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Question

Difficulty: MediumBasic Care and Comfort

An older adult client in a rehabilitation center is 48 hours postoperative following a right above-the-knee amputation. When planning basic care to prevent musculoskeletal complications, which positioning strategy should the practical nurse implement?

  1. Assist the client into a prone position for 20 to 30 minutes several times a day.Answer
  2. B
    Prop the right residual limb continuously on a stack of two pillows.
  3. C
    Maintain the client in a high-Fowler's position during daytime rest periods in bed.
  4. D
    Instruct the assistive personnel to perform the initial range-of-motion exercises on the operative leg.

Answer

Assist the client into a prone position for 20 to 30 minutes several times a day.
Following an above-the-knee amputation, the client is highly susceptible to developing hip flexion contractures, which can permanently impair their ability to use a prosthesis. Placing the client in a prone position for 20 to 30 minutes three to four times a day fully extends the hip joint, effectively stretching the flexor muscles and preventing contracture formation.

Step-by-Step Solution

1
Identify the time elapsed since the client's surgery.
The client is 48 hours postoperative.
Positioning protocols for amputation clients change significantly after the first 24 hours to transition from edema control to contracture prevention.
2
Determine the primary musculoskeletal risk for an above-the-knee amputation.
The client is at high risk for developing hip flexion contractures.
Contractures can severely limit mobility and prevent the proper fitting and use of a prosthetic limb.
3
Select the nursing intervention that directly prevents this complication.
Prone positioning stretches the hip flexor muscles.
Lying on the abdomen fully extends the hip joint, counteracting the prolonged flexion that occurs when the client is sitting in a chair or resting in bed.

Key Concept

Postoperative Positioning to Prevent Amputation Complications
Estimated Time:1m 0s
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Topics

Basic Care and Comfort

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