A client with diabetes mellitus has an above-knee amputation because of severe peripheral vascular disease, Two days following surgery, when preparing the client for dinner, it is the nurse’s primary responsibility to:
A. Check the client’s serum glucose level
B. Assist the client out of bed to the chair
C. Place the client in a High-Fowler's position
D. Ensure that the client’s residual limb is elevated
Correct Answer: A. Check the client’s serum glucose level
Because the client has diabetes, it is essential that the blood glucose level is determined before meals to evaluate the success of control of diabetes and the possible need for insulin coverage. Integrating CGMs as part of a glycemic control protocol can lead to better management of glucose levels with fewer hyperglycemia episodes and lower glucose level variability resulting in better post-surgical outcome.
Option B: Physical therapy will begin soon after surgery when the client’s condition is stable and the doctor clears the client for rehabilitation. The first 2 to 3 days of treatment may include gentle stretching and range-of-motion exercises, learning to roll in bed, sit on the side of the bed, and move safely to a chair.
Option C: In clients who have undergone transtibial and transfemoral amputations, prolonged sitting with the hip and knee flexed should be avoided. Clients who have undergone transfemoral amputations should be instructed to lie in the prone position multiple times during the day to stretch the hip musculature.
Option D: Elevate the stump for the first 24 to 48 hours. Move and turn the client gently and slowly to prevent severe muscle spasms. Reposition the client every 2 hours, turning the patient from side to side and prone, if possible.
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