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Tuesday, January 27, 2009

Nursing Care Plans For Amputation

Amputation is the removal of a body part, usually an extremity.  Goals of nursing care plans is relief of pain, absence of altered sensory perceptions, wound healing, acceptance of altered body image, resolution of the grieving process, independence in self-care, restoration of physical mobility, and absence of complications. Amputation is the surgical severing of any body part. Amputations can be surgical (therapeutic) or traumatic (emergencies resulting from injury) Amputation is used to relieve symptoms, improve function, and save or improve the patient’s quality of life. If the health care team communicates a positive attitude, the patient adjusts to the amputation more readily and actively participates in the rehabilitative plan, learning how to modify activities and how to use assistive devices for ADLs and mobility.

CAUSES
Peripheral vascular disease is much more frequently the cause of amputation than are traumatic injuries. Poor foot care, impaired circulation, and peripheral neuropathy lead to serious ulcerations. Congenital deformity, severe burns, and crushing injuries, Tumors (usually malignant) and chronic osteomyelitis that does not respond to other treatment may also necessitate amputation.



Type Levels of Amputation:
  • Below the knee
  • Syme procedure
  • Transmetatarsal/toe amputation
  • Hip disarticulation/extensive hemipelvectomy
  • Upper extremity

Diagnoses nursing care plans for Amputation
  • Acute pain related to amputation
  • Risk for disturbed sensory perception: phantom limb pain related to amputation
  • Impaired skin integrity related to surgical amputation
  • Disturbed body image related to amputation of body part
  • Ineffective coping, related to failure to accept loss of body part
  • Risk for anticipatory and/or dysfunctional grieving related to loss of body part
  • Self-care deficit: feeding, bathing/hygiene, dressing/grooming, or toileting, related to loss of extremity
  • Impaired physical mobility related to loss of extremity

Collaborative Problems nursing care plans for Amputation
  • Postoperative hemorrhage
  • Infection
  • Skin breakdown

Interventions nursing care plans for Amputation
  • Relieving pain
  • Minimizing altered sensory perceptions
  • Promoting wound healing
  • Enhancing body image
  • Resolve grieving
  • Promoting independent self-care
  • Helping the patient to achieve physical mobility
  • Monitoring and managing complications

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