amputations2

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Author:
jpowell22
ID:
168954
Filename:
amputations2
Updated:
2012-09-04 20:21:30
Tags:
specific pop
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Description:
amputations
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  1. What may a pre-op exers program involve?
    • deep breathing and coughing
    • general ex
    • increase proximal m strength
  2. What are some goals of rehab?
    • regain pre-surgical function
    • help function at higher level
  3. What are some goals of the post-surgical program?
    • promote healing of residual limb
    • reduce/prevent edema
    • reduce pain
    • prevent contractures/complications
    • maintain mobility of all proximal jts
    • maintain/regain strength of all proximal jts
    • increase/maintain strength in remaining limbs
    • pt education/independence
    • learn proper care of remaining limb
    • achieve max independence with ADLs
    • assist with adjustment to the loss of a body part
    • determine feasibility of prosthetic fitting
  4. What are the 3 types of dressings post-op?
    • rigid
    • semi-rigid
    • soft dressing
  5. What are the advantages of a rigid dressing (cast)?
    • controls edema the best
    • decreases pain
    • increases healing
    • can serve as a foundation for immediate post-op prosthesis (IPOP) for early weight bearing
    • pt can use the limb for function soon after surgery
    • early prosthetic use is associated with a greater likelyhood of eventual acceptance of final prosthesis
    • prevents contractures
    • protects limb from trauma
  6. What are the disadvantages of a rigid dressing?
    • need trained personnel to appy
    • cant check suture line
    • not removable or adjustable
  7. What are the advantages of a removeable rigid dressing (RRD)?
    • can be removed to check wound/incision healing
    • gives immediate post op fit for prothesis for early WBing
  8. What is a disadvantage of a removable rigid dressing?
    physician applies and must closely supervise
  9. What are the advantages of a semirigid dressing?
    semirigid unna dressing (not as hard as regular cast..type of medication in dressing)

    • limits edema formation
    • increase healing, decrease pain
    • limb can be placed in a temp prosthesis for earling WBing
    • prevents contractures
    • protects against trauma
  10. What are the disadvantages of a semirigid dressing?
    • need trained personnel to apply and reapply
    • cant check suture line
    • cant be done by pt/pta
  11. What are the advantages of a soft dressing?
    • easy to remove for wound/incision inspection
    • mid-mod edema control
    • shapes the limb
    • can be done by pt/pta
  12. What are some disadvantages of a soft dressing?
    • least amt of edema control
    • doesnt allow for attachment of a temp prosthesis
    • must reapply every 3-4 hours
    • no protection of limb
    • must use proper technique
    • no contracture prevention
  13. What are the advantages of shrinker socks?
    • better with edema control than ace wraps
    • easier to apply
  14. What are disadvantages of shrinker socks?
    • need new socks with edema changes
    • no prevention for contractures
  15. What are the advantages of an air splint?
    • same advantages as removable rigid dressing
    • allows for early amb (can be used for attachment for prosthesis
    • provides uniform pressure
  16. What are disadvantages of an air splint?
    • can be hot and increase moisture against skin
    • can be cumbersome
    • costly
  17. What will the post op therapist measure the residual limb for?
    • length
    • girth
    • measurements taken as soon as the dressing allows
  18. What is important for residual limb care?
    • edema control
    • proper hygiene
  19. What can pot begin to do once sutures are removed?
    • begin bathing normally
    • begin friction massage
    • inspect limb with mirror daily
    • nightly bathing/wrapping
  20. What is the proper skin care for the residual limb?
    • promote soft pliable skin
    • decrease use of home remedies
    • pt should never shave the residual limb
    • should not use lotions unless directed by physician
  21. How should an effective bandage wrap be?
    • smooth and wrinkle free
    • has angular turns (figure 8)
    • encourages proximal jt extension
    • ends are fastened with tape
    • if incision is ant-attempt to bring bandage from post-ant over the distal end
    • limbs should be rewrapped at least every 4 hours
  22. How should you take care of the elastic bands and shrinkers?
    • hand wash daily with mild soap and wring out
    • lay flat to dry on clean towel
    • should be allowed to dry for 12 hrs overnight
    • alternate between 2 sets of bandages
    • never dry elastic bandages or shrinkers on a radiator or in a dryer
  23. What is good positioning techniques for prosthetic pts?
    • goal is to prevent secondary complications like contractures
    • avoid prolonged sitting
    • pt should lie in prone for some each day
    • do not position limb over a pillow to elevate it
  24. What types of ROM should you perform?
    • hip flex/ext
    • hip abd/add
    • knee flex/ext
  25. What types of strengthening should you perform?
    • bilateral UEs
    • uninvolved LE
    • involved LE when healing allows
  26. For effective prosthetic ambulation, pts need good strength in the involved LE consisting of what? (most important)
    • hip ext
    • hip abd
    • knee flex/ext
  27. What type of general strengthening/conditioning should you perform?
    • trunk
    • all extremities
    • proprioception
  28. What types of gait patterns should a prosthetic pt use?
    3 point with crutches
  29. What types of mobility should you work on?
    • transfers
    • bed mobility
    • w/c mobility
  30. What are some advantaged of a temp prosthesis?
    • can enhance post op program
    • can be fit as soon as the wound is healed
  31. What do you need to increase with bilateral amputation pts?
    • more mat activities to increase a sense of body position and balance
    • more UE strength
    • independent in bed mobility, transfers, and w/c mobility
  32. Why would a pt not be appropriate for a prosthetic?
    • amb was contraindicated prior to surgery
    • transfemoral amputees that lack the balance/strength/energy reserves required
    • those that lack the mental facilities to follow the limb and prosthetic care required

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