Author Question: The client with diabetes mellitus reports having difficulty trimming the toenails because they are ... (Read 25 times)

ap345 · **on:** Jun 25, 2018

The client with diabetes mellitus reports having difficulty trimming the toenails because they are thick and ingrown. What should the nurse recommend to this client?

A) Make an appointment with a podiatrist.
B) Offer to file the tops of the nails to reduce thickness after cutting.
C) Cut the nails straight across with a clipper after the bath.
D) Make an appointment with a nail shop for a pedicure.

Question 2

The nurse is caring for a client who is experiencing an alteration in mobility related to a musculoskeletal alteration.

Which laboratory tests are appropriate to diagnose the client appropriately?
Select all that apply.
A) Magnetic resonance imaging (MRI)
B) Alkaline phosphatase (ALP)
C) Human leukocyte antigen-B27 (HLA-B27)
D) Rheumatoid factor (RF)
E) Electromyography (EMG)

jackie · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

Answer: A

The toenails of the client with diabetes require close care. If the nails are thick or ingrown, they require the attention of a podiatrist. Cutting the nails across after the bath is correct for toenails that do not demonstrate the complications listed. The client with diabetes is at an increased risk for infection and should avoid situations in which this risk is increased, such as the nail shop pedicure. The nurse should not cut the client's toenails.

Answer to Question 2

Answer: B, C, D

ALP, HLA-B27, and RF are all laboratory tests that are used to diagnose clients with musculoskeletal disorders that can cause an alteration in mobility. ALP is produced by bone and other organs. Increased ALP may indicate bone disease, bone fracture, bone tumors, osteomalacia, Paget disease, and rickets. Decreased ALP may indicate Wilson disease. The presence of HLA-B27 indicates an increased risk or ankylosing spondylitis and arthritis. Elevated levels of RF may indicate rheumatoid arthritis, scleroderma, lupus erythematosus, and adult Still disease. MRI and EMG are both diagnostic, not laboratory, tests use to diagnose the cause of alterations in mobility.