A nurse is collecting data from a client who is postoperative from a below-the-knee amputation and whose residual limb is wrapped with an elastic bandage to shrink the stump. Which of the following findings should alert the nurse to a possible complication?

Choice A rationale A dressing that forms a cone shape over the residual limb is generally considered a desirable outcome for a post-amputation stump. This shape is achieved through specific wrapping techniques to facilitate the shrinking and molding of the limb for future prosthetic fitting. It helps ensure that the distal end of the limb is narrower than the proximal portion. This is a standard therapeutic goal and does not indicate a complication that requires urgent nursing intervention. Choice B rationale Looseness of the stump dressing is a common occurrence as the initial post-operative edema begins to subside. While the nurse should rewrap the limb to maintain consistent pressure and continue the molding process, mild looseness is not usually a sign of an acute complication like ischemia or hemorrhage. The nurse should monitor the limb for changes in size and ensure the bandage is snug enough to provide support without cutting off the arterial blood supply. Choice C rationale Pitting edema observed above the bandage is a significant finding that suggests the elastic wrap is applied too tightly or is creating a tourniquet effect. This obstructs venous return and lymphatic drainage from the distal portion of the limb. Edema can lead to tissue ischemia, delayed healing, and skin breakdown. The nurse must recognize this as a sign of impaired circulation. Normal skin should be non-pitting, and any indentation indicates fluid accumulation in the interstitial spaces. Choice D rationale The figure-eight wrapping technique is the preferred method for applying an elastic bandage to a residual limb. This method provides even pressure distribution, avoids circular constriction that could impede blood flow, and helps mold the stump into the necessary shape for a prosthesis. Because this is the correct and standard procedure for stump care, it is not a finding that would alert the nurse to a complication. It demonstrates proper nursing practice and limb management.