Learning Needs of a Newly Amputated Patient Essay
Learning Needs of a Newly Amputated Patient Amputation or a loss of a limb equates all other major loss. It is devastating and dreadful to lose visible body parts for people of all ages. To be able to teach the patient the proper learning strategies, thorough physiological, psychological and social assessment is initially done. Self care deficit because of physical limitations is considerably important on this case.
The nursing plan care should focus on the adjustment and adaptation process of the newly amputated patient and achieving utmost self-care is the ultimate goal. For health professionals, the objectives are wound healing, reducing phantom pain, stabilizing residual limb, and providing psychological counseling. Wound care should be the priority and immediate care for lower limb and all other types of amputations.
Optimized nutrition, positioning, exercise and proper wound skin care management are the parameters to teach for fast healing. Smoking cessation, cholesterol reduction and glucose control are re-established. Since most of the patients cannot master wound wrapping techniques, elastic bandages are considered to be the easiest to apply and the most common bandage type advised for patients. Elastic bandages should always be worn 24 hours at all times except when taking a bath. Reapplication is done when the bandage or shrinker loosens. These guidelines are important so that healing of the stump will be in an appropriate shape. The patient must also be informed about phantom sensation or phantom limb which is the painful sensation felt on the missing limb or body part experienced either few weeks after the operation or during the healing process of the injury.
They should be educated about the intensity, frequency and all other characteristics of phantom pain because pain can be elicited in different reactions. This type of pain is explained as a continued sensation postoperatively and can be very painful, irritating and annoying. Use of pain assessment scale is done so that effective management techniques and appropriate pain medications can be prescribed.
Counter irritation is also thought to the patient to lessen and manage phantom limb sensations and diversion of attention such as guided imagery, relaxation, distraction and biofeedback are effective pain management as well. Three weeks postoperatively, the patient should be instructed to regularly massage the residual limb for desensitization purposes. When the wound healing process is complete, vigorous stimulation is done on the limb in the form of hitting the end of it with a rolled towel in a vigorous manner. If the pain is chronic and the techniques are not working, encourage the patient to seek for comprehensive program from pain clinics. Use of prosthesis, crutches, canes and other supportive equipments can also be advised with an explanation that it is a way of improving energy expenditure and safe ambulation. Crutch walking have a lot of different gaits and it is recommended to teach two types of gaits, if possible, so that the patient can shift alternately to relieve muscle fatigue.
Proper cane length is also a must. When holding the cane, the patient’s elbow should usually be flexed 20 to 30 degrees. The length of the cane is significant to ensure gait stability. Home modifications are necessary to provide effective management and quality care for the newly amputated patient. As an astonishing measure of reinforcement, introduction of the newly amputee to someone who has already made a positive recovery and adjustment regarding amputation is one way of establishing acceptance and adjustment process. The patient should be retrained of doing activities of daily living like walking with crutches or canes and going to the bathroom all by himself. By these instructions, we can make restore a productive life they once had..
ReferencesHobson, R. W., Wilson, S.
E. & Veith, F. J. 2003). Vascular surgery: principles and practice.
Informa Health Care.Swearingen, P. L. 2002). Manual of medical-surgical nursing care: nursing interventions & collaborative management.
Elsevier Health Sciences.