43: Diabetic Pt Behavior - Bennett

Question 1

big three complications of diabetes

Answer 1

blindness
kidney failure
foot and leg amputation

Question 2

reasons for poor quality of life

Answer 2

• reduced mobility
• change in lifestyle of individual and family
• loss of social role
• unemployment
• reduce social activities

Question 3

how many diabetics are undiagnosed?

Answer 3

8.1 million or 27.8% of diabetic pop.

Question 4

leading cause of amputation

Answer 4

foot ulcers

Question 5

why are diabetics at a higher risk for further breakdown post-amputation?

Answer 5

gait and foot mechanics have changed

Question 6

5 yr mortality rate after new onset of diabetic foot ulceration =

up to ______ with LE amputation

Answer 6

43-55%

74%

because of the increased cardiovascular risks post amputation

these rates are higher than a lot of cancers

Question 7

principles of ulcer management

Answer 7

1. infection
2. vascular supply
3. debridement
4. off loading
5. wound management
6. wound closure
7. management of medical comorbidities

Question 8

successful management needs to address _______ and ______

Answer 8

pts mental status

ulcer management

Question 9

3 requirements for successful amputation

Answer 9

1. remove all necrotic, painful or infected tissue
2. must be able to fit amputation stump with a functional and easily applied prosthesis
3. blood supply at the level of proposed amputation must be sufficient to allow primary skin healing

Question 10

major factors to consider for amputation level

Answer 10

• medical and mental status of pt

- infection

Question 11

what joints are amputated with choparts?

Answer 11

talonavicular

calcaneal-cuboid

Question 12

do amputees go through the grieving process?

Answer 12

yes

denial
anger
bargaining
depression
acceptance
recovery

Question 13

successful management needs to address pts __________ and _______

Answer 13

mental status

amputation management

Question 14

if things are progessing well …

Answer 14

express to pt and congratulate him or her

if not going well, need to be up front and honest and be clear for tx plan

consider professional psych help if significant signs of anxiety and depression