The nurse is caring for a 12-year-old child with a left leg below-the-knee amputation (BKA) . The child had the surgery 1 week ago. Which intervention should the nurse plan to implement for this child?

A) Elevate the left stump on a pillow.
B) Place an ice pack on the stump.
C) Encourage the child to use an overhead bed trapeze when repositioning.
D) Replace the ace wrap covering the stump with a gauze dressing.

Use of the overhead bed trapeze should be encouraged to begin to build up the arm muscles necessary for walking with crutches. Stump elevation may be used during the first 24 hours, but after this time, the extremity should not be left in this position because contractures in the proximal joint will develop and seriously hamper ambulation. Ice would not be an appropriate intervention and would decrease circulation to the stump. Stump shaping is done postoperatively with special elastic bandaging using a figure-eight bandage, which applies pressure in a cone-shaped fashion. This technique decreases stump edema, controls hemorrhage, and aids in developing desired contours so the child will bear weight on the posterior aspect of the skin flap rather than on the end of the stump. This wrap should not be replaced with a gauze dressing.