Amputation Concept Map
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Outline
Overview
- Concept maps
- Many types, variations, layouts
- Primary diagnosis
- Typically in center of map
- Connects to
- Contributing factors
- Medications
- Labwork
- Patient education
- Nursing diagnoses
- Interventions
- Evaluations
Nursing Points
General
- Nursing diagnosis
- Impaired physical mobility
- Encourage patient to perform prescribed exercises
- Trauma to limb is prevented
- Provide stump care
- Proper healing visualized
- Maintain extension to prevent contractures
- Contractures in patient prevented
- Encourage patient to perform prescribed exercises
- Risk for infection
- Follow aseptic technique when changing dressings
- Patient free from infection
- Monitor vital signs for elevated temperature
- Patient has normal vital signs
- Administer antibiotics as ordered
- Patient free from infection
- Follow aseptic technique when changing dressings
- Situational low self-esteem
- Help patient to cope with loss of limb
- Patient displays self acceptance
- Encourage patient to express feelings
- Patient displays increased coping
- Assess patient’s support systems available
- Patient uses support systems during rehabilitation
- Help patient to cope with loss of limb
- Impaired physical mobility
Assessment
- Contributing factors
- Traumatic injury
- Peripheral vascular disease
- Blood clots
- Osteomyelitis
- Diabetes
- Smoking
- Obesity
Therapeutic Management
- Labwork
- Complete blood count
- Other diagnostic testing
- Physical exam
- X-rays/scans
- Medications
- Anticonvulsants
- Gabapentin 300-600 mg oral
- Narcotics
- Morphine 75-300mg oral (total per day)
- Antibiotics
- Cefazolin 1-2 g IV
- Anticonvulsants
Nursing Concepts
- Clinical judgment
- Coping
- Infection control
- Function ability
Patient Education
- Patient education
- Teach patient to
- Report signs of infection
- Redness, swelling, drainage
- Wrap limb
- Maintain healthy diet
- Report signs of infection
- Teach patient about phantom pain
- How to manage/relieve
- Teach patient to
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Transcript
Hey guys! Today we are going to take a look at a concept map for amputation.
So in this lesson we will take a look at the components of a concept map including contributing factors, medications, lab work and the significance, patient education, and associated nursing diagnoses with interventions and evaluations!
Ok so here is a basic example of a concept map, guys there are many different variations and this is just one example. First, we start with the primary diagnosis typically in the center of the concept map which leads to nursing diagnoses and interventions and also contributing factors, medications, labwork, and patient education which are associated with the primary diagnosis. Lets jump in! Lets start with contributing factors in the upper corner. Contributing factors or in other words what can lead to this diagnosis include a traumatic injury, peripheral vascular disease, blood clot, osteomyeolitis, and diabetes, smoking, and obesity.
In this next circle right here we might see medications associated with amputation. You may see that your patient is on an anticonvulsant orepilepsy drug like gabapentin (300-600 mg/day) to treat nerve pain. The exact action is unknown although it seems as though gabapentin likely inhibits the alpha-2 delta subunits of calcium channels decreasing nerve pain. An amputation patient may also be on a narcotic like morphine (75-300 mg extended release oral) to help control phantom pain as the binding of morphine in the opioid receptors blocks the transmission of pain signals. Before an amputation a patient may be administered cefazolin (1-2 g IV) preoperatively to prevent surgical infection.
Ok additional information included in a concept map is commonly patient education and significant labwork. So in this circle here lets add important patient education. Teach your patient to report signs of infection following an amputation including redness, swelling, and drainage. Teach the patient how to wrap their limb appropriately to help the healing process. It is super important to teach the patient what phantom pain is and ways to deal with it. Finally, teach your patient to maintain healthy eating habits to help with the healing process. Before an amputation, the patient will most likely need blood tests including CBC and other diagnostic testing including physical exam, and x-rays.
Finally, in the three circles that are left, we will add nursing diagnoses with interventions and evaluations for amputation. Impaired physical mobility is an appropriate nursing diagnosis related to the loss of a limb. Possible interventions including encouraging the patient to perform prescribed exercises to prevent trauma to the limb. Provide stump care to the patient on a routine basis inspecting that the area, clean, dry and rewrap which allows you to take a good look at the wound and will be evaluated by the proper healing of the stump. Finally, help the patient to maintain extension to prevent contractures.
Risk of infection is another nursing intervention due to surgery and the possibility of chronic diseases and altered nutritional status. What interventions can we apply here? First, follow aseptic technique when changing dressings and caring for the wound which will be evaluated by an absence of infection in the patient. Monitor vital signs in your patient as tachycardia and temperature elevation can indicate sepsis. Guys this is obviously evaluated by normal vital signs in the patient. Finally, administer antibiotics and indicated and ordered which will be evaluated by the absence of infection in the patient.
One last nursing diagnosis that we can apply to an amputation patient include situational low self-esteem which is related to the loss of a body part or functional ability. Intervention include helping the amputee cope with the loss of a body part or with altered body image. This will be evaluated by the patient showing self acceptance more quickly. Encourage the patient to express feelings of anger or sadness which helps the patient to deal with their new reality and will be evaluated by increased coping. Finally, assess how much support the patient has which can help the rehabilitation process for the patient.
Ok guys! Here is a look at the completed concept map for amputation!
We love you guys! Go out and be your best self today! And as always, Happy Nursing!
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