Discharge And Home Healthcare Guidelines

PREVENTION OF COMPLICATIONS. Teach the patient to wash the stump daily with plain soap and water, inspecting for signs of irritation, infection, edema, or pressure. Remind him or her not to elevate the stump on pillows, as a contracture may still occur in the nearest joint.

PHANTOM LIMB PAIN. Teach the patient to apply gentle pressure to the stump with the hands to control occasional phantom limb pain and to report frequent phantom limb pain to the physician.

PHYSICAL THERAPY. Give the patient the physical therapy or exercise schedule she or he is to follow and make sure she or he understands it. If the patient needs to return to the hospital for physical therapy, check on the availability of transportation.

SUPPLIES AND EQUIPMENT. Make sure that the patient is provided with needed supplies and equipment, for example, stump socks and a well-fitting prosthesis.

ENVIRONMENT. Instruct the patient to avoid environmental hazards, for example, throw rugs and steps without banisters.

SUPPORT SERVICES. Many communities have support services for amputees and for patients who have suffered a loss (including a body part). Help the patient locate the appropriate service, or refer him or her to the social service department for future support.

^Amyloidosis is a rare, chronic metabolic disorder that is characterized by the extracellular deposition of the fibrous protein, amyloid, in one or more sites of the body. Eight people out of one million develop amyloidosis and the average age of diagnosis is approximately 65 years of age. Organ dysfunction results from accumulation and infiltration of amyloid into tissues, which ultimately puts pressure on surrounding tissues and causes atrophy of cells. Some forms of amyloi-dosis cause reticuloendothelial cell dysfunction and abnormal immunoglobulin synthesis.

The associated disease states may be inflammatory, hereditary, or neoplastic; deposition can be localized or systemic. Although primary amyloidosis is not associated with a chronic disease, secondary amyloidosis is associated with such chronic diseases as tuberculosis, syphilis, Hodgkin's disease, and rheumatoid arthritis, and with extensive tissue destruction. Amyloidosis occurs in about 5% to 10% of patients who have multiple myeloma, the second most common malignant tumor of bone. The spleen, liver, kidneys, and adrenal cortex are the organs tissue

DRG Category: 240

Mean LOS: 6.4 days

Description: MEDICAL: Connective Tissue

Disorders with CC

most frequently involved. For a patient with generalized amyloidosis, the average survival rate is 1 to 4 years. Some patients have lived longer, but amyloidosis can result in permanent or life-threatening organ damage. The major cause of death is renal failure.

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