A client has just returned to a nursing unit after an above-knee amputation of the right leg.

Explanation

Core Concept: Immediately post-operative care for an above-knee amputation (AKA) focuses on edema control, pain management, and preventing joint contractures. Placing pillows under the residual limb promotes hip and knee flexion, leading to severe contractures.

Clinical Presentation:

• Post-operative pain, residual limb edema, risk of hemorrhage.

Diagnosis:

• *First-line:* Assessment of the surgical dressing for bleeding and neurovascular status of the limb.
• *Gold Standard:* N/A.

Management:

• *Acute:* Place the patient *supine, with the amputated limb flat on the bed*. (Note: Some protocols allow elevation on a single pillow for the first 24 hours strictly for edema reduction, but it must be removed immediately after to prevent flexion contractures. Flat is the safest standard answer to prevent contractures).
• *Definitive:* Apply rigid removable dressings or compression bandages to shape the residual limb and transition to prone positioning as soon as the patient is stable.