530 Case Scenario. Partial Amputation.

Amputation is the surgical removal of body part such as the leg ,arm,finger, or toes. It is done to remove malignant tumor, recurrent infection, gangrene in peripheral vascular disease,it can also be due to traumatic accident or congenitally. Patient is highly sedated and the damaged part will be removed and a flap will be cut from the muscular and cutaneous thigh( inner or out thigh of the other leg) to cover the bone and it is suture around the edges or staple around depending on the surgeon.

The donor site is usually covered with Xeroform dressing and guaze.If there is infection a section will be open to drain out the infection. Sometimes the doctor will use a woundvac to drain and close the wound.

This change due to amputation can lead to inability to function, move around,walk, or do things.There is usually continuous pain,phantom limb pain. If a person lost one extremity or more.Sometime they feel like the leg is there but it is not.

Postoperatively :

1.Encourage the use of incentive Spirometry. 2.Evelate affected Extremity on pillows. 3.Monitor patient for bleeding.

4.Monitoring vital signs Q4hours and prn. The doctor will remove the first dressing after 72hours to evaluate the stump.

Physical therapy and Occupational therapy for evaluation and treatment to start weight training in 24hours after surgery.

Follow doctor orders move the stump frequently to prevent complications or necrosis. If patient has a cast it will remain in place for ten to 14days.Prothestic leg is usually recommended after swelling is gone.

KINGDOM OF GOD HOSPITAL LOS ANGELES CALIFORNIA 900000.INTERDISCIPLINARY KARDEX. Age/Sex: 48years old man.

Account number: Q0057634372.

MR #: Q000658867529.

Admission date:09/12/2021@08am.

Status: Inpatient admission.

Location: General Surgery.

Room 62113.

Attending doctor :Tommy Holbib.

Patient name: John Kolanut.

Resustation :Full code.

Primary diagnosis: Partial Amputation right lower Extremity/ motor vehicle accident. Pinning his right leg between the car and a pole.S/p right BKA.

Secondary diagnosis: Hypertension/Diabetes.

Isolation Status:Standard Precautions.

Is patient at risk for fall: No.

Suicidal risk: No.

Do patient have advance Directive: No.

Copy of advance Directive on the chart.

Diet: Carb Controlled diet.

Allergy: NKDA.

02 @ 2liter NC.

Voiding well.

Doctor orders:

Stump dressing with Ace wrap. 0.9NS @ 50ml/hour IV right forearm 20guage clean/dry/Patent.

Dilaudid 2mg IV Q3hours prn severe pain. Morphine sulfate 4mg IV Q4hours prn severe pain.

Norco 1tablet po Q4hours prn pain.

Norco 10/325mg 2tablets po prn severe pain.

Zofran 4mg IV Q4hours prn nausea/ Vomiting.

Accucheck Qac/Qhs.Humolog 2units SubQ Qam and QPM.

Insulin sliding scale : 0 to 200 zero insulin.

201 to 250 2unit regular insulin.

251 to 300 3units.

301 to 350 4units.

351 to 400 5units.

> 400 call the doctor.

Case manager consult.

Discharge to Skilled Nursing Facility for Rehabilitation when medically stable and when bed is available.

Pexels.com/pictures, amputation

Published by edochie99

A Registered Nurse with over twenty years of hospital experience, an author with Masters Degree in Nursing,also Bachelor Degree in Nursing,graduated in 1996 from USC,University of Southern California.MSN in 2009 University of Phoenix.

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