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Discussion

help please--position of amputation

:o the internet speed is so slow today.

Hi everyone, there is a question from Saunder's NCLEX Review

A client has just returned to a nursing unit after an above-the-knee amputation of the right leg.A nurse places the client in which of the following most appropriate positions?

A, Supine with the stump flat on the bed

B, Supine with the stump supported with pillows

C,reverse Trendelenburg

D,prone

The answer is B, but I got confused. If the stump was elevated by pillows, wouldn't the hip flexion contractures happen?Why don't just elevate the end of the bed?:idea: Please help.

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You have to focus on the context of the patient in question. The patient here was a fresh post-op. You do not have to worry about contractures because the things you do immediately after surgery will eventually change as the patient heals. You want to elevate just the surgical site, not the entire lower body. I hope that helps you with this question.

We were told in school to elevate stump first 24 hours, then straight to prevent contractures, with prone position a few times a day if not contraindicated. Does this sound okay to others?

It sounds good Louisiananurse, but trying to get your patient to lie prone for any time at all is going to be a challenge.

According to the lippincotts review series, "after 48 hours"(referring after amputation surgery),"avoid elevating residual limb to prevent formation of contractures."

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Immediately post op postition of comfort. After the draid is out day 3 or 3 he should lie prone on his tummy to keep the hip flexors from drawing the stump upwards. If he can keep it down it will help a prosthesis fit so much better.

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