Diabetic foot exam Flashcards
What things are done at the beginning of a diabetic foot exam?
- Asses gait (peripheral neuropathy can cause slow, painful, unsteady gait)
- Inspect footwear (for uneven wear, anything causing injury)
What are you looking for on inspection in a diabetic foot exam?
Inspect all aspects of lower limb (including between toes and behind heel)
- Colour (cyanosis/pallor/erythema): poor perfusion/infection
- Ulcers (arterial/venous)
- Scars
- Missing limbs/toes/fingers
- Hair loss/decreased sweating/dry skin: autonomic dysfunction
- Infection (gangrene/cellulitis)
- Calluses: abnormal gait, poor footwear
- Deformities: high arch/flat foot, clawed/hammer toes
What do you need to palpate in a diabetic foot exam?
- Temperature
- Bones/joint tenderness
- Capillary refill
- Posterior tibial pulse
- Dorsalis pedis pulse
What is tested for the neurological assessment in a diabetic foot exam?
- Sensation with a monofilament
- Vibration
- Proprioception
- Ankle reflex
- test sensations in the toes, if not present move higher
What further assessments could be done to complete a diabetic foot exam?
- Bedside capillary blood glucose
- HbA1C
- Lower limb neurological exam
- Peripheral vascular exam