The nurse is caring for a patient who has diabetes mellitus and circulatory insufficiency, with peripheral neuropathy and urinary incontinence. The nurse realizes that patients with these conditions
a. Have decreased pain sensation and increased risk of skin impairment.
b. Are at decreased risk of developing infection due to urinary pH level.
c. Also have decreased caloric intake, which results in accelerated wound healing.
d. Have impaired venous return, allowing for greater circulation and less breakdown.
A
Patients with paralysis, circulatory insufficiency, or local nerve damage are unable to sense an injury to the skin. The presence of perspiration, urine, watery fecal material, and wound drainage on the skin results in breakdown and infection. Patients with limited caloric and protein intake develop thinner, less elastic skin, with loss of subcutaneous tissue. This results in impaired or delayed wound healing. Impaired venous return decreases circulation to the extremities. Inadequate blood flow causes ischemia and breakdown.
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