The nurse is reviewing the healthcare record of a patient with ...

[jrubin]

The nurse is reviewing the healthcare record of a patient with type 2 diabetes mellitus who has a foot wound. Which outcome of care would be the most important at this time?
 
  1. The patient will bring a caregiver to the next healthcare appointment.
  2. The patient will describe the steps of effective diabetic foot care.
  3. The patient will explain why patients with diabetes should not go barefoot.
  4. The patient will obtain a thermometer for monitoring bath water temperature.

Question 2

The nurse is assessing a patient with type 2 diabetes mellitus. What questions should the nurse ask to determine the patient's risk for a lower extremity amputation?
 
  Select all that apply.
  1. Do you use insulin or oral hypoglycemic agents?
  2. What were your glycosylated hemoglobin values over the past year?
  3. Do you have any problems with your eyes related to diabetes?
  4. Do you have any problems with your kidney related to diabetes?
  5. When were you first diagnosed with diabetes mellitus?

[Missbam101]

Answer to Question 1

Correct Answer: 1
Foot care is a priority in DM management to prevent serious problems. If the person has visual deficits, is obese, or cannot reach the feet, teach the caregiver how to inspect and care for the feet. Feet should be inspected daily. Describing the steps of foot care will not be helpful since the patient cannot perform the care independently. Eliminating risk factors for foot wounds will not help the patient because a foot wound is already present. Monitoring bath water can help prevent future wounds; however, it does not address or help with the current foot problem.

Answer to Question 2

Correct Answer: 2, 3, 4
The high incidence of foot problems and amputations in people with diabetes mellitus is the result of angiopathy, neuropathy, and infection. People with diabetes mellitus, especially those who not meeting recommended glycemic goals, are at high risk for amputation of a lower extremity. Age of diagnosis has no influence on the patient's risk of needing an amputation in the future.