A patient with diabetes mellitus has just undergone a right, below-the-knee amputation following gangrene infection. A few days post-op, the patient confides in the nurse that he still feels his right foot
Knowing the pathophysiologic principles behind this, the nurse can
A)
administer a psychotropic medication to help the patient cope with the loss of his leg.
B)
explain that many amputees have this sensation and that one theory surmises that the end of a regenerating nerve becomes trapped in the scar tissue of the amputation site.
C)
call the physician and ask him for an order for a psychological consult.
D)
educate the patient that this area has an usually abnormal increase in sensitivity to sensation but that it will go away with time.
Ans:
B
Feedback:
Multiple theories exist related to the causes of phantom limb pain. One rationale is that the end of the regenerating nerve becomes trapped in the scar tissue that forms a barrier to regenerating outgrowth of the axon. The usual treatment includes the use of sympathetic blocks; TENS of the large myelinated afferents innervating the area; hypnosis; and relaxation training.
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