Mrs. gengie, age 92, has bilateral below-the-knee amputation due to peripheral vascular disease and diabetes. Which action should the nurse perform during the initial post-op period?

• A. Assess stump bandage for bleeding and drainage
• B. Change stump dressing hourly
• C. Initiate ambulation with crutches immediately
• D. Administer pain meds on a fixed schedule

Answer: (A)

After amputation, the priority is to protect the surgical site and start correct limb shaping while watching for complications. Assessing the stump bandage for bleeding and drainage is essential because fresh bleeding or unexpected drainage can signal postoperative hemorrhage or wound problems, and the amount and type of drainage help indicate how healing is progressing. The dressing also helps control edema and gradually shape the residual limb for eventual prosthesis fitting, so checking it closely supports both safety and rehabilitation.

Other actions either don’t address the immediate risk or aren’t appropriate yet: changing the stump dressing too often can disturb healing; starting ambulation with crutches right away isn’t safe in the immediate postoperative period; and while pain management is important, it doesn’t take precedence over monitoring the dressing for signs of bleeding or drainage.