1. Monitor for signs of complications.
2. Mark bleeding and drainage on the dressing if
3. Evaluate for phantom limb sensation and pain;
explain sensation and pain to the client, and
medicate the client as prescribed.
4. To prevent hip flexion contractures, do not
elevate the residual limb on a pillow.
5. First 24 hours: Elevate the foot of the bed to
reduce edema, and then keep the bed flat to prevent hip flexion contractures, if prescribed by the PHCP.
6. After 24 to 48 hours postoperatively, position the client prone to stretch the muscles and prevent hip flexion contractures, if prescribed.
7. Maintain surgical application of dressing, elastic compression wrap, or elastic stump (residual limb) shrinker, as prescribed, to reduce swelling, minimize pain, and mold the residual limb in preparation for prosthesis (Figure 57-5).
8. As prescribed, wash the residual limb with mild soap and water and dry completely.
9. Massage the skin toward the suture line to mobilize scar and prevent its adherence to underlying bone.
10. Prepare for the prosthesis and reinforce instructions about progressive resistive techniques by gently pushing the residual limb against pillows and progressing to firmer surfaces.
11. Encourage verbalization regarding loss of the body part, and assist the client with identifying coping mechanisms to deal with the loss.