A nurse is preparing to care for a client who had undergone an above-knee amputation of right leg. The nurse plans to allow which position for client in first 24 hours?

Correct Answer: B. Supine position, with the affected limb supported with pillows.

The amputated limb is usually supported with pillows on the first post-op day to promote venous return and reduce edema. Preventing contractures is very important. A contracture occurs when a joint becomes stuck in one position. If this happens, it may be hard or impossible to straighten the remaining limb and use an artificial leg.

• Option A: Make sure the client puts equal weight on both hips when he sits. Use firm chairs, and sit up straight. The client should keep the remaining limb flat with both legs together while lying on the back. The client should not sit for more than an hour or two. He must stand, or lie on his stomach now and then.
• Option C: If the affected limb is put in a dependent position, edema might occur. Edema in the residual limb is also a common complication after LLA surgery. Controlling the amount of edema post-surgically is vital for promoting wound-healing, pain control, protecting the incision during rehabilitation, and assisting in shaping the stump for prosthetic fitting
• Option D: The main goal of good positioning at any time is to prevent adjacent joint contractures. The patient should be advised on how to position themselves while sitting and lying in the hospital bed or standing to prevent contractures. Make sure you explain to the patient the dangers of the dependent position (residual limb hanging down) in the early post-op phase as this may increase edema, pain, and healing time.