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Difficulty: MediumBasic Care and Comfort

During shift rounds on a rehabilitation unit, the nurse plans care for a client who underwent a right above-the-knee amputation three days ago. To prevent the development of a flexion contracture, which positioning intervention is most appropriate to implement?

  1. Assist the client into a prone position for 30 minutes several times a day.Answer
  2. B
    Elevate the residual limb on a firm pillow while the client is resting in bed.
  3. C
    Maintain the head of the bed at a 90-degree angle for the majority of the shift.
  4. D
    Encourage the client to sit upright in a bedside chair for at least four continuous hours.

Answer

Assisting the client into a prone position for 30 minutes several times a day is the correct intervention to prevent hip flexion contractures.
Placing the client in a prone position for 20 to 30 minutes multiple times a day allows the hip joint to extend fully. This stretching of the flexor muscles is a critical basic care intervention to prevent hip flexion contractures following an above-the-knee amputation, which is essential for future prosthetic use.

Step-by-Step Solution

1
Identify the client's surgical procedure and the time elapsed since surgery.
The client is 72 hours post-operative following a right above-the-knee amputation.
Postoperative timelines dictate appropriate comfort and mobility interventions; care changes significantly after the initial 24-hour period.
2
Determine the most significant mobility complication associated with this specific amputation.
Hip flexion contractures are a major risk that can prevent the client from being able to use a prosthetic limb.
Maintaining proper joint alignment is a fundamental aspect of basic care and mobility management.
3
Select the positioning strategy that directly counteracts continuous hip flexion.
Prone positioning extends the hip joint.
Lying flat on the abdomen straightens the hip flexors, preventing the muscles from tightening and shortening into a contracture.

Key Concept

Prevention of flexion contractures following lower extremity amputation
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Topics

Basic Care and Comfort

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