Emma is a brittle diabetic who is very noncompliant. She is in the ED today because her physician has sent her over after her routine checkup
Her left leg and foot are swollen, black, and have a foul odor, and Emma "doesn't remember how it got that way." After examination, she is admitted and scheduled for an amputation of the leg below the knee.
a. Discuss amputations, indications for them, and what may hinder healing of this type of surgery.
b. What in Emma's history given will play a role in her healing process? Explain.
c. What type of complications may occur?
d. What are some of the nursing care involved?
Students' answers should include the following:
a. Amputations are surgical procedures to remove a portion of the body that is infectious; dying or dead; and has extensive trauma, malignant tumors, or deformity.
Removal of the limb includes all tissue to an area that has not yet been destroyed and still has functioning blood vessels, nerves, and adequate tissue perfusion
Open and closed methods: One has skin flap, the other does not.
b. Emma will have complications stemming from her diabetes, which will slow her healing process, especially since her diabetes is difficult to control.
c. Uncontrolled diabetes, dehydration, electrolyte imbalance, infections, poor healing, as well as poor nutrition and chronic respiratory disorders
Poor healing due to complications, hemorrhage, hematoma, and osteomyelitis
May have phantom limb pain
d. Nursing includes reducing pain and anxiety.
Emotional and psychological support
Deep breathing and coughing exercises as well as monitoring vital signs and neurologic changes.
Physical and occupational therapy will be needed for discharge and appliance usage.
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