GROUP 3 Teng Hoi Xian Thu Kim Pei Yeoh Boon Bok Malarvili A/P Letchuman Manmeet Kaur A/P Amar

Singh Kasturi A/P Rajaveloo

AMPUTATION

DEFINITION

The surgical removal of part of the body, usually a leg or an arm.

CAUSES

  

Disease
Trauma Tumors Congenital malformation

AMPUTATION

Above-elbow amputation

AMPUTATION  Below-elbow amputation .

AMPUTATION  Hemipelvectomy .

AMPUTATION  Hip amputation .

AMPUTATION  Above-knee amputation .

AMPUTATION  Below-knee amputation .

AMPUTATION  Syme’s amputation .

FLAP .

CLOSED .

COMPLICATION     Infection Hemorrhage Joint contracture Phantom limb pain .

Phantom Pain  Pain in the missing part of the arm or leg  can also occur following nerve avulsion or spinal cord injury. .

2. 3.AMPUTATION PRE-PROCEDURE 1. R: To assess the function and condition of the residual limb. Assess patient neurovascular and functional status of the extremity through history and physical assessment. R: So that patient will more understand about the amputation. Discuss to patient the postoperation . and patient may experience of phantom pain in surgery site. . R: Amputation is a invasive procedure. Obtain consent before an amputation surgery. including appearance of the stump.

6. R: To determine of patient’s emotional reaction to amputation. Assess patient‘s psychological status. R: To detect any abnormality. 5.AMPUTATION PRE-PROCEDURE 4. Monitor patient v/s such as b/p. R: Help patient to cope in the aftermath of amputation surgery. pulse as baseline data. Give an adequate support system and professional counseling to patient. Grief response to a permanent alteration in body image is normal. .

Patient may feel phantom pain when the sensation they are feeling is pain in the missing limb. 2.AMPUTATION POST-PROCEDURE 1. Change dressing in aseptic technique. R: To treat pain after the amputation. Serve pain killer such as ponstan to patient. . Ensure dressing site is always in a clean and dry condition. R: To prevent wound infection and possible osteomyelitis.

Change patient position or placing a light sandbag on the residual limb to counteract the muscle spasm. R: To encourage patient to more concern about their health. Assist patient in daily live activities. R: To improve the amputation site blood circulation. Encourage patient to have a post exercise. R: To improve the patient the patient level of comfort.AMPUTATION POST-PROCEDURE 3. 4. 5. .

R: To prevent the development of hip or knee joint contracture in the patient with a lower extremity amputation. 7. . feel and care for the residual limb . Assist patient in positioning.AMPUTATION POST-PROCEDURE 6. Encourages patient to look at. R: It is important to identify the patient’s strength and resources to facilitate rehabilitation.

R: To have the maximum extent possible of treatment and patient’s members will more understand the patient’s condition. . R: To promote the wound healing process. 9. Include patient’s family and significant other in plan of care. Encourage the patient protein intake such as fish . Keep them informed and allow them to assist with care when feasible.AMPUTATION POST-PROCEDURE 8. egg at least once per day.

EXERCISE [1] Static Quadriceps · Push your legs straight out in front of you · Push the back of your knees into the bed and tighten the thigh muscles · Hold for 5 seconds · Repeat this ___ times .

.[2] Straight Leg Raise · Put your legs out in front of you · Tighten your thigh · Lift your leg off the bed · Hold for ___ seconds · Slowly lower · Repeat ___ times Repeat the above with the other leg.

. blanket or pillow under your knee · Straighten your knee · Hold for 5 seconds · Repeat ___ times Repeat the above with the other leg.[3] Inner Range Quads · Sit with both legs straight out in front of you · Place a rolled up towel.

.[4] Hip Adduction With Resistance · Sit with both legs out in front of you · Place a pillow or rolled up towel between your knees · Squeeze your legs together · Hold for 5 seconds · Repeat ___ times NB This exercise can also be performed when sitting in a wheelchair or at the edge of a bed.

Place your hands on your lap · Straighten one knee · Hold for 5 seconds · Now bend your knee · Repeat ___ times Repeat the above with the other leg.[5] Outer Range Quadriceps · Sit on a chair or edge of the bed. .

[6] Static Gluteal Contractions · Lie on your back · Keep both legs straight and close together · Squeeze your buttocks as tightly as possible · Hold for 5 seconds · Repeat ___ times .

preferably without a pillow · Bend your knee towards your chest and hold with your hands · Push your opposite leg down flat on to the bed · Hold for 30 – 60 seconds. then relax · Repeat ___ times Repeat the above with the other leg.[7] Hip Flexor Stretch · Lie on your back. .

. tighten your buttocks and lift your bottom up off the bed · Hold for 5 seconds · Repeat ___ times To make this exercise more difficult.[8] Bridging · Lie on your back with your arms at the side · Place a couple of firm pillows or rolled up blankets under your thighs · Pull in your stomach. place your arms across your chest as shown in the picture.

.[9] Hip Flexion and Extension in Side Lying · Lie on your side · Bend the bottom leg · Lift your top leg slightly · Bend your knee fully towards your chest · Straighten your knee and push your leg backwards · Repeat ___ times NB Try not to let your hips roll forwards or backwards. Repeat the above with the other leg.

keeping your knee straight · Slowly lower · Repeat __ times NB Try not to let your hips roll forwards or backwards. . Repeat the above with the other leg.[10] Hip Abduction in Side Lying · Lie on your side · Bend the bottom leg · Keep hips and top leg in line with your body · Slowly lift your top leg up.

.[11] Knee Flexion in Prone Lying · Lie on your stomach · Place your arms in a comfortable position · Keeping your thigh on the bed. bend your knee as far as possible · Hold for 5 seconds · Straighten your knee · Repeat ___ times Repeat the above with the other leg.

.CAST  As a support and protect injured bones and soft tissue.

TYPE OF CAST  Short arm cast Long arm cast  .

TYPE OF CAST  Short leg cast  Long leg cast .

. R: To ensure complete drying and hardening of cast. R: To reduce swelling.CARE OF PATIENT WITH CAST 1. Keep the plaster cast uncovered for 48 to 72 hours. Elevate your injured arm or leg for the first 24 to 72 hours. 2.

CARE OF PATIENT WITH CAST 3. R : To prevent infection. Educate patient always keep the cast dry. R: To prevent any complication occur. . Advice patient to report if cast is too tight or too loose. 4.

. R: To detect any irritation. Inspect the skin around the cast.CARE OF PATIENT WITH CAST 5.

COMPLICATION  Compartment syndrome  Pressure sore .

 Hot spot • infection and inflammation in the cast • Patient will feel hot and itchy  Cold spot • bleeding inside the cast .

.TRACTION  Pulling on part of the body.

More than 5 kg of weight will result in the skin becoming excoriated with blister formation and pressure sores.SKIN TRACTION  Requires pressure on the skin to maintain the pulling force across the bone.   . A maximum of 5 kg of weight may be applied.

TYPE OF SKIN TRACTION        Russell’s traction Buck’s extension Bryant’s traction Head halter Balance suspension Lateral skeletal traction Skull tongs and turning frames .

.

line of traction is within the long axis of the bone Observe for deep-vein thrombosis. 2. bed is in proper position c.CARE OF PATIENT WITH SKIN TRACTION 1. Check traction apparatus frequently to ensure that : a. ropes are aligned and weighs are hanging freely b. .

4. Perform neurovascular checks to affected extremity. . Encourage active ROM exercises to unaffected extremities. Maintain client in proper alignment.CARE OF PATIENT WITH SKIN TRACTION 3. 5.

SKELETAL TRACTION  Applied directly upon long bones.  By pins or wires. .

TYPE OF SKELETAL TRACTION  Cervical traction with gardner wells tongs .

TYPE OF SKELETAL TRACTION  Hoen’s Skull traction .

TYPE OF SKELETAL TRACTION  Halo traction .

TYPE OF SKELETAL TRACTION .

hospital routine. 2.CARE OF PATIENT WITH SKELETON TRACTION 1. Assess neurovascular integrity based on the patient's condition. Make sure traction equipment connections are tight. and practitioner's orders. Show the patient how much movement he's allowed and instruct him not to adjust equipment. 3. .

Encourage patient to practice coughing and deep-breathing exercises. Check pin sites and surrounding skin regularly. . 6. 5. Clean pin site and surrounding skin with cottontipped applicator dipped in ordered antiseptic.CARE OF PATIENT WITH SKELETON TRACTION 4.

com/watch?v=XFb2fXPZi8A  .youtube.youtube.VIDEO  http://www.com/watch?v=_GS948ycVxo http://www.

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