4 Amputation Nursing Care Plans

Impaired Physical Mobility

Nursing Diagnosis

• Impaired Physical Mobility

May be 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 

• The client will verbalize understanding of the individual situation, treatment regimen, and safety measures.
• The client will maintain a position of function as evidenced by the absence of contractures.
• The client will demonstrate techniques/behaviors that enable the resumption of activities.
• The client will display a willingness to participate in activities.

Nursing Assessment and Rationales

1. Measure circumference periodically
Measurement is done to estimate shrinkage to ensure proper fit of sock and prosthesis.

Nursing Interventions and Rationales

1. Encourage the patient to perform prescribed exercises.
To prevent stump trauma.

2. Provide stump care on a routine basis: inspect the area, cleanse and dry thoroughly, and rewrap the stump with an elastic bandage or air splint, or apply a stump shrinker (heavy stockinette sock), for “delayed” prosthesis.
Provides an opportunity to evaluate healing and note complications (unless covered by immediate prosthesis). Wrapping the stump controls edema and helps form the stump into a conical shape to facilitate the fitting of the prosthesis.

3. Rewrap the stump immediately with an elastic bandage, and elevate if the “immediate or early” cast is accidentally dislodged. Prepare for reapplication of the cast.
Edema will occur rapidly, and rehabilitation can be delayed

4. Assist with specified ROM exercises for both the affected and unaffected limbs beginning early in the postoperative stage.
Prevents contracture deformities, which can develop rapidly and could delay prosthesis usage.

5. Encourage active and isometric exercises for the upper torso and unaffected limbs.
Increases muscle strength to facilitate transfers and ambulation and promote mobility and more normal lifestyle.

6. Maintain knee extension.
To prevent hamstring muscle contractures.

7. Provide trochanter rolls as indicated.
Prevents external rotation of lower-limb stump

8. Instruct the patient to lie in the prone position as tolerated at least twice a day with a pillow under the 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.

9. Caution against keeping the pillow under a lower-extremity stump or allowing the BKA limb to hang dependently over the side of the bed or chair.
The use of pillows can cause permanent flexion contracture of the hip; a dependent position of the stump impairs venous return and may increase edema formation.

10. Demonstrate and assist with transfer techniques and use of mobility aids like trapeze, crutches, or walkers.
Facilitates self-care and patient independence. Proper transfer techniques prevent shearing abrasions and dermal injury related to “scooting.”

11. Assist with ambulation.
Reduces the potential for injury. Ambulation after lower-limb amputation depends on the timing of prosthesis placement.

12. Instruct patient in stump-conditioning exercises.
Hardens the stump by toughening the skin and altering feedback of resected nerves to facilitate the use of the prosthesis.

13. Provide foam or flotation mattress.
Reduces pressure on skin and tissues that can impair circulation, potentiating the risk of tissue ischemia and breakdown.

14. Refer to the rehabilitation team.
Provides for the creation of exercise and activity programs 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 and a positive outlook.