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Difficulty: MediumBasic Care and Comfort

A practical nurse is providing care for a client who is 48 hours postoperative following a right above-the-knee amputation. To help prevent a hip flexion contracture, which of the following positioning interventions should the nurse implement?

  1. A
    Elevate the residual limb continuously on two pillows while the client is resting.
  2. Assist the client to a prone position for 20 to 30 minutes every 3 to 4 hours.Answer
  3. C
    Maintain the client in a high Fowler's position during daytime hours.
  4. D
    Place the client in a side-lying position with the knees drawn up toward the chest.

Answer

Assist the client to a prone position for 20 to 30 minutes every 3 to 4 hours.
Placing a client with an above-the-knee amputation in a prone position for 20 to 30 minutes multiple times a day actively stretches the flexor muscles and extends the hip joint. This targeted positioning is essential to prevent hip flexion contractures, which can severely limit future mobility and make prosthetic fitting impossible.

Step-by-Step Solution

1
Identify the primary complication risk specific to the postoperative time frame and surgical site.
The client is at high risk for a hip flexion contracture following an above-the-knee amputation.
Without proper positioning, the hip joint naturally rests in a flexed position, which can permanently impair mobility and prevent future use of a prosthetic limb.
2
Evaluate the anatomical effect of each positioning option.
Pillows, high Fowler's, and drawing knees to the chest all promote hip flexion. The prone position promotes hip extension.
Extending the hip counteracts the natural tendency for the joint to flex and stiffen.
3
Select the intervention that actively extends the hip joint.
The prone position for short intervals is identified as the correct nursing action.
This directly aligns with evidence-based basic care principles for amputation recovery after the initial 24 hours.

Key Concept

Postoperative Positioning for Amputation
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Topics

Basic Care and Comfort

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