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Difficulty: Very hardBasic Care and Comfort

An individual is receiving ongoing rehabilitative care one week after a unilateral below-the-knee amputation for severe peripheral arterial disease. The care plan focuses on promoting optimal healing, preparing the residual limb for future prosthetic fitting, and maintaining overall well-being. Which of the following actions are appropriate for the practical nurse to include in the client's daily care? Select all that apply.

  1. Assist the client into a prone position with the hips completely flat for 20 to 30 minutes several times daily.Answer
  2. Wrap the residual limb with an elastic compression bandage using a figure-eight technique, proceeding from distal to proximal.Answer
  3. Encourage the client to actively push the residual limb downward against the bed mattress while resting in a supine position.Answer
  4. D
    Maintain continuous elevation of the residual limb on two firm pillows to prevent swelling and promote comfort.
  5. E
    Accept delegation from the registered nurse to administer an intravenous push analgesic prior to performing painful dressing changes.
  6. F
    Provide the standard high-protein meal tray to support tissue healing without confirming the client's cultural or religious dietary needs.

Answer

The correct interventions are assisting the client into a prone position, wrapping the residual limb with a figure-eight technique, and encouraging the client to actively push the limb against the mattress.
Appropriate basic care for a client with a recent lower extremity amputation involves interventions that prepare the limb for a prosthesis and prevent complications. Assisting the client to a prone position for 20 to 30 minutes multiple times a day stretches the flexor muscles and prevents hip flexion contractures. Wrapping the residual limb with a figure-eight technique from distal to proximal reduces edema and properly shapes the limb for a future prosthesis, while avoiding the restricted blood flow associated with circular wrapping. Encouraging the client to push the limb down against the mattress strengthens the necessary muscles and further prevents contracture formation.

Step-by-Step Solution

1
Evaluate the positioning, mobility, and healing needs for a client recovering from a lower extremity amputation.
Identified that preventing hip flexion contractures and correctly shaping the residual limb are primary priorities for basic care and comfort during the rehabilitative phase.
Contractures can permanently prevent the successful fitting and use of a prosthetic limb, undermining the entire rehabilitation process.
2
Analyze each proposed intervention against evidence-based basic care standards and the practical nursing scope of practice.
Selected prone positioning, figure-eight wrapping, and active muscle pushing as correct actions. Rejected continuous pillow elevation, intravenous push administration, and bypassing cultural dietary assessments as unsafe or inappropriate.
Safe nursing practice requires strict adherence to physiological principles (avoiding contractures), legal boundaries (refusing out-of-scope tasks), and psychosocial integrity (respecting cultural diets).

Key Concept

Basic care and comfort following an amputation focuses on contracture prevention, proper limb shaping, and holistic, safe care within the practical nurse's legal scope.
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Basic Care and Comfort

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