for amputation. The decision should be made collaboratively between the patient, the healthcare team, and other specialists as needed.

d. Availability of advanced medical technology: While medical technology can play a role in the treatment and rehabilitation of amputees, it is not the primary consideration in the decision for amputation. The decision is primarily based on the patient's health and overall well-being.


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Question 4:

What is the primary goal of rehabilitation after amputation?

Explanation

The primary goal of rehabilitation after amputation is to help the patient achieve the highest level of mobility and independence possible with the use of assistive devices and prosthetics. While rehabilitation can improve function and quality of life, it may not fully restore the limb to its pre-amputation function.

a. To restore the limb to its pre-amputation function: While rehabilitation aims to improve function, restoring the limb to its pre-amputation function is not always feasible. Amputation involves the permanent removal of a limb or body part, and some limitations may persist.

b. To minimize the use of assistive devices: While rehabilitation may help the patient adapt to using assistive devices, the goal is not necessarily to minimize their use. Assistive devices can greatly improve mobility and independence for amputees.

d. To eliminate all residual pain and discomfort: While rehabilitation can help manage pain and discomfort, eliminating all residual pain is not always achievable. The goal is to optimize the patient's function and well-being while addressing pain and discomfort as effectively as possible.


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Question 5:

Which healthcare team member plays a critical role in the post-operative rehabilitation process for a patient who has undergone amputation?

Explanation

A physical therapist plays a critical role in the post-operative rehabilitation process for a patient who has undergone amputation. They work closely with the patient to help improve strength, mobility, and function, and assist them in adapting to the use of assistive devices and prosthetics.

a. Surgeon: The surgeon performs the amputation surgery but is not directly involved in post-operative rehabilitation. Their role is to ensure a safe and successful surgical procedure.

b. Anesthesiologist: The anesthesiologist is responsible for administering anesthesia during the surgery and ensuring the patient's comfort and safety. They are not directly involved in post-operative rehabilitation.

d. Radiologic technologist: Radiologic technologists perform medical imaging procedures but are not involved in the rehabilitation process for patients who have undergone amputation.


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Question 6:

Which of the following is a common indication for amputation?

Explanation

Peripheral vascular disease, which involves decreased blood flow to the extremities, is a common indication for amputation. In severe cases, where blood flow cannot be restored, amputation may be necessary to prevent further complications. It is important to address the underlying vascular issues to avoid the risk of gangrene and potential spread of infection.

a. Chronic low back pain: Chronic low back pain is not an indication for amputation. It is usually managed through conservative treatments such as physical therapy, medications, or injections.
b. Osteoarthritis of the knee: Osteoarthritis of the knee may cause pain and mobility issues, but it does not typically lead to amputation. Treatment for osteoarthritis includes pain management, physical therapy, and, in some cases, joint replacement surgery.
d. Minor soft tissue injury: Minor soft tissue injuries do not require amputation. They are usually treated with wound care, rest, and possibly antibiotics if there is an infection.


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Question 7:

Which of the following conditions may require amputation to prevent the spread of infection and tissue damage?

Explanation

Acute osteomyelitis is a severe bacterial infection of the bone that can lead to tissue damage and the spread of infection if not promptly treated. In some cases, when antibiotic therapy is not effective or the infection is severe, amputation may be considered to remove the infected bone and prevent further complications.

a. Severe joint pain: Severe joint pain may be caused by various conditions, but it is not an indication for amputation. Treatment for joint pain involves identifying and managing the underlying cause.
b. Chronic osteoporosis: Osteoporosis is a condition characterized by weakened bones, but it does not typically lead to amputation. Treatment for osteoporosis focuses on preventing fractures and improving bone density through medication and lifestyle modifications.
d. Muscle strain: Muscle strains are common injuries that do not require amputation. They can usually be managed with rest, ice, compression, and elevation (RICE) and physical therapy.


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Question 8:

In which situation would amputation be considered as a lifesaving measure?

Explanation

In severe cases of diabetic neuropathy, where peripheral nerve damage leads to non-healing ulcers, infections, and gangrene, amputation may be considered as a lifesaving measure. Removing the affected limb can prevent the spread of infection and potentially save the patient's life.

b. Chronic obstructive pulmonary disease (COPD): COPD is a chronic respiratory condition that primarily affects the lungs. It is not an indication for amputation.
c. Bone fracture with non-union: A bone fracture with non-union refers to a fracture that fails to heal properly. While it may require surgical intervention, it does not typically lead to amputation unless there are severe complications.
d. Malignant bone tumor: Malignant bone tumors may require surgical resection, but amputation is usually a last resort and only considered when the tumor cannot be safely removed through other means.


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Question 9:

What condition might lead to the need for an emergency amputation to save a patient's life?

Explanation

Acute compartment syndrome is a medical emergency where increased pressure within a muscle compartment compromises blood flow and can lead to tissue damage and permanent disability. In severe cases, where the condition is not relieved promptly, emergency amputation may be necessary to prevent further tissue damage and save the patient's life.

a. Acute appendicitis: Acute appendicitis is a condition involving inflammation of the appendix and typically requires surgical removal of the appendix (appendectomy) but not amputation.
c. Urinary tract infection: A urinary tract infection is a common infection that is not an indication for amputation. It is usually treated with antibiotics.
d. Minor laceration: A minor laceration does not require amputation. It can typically be treated with wound care and, if needed, sutures or adhesive strips.


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Question 10:

What is a potential pre-operative complication that may occur in a patient scheduled for amputation?

Explanation

Infection at the amputation site is a potential pre-operative complication that may occur before the actual surgery. The presence of infection at the surgical site can increase the risk of post-operative complications, delay the surgery, and affect wound healing. Proper pre-operative assessment and management of infections are crucial to ensure a successful amputation procedure.

b. Post-operative pain management: Post-operative pain management is a consideration after the surgery, not a pre-operative complication. It involves planning for pain relief strategies to provide comfort and promote healing after the amputation.
c. Surgical wound dehiscence: Surgical wound dehiscence refers to the separation or opening of the surgical wound, which can occur after the surgery, not before. Proper wound care and surgical techniques are essential to prevent wound dehiscence.
d. Prosthetic fitting and training: Prosthetic fitting and training are part of the post-operative care, not pre-operative complications. After the amputation, the patient will be evaluated for the appropriate prosthetic device, and training will be provided to adapt to using it effectively.


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Question 11:

Which pre-operative intervention is essential to prevent potential complications in a patient scheduled for amputation?

Explanation

Assessing the patient's psychological readiness for surgery is essential to prevent potential complications in a patient scheduled for amputation. Pre-operative anxiety, fear, or emotional distress can impact the patient's overall well-being and affect their post-operative recovery. Identifying and addressing these concerns before the surgery is crucial to promote a positive surgical experience and improve outcomes.

a. Performing active range of motion exercises on the affected limb: While range of motion exercises may be beneficial in certain cases, this intervention is not specific to preventing pre-operative complications. Pre-operative exercises may be recommended in some cases to improve overall limb function, but they are not directly related to preventing complications.
b. Administering post-operative pain medications: Administering post-operative pain medications is a consideration after the surgery, not a pre-operative intervention. Pain management strategies are planned and implemented to address pain after the amputation.
d. Educating the patient about post-operative care and rehabilitation: Patient education about post-operative care and rehabilitation is vital, but it is not a pre-operative intervention to prevent complications. This education takes place before and after the surgery to prepare the patient for the recovery process.


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Question 12:

Which of the following pre-operative assessments is essential for a patient scheduled for amputation?

Explanation

Circulation assessment of the affected limb is essential for a patient scheduled for amputation. This assessment helps identify any vascular issues or compromised blood flow to the limb, which can impact wound healing and increase the risk of post-operative complications. It is crucial to assess circulation to ensure the patient's safety during and after the amputation procedure.

a. Blood pressure measurement: While blood pressure measurement is a routine assessment, it is not specific to amputation and not directly related to preventing pre-operative complications.
b. Assessment of respiratory rate: Respiratory rate assessment is important for general health assessment, but it is not directly related to preventing complications specifically related to amputation.
d. Height and weight measurement: Height and weight measurement are important for general health assessment, but they are not directly related to preventing complications specifically related to amputation.


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Question 13:

What pre-operative intervention is essential to prevent post-operative infection in a patient undergoing amputation?

Explanation

Administering pre-operative antibiotics is essential to prevent post-operative infection in a patient undergoing amputation. Prophylactic antibiotics are often given before the surgical procedure to reduce the risk of infection at the surgical site and promote successful wound healing.

b. Providing pre-operative analgesia: Providing pre-operative analgesia is important for pain management, but it is not directly related to preventing post-operative infection.
c. Ensuring proper patient positioning: Ensuring proper patient positioning is crucial for the surgical procedure's success and patient safety, but it is not directly related to preventing post-operative infection.
d. Educating the patient about post-operative exercises: Patient education about post-operative exercises is important for rehabilitation, but it does not directly prevent post-operative infection. Proper wound care and infection prevention protocols are more relevant to reducing the risk of infection.


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Question 14:

Why is it important to identify pre-existing medical conditions and allergies in a patient scheduled for amputation?

Explanation

Identifying pre-existing medical conditions and allergies is essential to assess the risk of post-operative infection and complications in a patient scheduled for amputation. Certain medical conditions and allergies can impact wound healing and increase the risk of surgical complications. By knowing the patient's medical history and allergies, the healthcare team can take appropriate measures to prevent potential problems and improve the patient's overall surgical outcome.

a. To determine the patient's ability to perform post-operative exercises: While identifying pre-existing conditions may provide some insight into the patient's functional abilities, it is not the primary reason for identifying medical conditions and allergies in this context.
b. To identify potential complications during the surgical procedure: Identifying pre-existing conditions is not primarily for identifying potential complications during the surgery itself. Pre-operative assessments and evaluations are conducted to ensure the patient's safety during the surgical procedure.
c. To tailor the prosthetic fitting and training: Identifying pre-existing conditions and allergies can be relevant for prosthetic fitting and training, but it is not the primary reason for identifying them.


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Question 15:

Which surgical technique is commonly used for below-the-knee amputations?

Explanation

Transmetatarsal amputation involves the surgical removal of the forefoot and toes while preserving the heel and ankle joint. It is commonly used for below-the-knee amputations, specifically for conditions that affect the toes and forefoot but spare the ankle joint.

a. Hip disarticulation: Hip disarticulation is a higher-level amputation that involves the removal of the entire lower limb at the hip joint. It is not commonly used for below-the-knee amputations.
c. Above-the-knee amputation: Above-the-knee amputation involves the removal of the entire lower limb above the knee joint. It is not used for below-the-knee amputations.
d. Syme amputation: Syme amputation involves the removal of the foot at the ankle joint while preserving the heel pad. It is used for specific conditions affecting the foot and ankle joint but is not a common choice for below-the-knee amputations.


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Question 16:

: What is the primary goal of surgical amputation?

Explanation

The primary goal of surgical amputation is to remove the diseased or damaged tissue to promote healing and prevent the spread of infection. While pain relief and restoration of function are important considerations, the main purpose of amputation is to address the underlying condition and improve the patient's overall health and well-being.

a. To eliminate all pain and discomfort in the affected limb: While pain relief is a desired outcome of amputation, it is not always possible to eliminate all pain and discomfort. The goal is to manage pain effectively and improve the patient's quality of life.
b. To restore full function and mobility of the limb: Restoring full function and mobility may not always be achievable after amputation. The extent of functional restoration depends on various factors, including the level of amputation and the patient's overall health.
c. To achieve the most cosmetically appealing result: While achieving a cosmetically appealing result may be important for some patients, it is not the primary goal of amputation. The focus is on medical necessity and addressing the underlying condition.


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Question 17:

During an amputation procedure, which structure is typically left intact to facilitate prosthetic fitting?

Explanation

During an amputation procedure, the bone stump is typically left intact to provide a stable base for prosthetic fitting. The muscles, nerves, and tendons are carefully dissected and secured to prevent complications and facilitate healing.

a. Muscles: While muscles are involved in the surgical procedure, they are typically resected to the appropriate level to accommodate the prosthetic device.
b. Nerves: Nerves are carefully dissected and secured during the amputation procedure to prevent neuromas and phantom limb pain but are not left intact for prosthetic fitting.
c. Tendons: Tendons are typically resected during the amputation procedure, and their positioning and attachment are crucial for proper wound closure and healing, but they are not left intact for prosthetic fitting.


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Question 18:

Which surgical technique involves the removal of a limb at the joint level?

Explanation

Hip disarticulation involves the removal of the entire lower limb at the hip joint. This surgical technique is indicated for severe disease or trauma affecting the entire lower limb, where preservation of the knee joint is not feasible or beneficial.

b. Knee disarticulation: Knee disarticulation involves the removal of the lower limb at the knee joint. It is a different level of amputation compared to hip disarticulation.
c. Transfemoral amputation: Transfemoral amputation is the removal of the lower limb above the knee joint, preserving the femur. It is a different level of amputation compared to hip disarticulation.
d. Transtibial amputation: Transtibial amputation involves the removal of the lower limb below the knee joint, preserving the tibia. It is a different level of amputation compared to hip disarticulation.


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Question 19:

During a below-the-knee amputation, what is the primary focus of the surgical technique?

Explanation

During a below-the-knee amputation, the primary focus of the surgical technique is to preserve the ankle joint whenever possible. This allows for better functional outcomes and facilitates the use of a prosthetic device.

b. Removing all muscles from the affected limb: While some muscle tissue is removed during amputation, the goal is not to remove all muscles. Some muscles are retained to provide coverage over the bone stump and to facilitate prosthetic fitting.
c. Creating a cosmetic incision line: While cosmetic considerations may be taken into account, the primary focus of the surgical technique is not solely on creating a cosmetic incision line. The incision is made to ensure appropriate tissue healing and to prevent complications.
d. Resecting the tibia and fibula bones: In a below-the-knee amputation, the tibia and fibula bones are typically resected to the appropriate level to accommodate the prosthetic device, but the primary focus is on preserving the ankle joint when possible.


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Question 20:

What is the priority nursing intervention in the immediate post-operative period for a patient who has undergone amputation?

Explanation

The priority nursing intervention in the immediate post-operative period for a patient who has undergone amputation is to assess the surgical incision for signs of infection. Infection is a common concern after surgery, and early detection and intervention are crucial to prevent complications and promote healing.

a. Administering pain medications as prescribed: Pain management is important for the patient's comfort and well-being, but it is not the priority nursing intervention immediately after amputation. Assessing the surgical incision for signs of infection takes precedence to prevent potential complications.
c. Applying a compression bandage to the residual limb: While compression bandages may be used as part of the post-operative care, they are not the priority intervention immediately after amputation. Ensuring the surgical site's integrity and preventing infection are more critical in the early post-operative period.
d. Providing emotional support and counseling: Emotional support and counseling are essential for the patient's overall well-being, but they are not the priority nursing intervention in the immediate post-operative period. The focus at this time is on physical assessment and early detection of any complications.


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Question 21:

What is the purpose of elevation in the post-operative care of a patient with a lower extremity amputation?

Explanation

The purpose of elevation in the post-operative care of a patient with a lower extremity amputation is to promote venous return and reduce swelling. Elevating the residual limb helps to decrease edema and improve blood flow, which can enhance healing and prevent complications such as deep vein thrombosis.

b. To improve the patient's comfort and relaxation: While elevation may improve the patient's comfort, the primary purpose is to address physiological concerns related to venous return and swelling.
c. To encourage early ambulation and mobility: Ambulation and mobility are essential components of post-operative care, but the specific purpose of elevation is not related to encouraging early ambulation.
d. To protect the surgical incision from contamination: While protecting the surgical incision is important, elevation is not the primary method for this purpose. Dressings and wound care techniques are used to protect the surgical site from contamination.


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Question 22:

What is the appropriate method of positioning the residual limb in the post-operative period for a patient who underwent a below-the-knee amputation?

Explanation

The appropriate method of positioning the residual limb in the post-operative period for a patient who underwent a below-the-knee amputation is to elevate the residual limb on a pillow. Elevating the limb helps reduce swelling and promotes venous return, which can enhance healing and prevent complications.

a. Keep the residual limb in a dependent position: Keeping the residual limb in a dependent position (hanging down) can impede venous return and increase swelling. It is not the recommended position for post-operative care.
b. Maintain the residual limb in a flexed position: Keeping the residual limb in a flexed position may increase pressure on the surgical site and hinder proper wound healing. A flexed position is not the recommended post-operative positioning for the residual limb.
d. Keep the residual limb in a neutral, flat position: While keeping the residual limb in a neutral, flat position is generally recommended for some post-operative care, elevating the limb on a pillow is preferred in the immediate post-operative period for below-the-knee amputation to reduce swelling and promote healing.


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Question 23:

What is the primary goal of wound care in the post-operative period for a patient who underwent amputation?

Explanation

The primary goal of wound care in the post-operative period for a patient who underwent amputation is to promote tissue regeneration and wound healing. Proper wound care techniques, including dressing changes, are essential to create an optimal environment for healing and prevent infection.

a. Preventing pressure ulcers and skin breakdown: While pressure ulcers and skin breakdown are important considerations in post-operative care, they are not the primary goal of wound care specifically for amputation.
c. Removing all dressings to allow for air exposure: Dressings are typically used to protect the surgical site and promote healing by creating a moist wound environment. Removing all dressings for air exposure is not recommended as it can impede wound healing.
d. Applying topical antibiotics to the surgical site: While topical antibiotics may be used if there is an infection or as directed by the healthcare provider, applying them to the surgical site without proper indication can lead to antibiotic resistance and is not the primary goal of wound care for amputation.


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Question 24:

Why is meticulous monitoring of wound drainage important in the post-operative care of a patient who underwent amputation?

Explanation

Meticulous monitoring of wound drainage is important in the post-operative care of a patient who underwent amputation to assess for signs of infection. Excessive drainage, changes in color or odor, or the presence of pus may indicate an infection at the surgical site, and prompt intervention is essential to prevent complications.

b. To determine the need for wound irrigation: While wound irrigation may be part of wound care, monitoring wound drainage is primarily to assess for signs of infection, not to determine the need for wound irrigation.
c. To prevent pressure ulcers and skin breakdown: Monitoring wound drainage is not directly related to preventing pressure ulcers and skin breakdown. Preventing pressure ulcers involves measures such as repositioning and proper support surfaces.
d. To evaluate the effectiveness of pain management: Monitoring wound drainage does not directly evaluate the effectiveness of pain management. Pain management is assessed separately through communication with the patient and observation of their pain levels and response to interventions.


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Question 25:

What is a potential complication of amputation that may occur in the immediate post-operative period?

Explanation

Delayed wound healing is a potential complication that may occur in the immediate post-operative period following 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.


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Question 26:

What is the primary purpose of a follow-up visit for a patient who underwent amputation?

Explanation

The primary purpose of a follow-up visit for a patient who underwent amputation is to adjust the prosthetic fitting and alignment. Prosthetic devices need to be customized and aligned correctly to ensure the patient's optimal mobility and function.

a. To assess for surgical wound dehiscence: While wound assessment is essential, it is not the primary purpose of a follow-up visit. Wound dehiscence, if present, would typically be detected earlier and addressed during the immediate post-operative period.
b. To provide emotional support and counseling: Emotional support and counseling are essential aspects of care for a patient who underwent amputation, but they are not the primary purpose of a follow-up visit, which focuses on the prosthetic fitting and functional outcomes.
d. To initiate post-operative physical therapy: Post-operative physical therapy may be initiated during the rehabilitation process, but it is not typically the primary purpose of a follow-up visit. Initial physical therapy sessions may begin earlier, often shortly after the amputation surgery.


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Question 27:

Which complication of amputation may result in the need for revision surgery?

Explanation

A non-healing surgical wound is a significant complication of amputation that may require revision surgery. Revision surgery involves re-intervention on the surgical site to address wound healing issues and promote better outcomes.

a. Phantom limb sensation: Phantom limb sensation is a common experience after amputation but does not typically require revision surgery. It is a neurological phenomenon related to the brain's perception of the missing limb.
b. Skin breakdown and pressure ulcers: Skin breakdown and pressure ulcers can occur around the residual limb due to pressure and friction from the prosthetic device. While they require attention and management, they may not always necessitate revision surgery.
c. Infection at the surgical site: Infection at the surgical site is a serious complication, but it is typically managed with appropriate antimicrobial therapy and wound care. In some cases, infection may lead to revision surgery, but it is not an automatic indication.


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Question 28:

Which assessment finding indicates a possible complication of a below-the-knee amputation?

Explanation

Increased swelling and bruising of the residual limb after a below-the-knee amputation may indicate a possible complication such as hematoma formation or poor wound healing. It requires further assessment and intervention by the healthcare team.

b. Mild tenderness and discomfort at the surgical site: Mild tenderness and discomfort are common after surgery and may be expected in the post-operative period. As long as the pain is manageable and not worsening, it is not necessarily an indication of a significant complication.
c. Gradual decrease in phantom limb pain over time: Phantom limb pain may gradually decrease over time as the nerve endings adapt to the amputation, and the brain's perception of the missing limb changes. This finding is a normal part of the post-amputation process and is not typically a complication.
d. Resumption of normal daily activities with a prosthetic limb: Resuming normal daily activities with a prosthetic limb is a positive outcome and a sign of successful rehabilitation and adaptation to the prosthesis. It is not indicative of a complication.


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Question 29:

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?

Explanation

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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Question 30:

: The nurse is providing education to a patient who will undergo an upper extremity amputation. What should the nurse emphasize as the priority nursing intervention in the immediate post-operative period?

Explanation

The priority nursing intervention in the immediate post-operative period after an upper extremity amputation is to assess the surgical incision for infection. Early detection of signs of infection, such as redness, swelling, warmth, or drainage, is crucial to prevent complications and promote healing.

a. Managing phantom limb pain: While managing phantom limb pain is important, it may not be the priority nursing intervention immediately after the surgery. Assessing the surgical incision for infection and monitoring for any complications take precedence.
b. Ensuring proper prosthetic fitting: Prosthetic fitting is essential for functional outcomes, but it may not be the priority in the immediate post-operative period. It is addressed during the rehabilitation phase.
c. Elevating the residual limb on a pillow: Elevating the residual limb on a pillow is typically recommended for lower extremity amputations to reduce edema and promote venous return, not for upper extremity amputations.


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Question 31:

Which nursing intervention is essential to prevent skin breakdown in a patient with a lower extremity amputation who is using a prosthetic device?

Explanation

Inspecting the skin under the prosthetic device daily is essential to prevent skin breakdown and pressure ulcers. Continuous pressure and friction from the prosthetic device can cause skin irritation and breakdown, and early detection allows for timely intervention and prevention of complications.

a. Applying a topical antibiotic to the residual limb daily: Applying a topical antibiotic daily is not recommended unless specifically prescribed by the healthcare provider for a wound or infection. Routine use of topical antibiotics can lead to antibiotic resistance.
b. Massaging the residual limb with lotion to improve circulation: Massaging the residual limb with lotion may be beneficial for comfort, but it is not a preventive measure for skin breakdown. Excessive massage can cause skin irritation.
d. Wearing a compression bandage over the prosthetic device: While compression bandages may be used as part of post-operative care, wearing a compression bandage over the prosthetic device is not a standard preventive measure for skin breakdown.


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Question 32:

The nurse is caring for a patient who underwent an above-the-knee amputation. What is the priority nursing intervention to prevent hip flexion contractures?

Explanation

The priority nursing intervention to prevent hip flexion contractures after an above-the-knee amputation is performing passive range of motion exercises to the hip joint. Contractures are abnormal shortening and tightening of muscles and tendons, leading to restricted joint movement. Passive range of motion exercises help maintain joint flexibility and prevent contractures.

b. Elevating the residual limb on a pillow: Elevating the residual limb on a pillow is more applicable for preventing swelling and edema, not specifically for preventing hip flexion contractures.
c. Administering analgesics as prescribed: While pain management is essential for the patient's comfort, it is not directly related to preventing hip flexion contractures.
d. Providing emotional support and counseling: Emotional support and counseling are important aspects of care but are not directly related to preventing hip flexion contractures.


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Question 33:

The nurse is caring for a patient who had a below-the-elbow amputation. Which activity should the nurse encourage the patient to perform during the post-operative period to promote muscle strength and flexibility in the residual limb?

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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Question 34:

Which nursing intervention is essential for preventing complications in the immediate post-operative period after amputation?

Explanation

Assessing the surgical incision for signs of infection is essential in the immediate post-operative period after amputation to detect any early signs of complications such as infection. Prompt identification and intervention can prevent further complications and promote healing.

a. Administering opioid pain medications regularly: While pain management is important after amputation, administering opioid pain medications regularly may lead to potential side effects and dependency. Pain medications should be given as needed and in response to the patient's pain level.

c. Encouraging the patient to perform active range of motion exercises: Active range of motion exercises may not be appropriate immediately after amputation due to wound healing and surgical site considerations. The focus in the immediate post-operative period is on wound care and monitoring.

d. Providing emotional support and counseling: Emotional support and counseling are essential for a patient who underwent amputation, but in the immediate post-operative period, the priority is on physical assessment and wound care.


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Question 35:

What is the primary goal of positioning the residual limb in the post-operative period after amputation?

Explanation

The primary goal of positioning the residual limb in the post-operative period after amputation is to promote venous return and reduce swelling. Elevating the limb helps improve blood flow and reduce edema, which can enhance healing and prevent complications.

b. To improve the patient's comfort and relaxation: While positioning may improve the patient's comfort, the primary goal is related to physiological considerations such as venous return and swelling reduction.
c. To encourage early ambulation and mobility: Early ambulation and mobility are important components of post-operative care, but the primary goal of positioning is not directly related to encouraging ambulation.
d. To protect the surgical incision from contamination: Positioning the residual limb is not primarily intended to protect the surgical incision from contamination. Dressings and wound care techniques are used for this purpose.


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Question 36:

What is the primary purpose of wound care in the post-operative period after amputation?

Explanation

The primary purpose of wound care in the post-operative period after amputation is to promote tissue regeneration and wound healing. Proper wound care techniques, including dressing changes, are essential to create an optimal environment for healing and prevent infection.

a. To prevent pressure ulcers and skin breakdown: While pressure ulcers and skin breakdown are important considerations in post-operative care, they are not the primary purpose of wound care specifically for amputation.
c. To remove all dressings to allow for air exposure: Dressings are typically used to protect the surgical site and promote healing by creating a moist wound environment. Removing all dressings for air exposure is not recommended as it can impede wound healing.
d. To apply topical antibiotics to the surgical site: While topical antibiotics may be used if there is an infection or as directed by the healthcare provider, applying them to the surgical site without proper indication can lead to antibiotic resistance and is not the primary purpose of wound care for amputation.


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Question 37:

What is a common complication that may occur in the immediate post-operative period after amputation?

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.


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Question 38:

Which nursing intervention is important to prevent infection in a patient who underwent amputation?

Explanation

Using sterile technique during wound dressing changes is important to prevent infection in a patient who underwent amputation. Sterile technique helps reduce the risk of introducing microorganisms into the wound, promoting healing and reducing the risk of complications.

a. Performing passive range of motion exercises regularly: Passive range of motion exercises may be appropriate at the appropriate time during the rehabilitation process but are not directly related to preventing infection.
b. Applying a compression bandage to the residual limb: Compression bandages may be used as part of post-operative care, but they are not the primary intervention to prevent infection.
d. Encouraging the patient to bear weight on the residual limb: Encouraging weight-bearing on the residual limb is part of the rehabilitation process but may not be appropriate immediately after amputation. It is not a direct measure to prevent infection.


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