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Andrew Pollack-Gray

Nursing Notes

Prosthetic and Orthotic Care

3 min read

Patient Needs

Support residents using prosthetic or orthotic devices while maintaining skin integrity, comfort, mobility, dignity, and independence.

Prosthesis: An artificial replacement for a missing body part, such as an artificial limb.

Orthosis: A device, such as a brace or splint, used to support, align, stabilize, or protect a body part.

Care Goals:

  • Maintain safe, comfortable device use.
  • Prevent pressure, friction, and skin breakdown.
  • Support prescribed mobility and rehabilitation activities.
  • Encourage independence with device management when appropriate.

What Should I Assess?

Skin:

  • Redness, swelling, blisters, or open areas.
  • Pain, tenderness, or unusual pressure.
  • Moisture buildup or irritation at device contact points.

Device:

  • Poor fit, looseness, or excessive pressure.
  • Wrinkled socks or liners.
  • Damaged straps, sockets, fasteners, or other components.
  • Changes in fit associated with swelling or changes in residual-limb volume.

Resident:

  • Ability to apply, remove, and use the device as directed.
  • Changes in mobility, balance, or comfort.
  • Difficulty completing daily activities.

How Do I Provide Care?

Skin Care

  1. Review the care plan and device-specific instructions.
  2. Assist with inspection of the residual limb or affected skin as directed.
  3. Clean the skin using approved methods.
  4. Dry thoroughly, especially where moisture may accumulate.
  5. Observe for irritation, pressure marks, or breakdown.
  6. Report concerning changes before continuing device use.

Device Care

  • Assist with application and removal only when trained and authorized.
  • Follow prescribed wearing schedules and restrictions.
  • Inspect device components for visible damage.
  • Clean socks, liners, sockets, and braces according to manufacturer instructions.
  • Allow components to dry as required.
  • Report changes in fit rather than independently modifying the device.

Supporting Independence

  • Encourage participation in device care when appropriate.
  • Assist with prescribed mobility and rehabilitation activities.
  • Respect preferences and emotional adjustment.
  • Support safe use of adaptive equipment according to the care plan.

Safety & Precautions

  • Never force a device that does not fit properly.
  • Do not apply a device over broken skin without clinical direction.
  • Do not independently adjust prosthetic alignment, orthotic settings, or prescribed fit.
  • Follow device-specific restrictions, including weight-bearing precautions.
  • Avoid unapproved lotions, powders, cleaning products, or device modifications.
  • Report persistent redness, pain, swelling, or skin breakdown.
  • Seek nursing or rehabilitation-team guidance before resuming use when concerning skin changes or fit problems occur.

What Should I Report?

  • New redness, blisters, open skin, drainage, or swelling.
  • Persistent pain or discomfort during device use.
  • A device that rubs, pinches, slips, or fits poorly.
  • Broken, damaged, or missing components.
  • Changes in mobility, balance, or ability to manage the device.
  • Inability to follow the prescribed wearing schedule.

Sources

Flashcards

What must be checked when a resident uses a prosthesis or brace?03-application / patient-care
Answer

Fit, skin pressure, discomfort, and care-plan instructions.

What should a CNA do if a prosthetic device causes persistent redness or pain?03-application / patient-care
Answer

Stop or defer use as appropriate, report the concern, and obtain guidance.

Who determines necessary adjustments to a poorly fitting prosthesis?03-application / patient-care
Answer

The authorized rehabilitation or prosthetic care team.

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