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In general, amputation of limbs is the result of trauma, peripheral vascular disease, tumors, and congenital disorders. This is an amputation nursing care plan for a patient with impaired physical mobility.
Nursing Diagnosis
- Impaired Physical Mobility
Related to:
- Loss of a limb (particularly a lower extremity); pain/discomfort; perceptual impairment (altered sense of
- balance)
Possibly evidenced by
- Reluctance to attempt movement
- Impaired coordination; decreased muscle strength, control, and mass
Desired Outcomes:
- Verbalize understanding of individual situation, treatment regimen, and safety measures.
- Maintain position of function as evidenced by absence of contractures.
- Demonstrate techniques/behaviors that enable resumption of activities.
- Display willingness to participate in activities.
4 Amputation Nursing Care Plan (NCP)
Impaired Physical Mobility — Amputation Nursing Care Plan (NCP)
Nursing Interventions | Rationale |
| Provide stump care on a routine basis, e.g., inspect area, cleanse and dry thoroughly, and rewrap stump with elastic bandage or air splint, or apply a stump shrinker (heavy stockinette sock), for “delayed” prosthesis. | Provides opportunity to evaluate healing and note complications (unless covered by immediate prosthesis). Wrapping stump controls edema and helps form stump into conical shape to facilitate fitting of prosthesis. Note: Air splint may be preferred, because it permits visual inspection of the wound |
| Measure circumference periodically | Measurement is done to estimate shrinkage to ensure proper fit of sock and prosthesis. |
| Rewrap stump immediately with an elastic bandage, elevate if “immediate/early” cast is accidentally dislodged. Prepare for reapplication of cast. | Edema will occur rapidly, and rehabilitation can be delayed |
| Assist with specified ROM exercises for both the affected and unaffected limbs beginning early in postoperative stage. | Prevents contracture deformities, which can develop rapidly and could delay prosthesis usage. |
| Encourage active/isometric exercises for upper torso and unaffected limbs. | Increases muscle strength to facilitate transfers/ambulation and promote mobility and more normal lifestyle. |
| Provide trochanter rolls as indicated. | Prevents external rotation of lower-limb stump |
| Instruct patient to lie in prone position as tolerated at least twice a day with pillow under abdomen and lower-extremity stump. | Strengthens extensor muscles and prevents flexion contracture of the hip, which can begin to develop within 24 hr of sustained malpositioning. |
| Caution against keeping pillow under lower-extremity stump or allowing BKA limb to hang dependently over side of bed or chair. | Use of pillows can cause permanent flexion contracture of hip; a dependent position of stump impairs venous return and may increase edema formation. |
| Demonstrate/assist with transfer techniques and use of mobility aids, e.g., trapeze, crutches, or walker. | Facilitates self-care and patient’s independence. Proper transfer techniques prevent shearing abrasions/dermal injury related to “scooting.” |
| Assist with ambulation. | Reduces potential for injury. Ambulation after lower-limb amputation depends on timing of prosthesis placement. |
| Instruct patient in stump-conditioning exercises | Hardens the stump by toughening the skin and altering feedback of resected nerves to facilitate use of prosthesis. |
| Refer to rehabilitation team | Provides for creation of exercise/activity program to meet individual needs and strengths, and identifies mobility functional aids to promote independence. Early use of a temporary prosthesis promotes activity and enhances general well-being/positive outlook. Note: Vocational counseling/retraining also may be indicated. |
| Provide foam/flotation mattress. | Reduces pressure on skin/tissues that can impair circulation, potentiating risk of tissueischemia/breakdown |
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