1, 2, 3, 5 Residual limb care following an above-knee amputation (AKA) or below knee amputation (BKA) is an important component of rehabilitation and focuses on maintaining skin integrity, controlling pain, preventing infection, and restoring mobility. It is also important for the nurse to consider that the client may experience grief due to disturbed body image The nurse should include the following residual limb care
instructions: HIP FLEXION CONTRACTURES are a common complication during the recovery process. Nurses should teach clients to LIE PRONE several times each day and to AVOID SITTING in a chair for more than an hour Option 4: 3 Fat embolism syndrome is a life-threatening condition that has no specific treatment. Therefore, prevention, early diagnosis, and immediate management of symptoms are critical. When a long bone is fractured, pressure within the bone marrow leads to release of fat globules into the bloodstream. These combine with platelets (fat embolus) and can travel to the brain, lungs, and kidneys, leading to small-vessel occlusion and tissue ischemia. Therefore, early stabilization of the injury and surgery as soon as possible to repair long bone (humerus, radius, ulna, femur, tibia, fibula) fractures is recommended to reduce further injury to soft tissue 1 Clients with orthopedic injuries, particularly pelvic and long bone injuries (femoral fracture) may develop a FAT EMBOLUS. Fat emboli are thought to occur from the release of fat globules (lipids) from bone marrow or the systemic release of triglycerides into the bloodstream following a mechanical insult. The circulating lipids can OCCLUDE SMALL VESSELS in the lungs, brain, and skin, which impair circulation and oxygenation, leading to: -Respiratory distress syndrome (dyspnea, tachycardia, sudden and worsening chest pain, hypoxemia, restlessness,
anxiety) Option 3: 1, 4, 5 FES is a rare, but life-threatening complication that occurs in clients with long bone and pelvis fractures. It can also occur in nontrauma-related conditions, such as pancreatitis and liposuction. It usually develops 24-72 hours following the injury or surgical repair There are no specific diagnostic tests to identify FES. However, the initial characteristic signs and symptoms include: -Respiratory problems (dyspnea, tachypnea, hypoxemia) after a fat embolus travels through the pulmonary circulation and lodges in a pulmonary capillary, leading to impaired gas exchange and acute respiratory failure -Neuro changes (altered mental status, confusion, restlessness), which occur due to cerebral embolism and hypoxia -Petechial rash (pin-sized purplish spots that do not blanch with pressure), which appears on the neck, chest, and axilla due to microvascular occlusion. This defining characteristic differentiates a fat embolus from a PE -Fever (>101.4 F) which is due to a cerebral embolism leading to hypothalamus dysfunction 1, 3, 4 Osteoarthritis is a degenerative disorder of the synovial joints (knee, hip, fingers) that causes progressive erosion of the articular (joint) cartilage and bone beneath the cartilage. As the degenerative process continues, bone spurs (osteophytes), calcifications, and ulcerations develop within the joint space, and the "cushion" between the ends of the bones breaks down Clinical manifestations of OA of the knee include: 2 Osteopenia is more than normal bone loss for the client's age and sex. Adequate dietary intake of calcium and vitamin D is necessary to promote bone growth, prevent resorption (bone loss), and prevent progression to osteoporosis. Other food sources that are high in calcium are fish (sardines, salmon, trout), tofu, some green veggies (spinach, kale, broccoli), and almonds. Good food sources of vitamin D include egg yolk and oily fish (salmon, sardines, tuna) |