part 14

Question 1

What does diabetic neuropathy autonomic neuropathy cause?

Answer 1

• gastroparesis: delayed gastric emptying
• cardiovascular abnormalities: postural hypotension, resting tachycardia, painless myocardial infarction
• sexual dysfunction: erectile dysf., decreased libido, vaginal infx
• neurogenic bladder—–> urinary retention: self cath, meds, empty frequently

Question 2

What causes foot complications with DM patients?

Answer 2

microvascula and macrovascular diseases with place the pt at an increased risk for injury and serious infection

• sensory neuropathy: LOPS (loss of protective sensation and unawareness of injury)
• PAD: decreased blood flow and wound healing increases risk of infection
• clotting abnormalities
• smoking

Question 3

What do we need to teach out pts about preventing foot ulcers?

Answer 3

• proper footwear
• avoidance of foot care
• skin and nail care
• daily inspection of feet
• prompt treatment of small problems
• diligent wound care for foot ulcers
• Neuropathic arthropathy (Charcot’s foot): causes deformity which causes ulcer

Question 4

What are some common chronic skin problems diabetic pt’s will have?

Answer 4

• diabetic dermopathy: red-brown patches
• acanthosis nigricans: light brown/black skin
• necrobiosis lipoidica diabeticorum: red yellow lesions

Question 5

Why are diabetic pts more susceptible to infections?

Answer 5

-mobilization of inflammatory cells and impaired phagocytosis by neutorphils and monocytes

Question 6

What are some psychological considerations for a DM pt?

Answer 6

depression
anxiety
eating disorders
-open communication is critical

Question 7

What are some gerontological considerations for DM pt’s?

Answer 7

• increased prevalence and mortality
• glycemic control challenging
• increased hypoglycemic unawareness
• renal insufficiency
• meal planning
• adapt teaching to pt needs