The nurse teaches the patient with diabetes that he is particularly prone to injury that may lead to amputation of the lower extremities due to which of the following? Select all that apply
1. Loss of protective sensation may lead to ulceration and infection.
2. The patient with diabetes is at risk for impaired tissue perfusion secondary to peripheral arterial disease.
3. Taking insulin increases the likelihood of developing atherosclerotic disease.
4. Patients with hemoglobin A1C greater than 4 are at risk for gangrene.
5. Individuals with diabetes are particularly prone to arthritis.
1. Loss of protective sensation may lead to ulceration and infection.
2. The patient with diabetes is at risk for impaired tissue perfusion secondary to peripheral arterial disease.
Rationale: Loss of protective sensation may lead to ulceration and infection. Poor blood flow (PAD) may cause gangrene and decreased sensation may allow an injury to go unobserved and infection such as osteomyelitis may develop, requiring amputation. The patient with diabetes is at risk for impaired tissue perfusion secondary to peripheral arterial disease. Clients with diabetes are prone to atherosclerotic disease and peripheral neuropathy; these process decrease blood flow to the lower extremities and cause lack of sensation. Taking insulin increases the likelihood of developing atherosclerotic disease. Taking insulin promotes glycemic control and decreases risk of vascular complications. Patients with hemoglobin A1C greater than 4 are at risk for gangrene. The target for hemoglobin A1C should be below 7. Individuals with diabetes are particularly prone to arthritis. Arthritis is not a risk factor for injury and PAD leading to amputation.
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