A 61-year-old client with diabetes mellitus has a physician's order for meticulous foot care. Which of the following rationales is most appropriate with respect to the physician's order?
a. The aging process causes increased skin breakdown.
b. Increased neuropathy occurs with this pathology and places the client at risk.
c. The client probably has a history of poor hygienic care.
d. The lower extremities are difficult to see and therefore more prone to inadequate hygiene.
B
Vascular changes associated with diabetes mellitus reduce the blood flow to peripheral tissues. Breaks in skin integrity place a diabetic client at risk for skin infection. Meticulous foot assess-ment reduces the diabetic client's risk of debilitating foot problems.
The best rationale for meticulous foot care for this client relates to the risks associated with the client's diagnosis of diabetes mellitus.
No indication is apparent that the client has a history of poor hygienic care.
Poor vision may contribute to difficulty in providing foot care, but this client's greatest risk for developing a foot ulcer is diabetic neuropathy.
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