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Information

  1. Assessment:
    1. Loss of self-esteem; feelings of helplessness, worthlessness, shame, and guilt.
    2. Fear of abandonment may lead to appeals for sympathy by exhibiting helplessness and vulnerability.
    3. Feelings of castration (loss of self) and symbolic death; loss of wholeness.
    4. Existence of phantom pain (most clients).
    5. Passivity, lack of responsibility for use of disabled body parts.
  2. Nursing care plan/implementation:
    1. Avoid stereotyping person as being less competent now than previously by not referring to client as the "amputee."
    2. Foster independence; encourage self-care by assessing what client can do for himself or herself.
    3. Help person set realistic short-term and long-term goals by exploring with the client his or her strengths and resources.
    4. Health teaching:
      1. Encourage family members to work through their feelings, to accept person as he or she presents self.
      2. Teach how to set realistic goals and limitations.
      3. Explain what phantom pain is; that it is a normal experience.
      4. Explain role and function of prosthetic devices, where and how to obtain them, and how to find assistance in their use.
  3. Evaluation/outcome criteria:
    1. Can acknowledge the loss and move through three stages of mourning (shock and disbelief, developing awareness, and resolution).
    2. Can discuss fears and concerns about loss of body part, its meaning, the problem of compensating for the loss, and reaction of persons (repulsion, rejection, and sympathy).