Patient Data Exhibits Which of the following conditions is the client is at risk of?
Explanation & Rationale
Rationale for Correct Choices: • Infection: The client has a recent below-the-knee amputation, and although the incision currently shows no redness, postoperative wounds are at risk for infection due to open tissue, presence of drainage, and potential contamination. Monitoring for redness, increased drainage, odor, or fever is essential. • Deep vein thrombosis (DVT): Postoperative immobility, especially with the right leg hanging off the bed, increases the risk of venous stasis and clot formation. The client’s history of peripheral vascular disease and limited mobility further elevates the risk for DVT. • Contractures: Prolonged immobility and improper positioning of the residual limb can lead to joint contractures, particularly at the knee and hip. The prone positioning and encouragement of physical therapy help reduce this risk, but vigilance is necessary to maintain proper range of motion. Rationale for Incorrect Choices: • Neuroma: While neuromas can develop after amputations, they are a long-term postoperative complication caused by nerve regrowth, not an immediate risk on day 3. • Pneumonia: The client’s lungs are clear, respiratory rate is normal, and he is using an incentive spirometer. While postoperative patients can develop pneumonia, current assessment findings do not indicate acute respiratory risk.