Phantom limb pain is a real sensation of pain in the missing limb and should be acknowledged, not dismissed.
Before you read
Test yourself first: 3 questions
Question 1 of 3
A client with a below-the-knee amputation reports feeling pain in the foot that has been removed. Which response by the nurse is BEST?
Answer: B. Phantom limb pain is a real neurologic phenomenon in which the client perceives sensation or pain in the missing limb. The nurse should acknowledge that the pain is real, provide prescribed analgesia, and use adjunct measures. Dismissing the pain as imaginary is non-therapeutic.
Question 2 of 3
A child with asthma uses a peak expiratory flow meter at home. The reading falls in the red zone (less than 50% of the personal best). Which instruction should the nurse reinforce with the family?
Answer: B. A red-zone peak flow reading signals a medical alert: the child should take the prescribed quick-relief (short-acting beta agonist) medication and seek medical care immediately. Continuing routine activity, doubling the controller, or waiting to recheck delays needed treatment.
Question 3 of 3
A client passes a renal calculus and reports severe flank pain radiating to the groin. Nursing care includes:
Answer: B. Provide pain relief, encourage fluids (unless contraindicated) to help pass the stone, strain all urine to capture the stone for analysis, and monitor output. Restricting fluids and discarding urine are incorrect.
Keep the streak going with more questions like these, each with a full rationale.
What is amputation care?
Nursing care focuses on preventing hemorrhage and infection, managing pain including phantom limb pain, shaping the residual limb for prosthesis fitting, and supporting psychosocial adjustment to body image change.
Key points to remember
- Phantom limb pain is a real sensation of pain in the missing limb and should be acknowledged, not dismissed.
- Hemorrhage is the most life-threatening early complication, so a tourniquet is kept at the bedside.
- Residual limb (stump) shaping with elastic wrapping or shrinker socks prepares it for a prosthesis.
- Contractures of the hip and knee can develop and prevent prosthesis use if positioning is poor.
- For the first 24 hours, the foot of the bed may be elevated to reduce swelling, then elevation is avoided to prevent flexion contractures.
- Diabetes and peripheral vascular disease are the most common causes of lower limb amputation.
Nursing priorities
- Monitor the surgical dressing for bleeding and keep a tourniquet at the bedside for hemorrhage.
- Position the patient prone periodically and avoid prolonged hip or knee flexion to prevent contractures.
- Wrap the residual limb in a figure-eight pattern to shape it for the prosthesis.
- Manage phantom limb pain with prescribed medications and acknowledge that the pain is real.
- Support the patient through grief and body image changes and encourage expression of feelings.
Labs & values
Patient teaching
- Wrap and care for the residual limb daily, inspecting the skin for breakdown and signs of infection.
- Avoid resting the limb on a pillow for long periods and do prescribed exercises to prevent contractures.
- Report phantom limb pain so it can be treated, and seek support for emotional adjustment.
Red flags: report now
- Bright red bleeding or a rapidly enlarging blood spot on the dressing signals hemorrhage; apply pressure and use the tourniquet.
- Do not elevate the residual limb on a pillow after the first 24 hours, as this causes a flexion contracture.
- Signs of infection (fever, increasing redness, foul drainage) or stump necrosis must be reported.
References
Clinical references for this topic
