the internet speed is so slow today.Hi everyone, there is a question from Saunder's NCLEX ReviewA 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 bedB, Supine with the stump supported with pillowsC,reverse TrendelenburgD,proneThe 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? Please help.
RNinSoCal 134 Posts Specializes in Home health, Med/Surg. Has 13 years experience. Mar 14, 2006 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.
LouisianaNurse2006 185 Posts May 28, 2006 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?
meownsmile, BSN, RN 2,532 Posts Specializes in Med/Surg, Ortho. Jun 5, 2006 It sounds good Louisiananurse, but trying to get your patient to lie prone for any time at all is going to be a challenge.
nychikarudono 1 Post Dec 13, 2008 According to the lippincotts review series, "after 48 hours"(referring after amputation surgery),"avoid elevating residual limb to prevent formation of contractures."
P_RN, ADN, RN 6,011 Posts Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89. Has 30 years experience. Jan 27, 2009 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.
