A nurse in a primary care clinic is working with a 57-year-old man with type 2 diabetes who has leg ulcerations that are weeping and open. He also has vascular insufficiency as a new medical diagnosis

Question

The most appropriate nursing diagnosis would be:
A) Impaired physical mobility related to activity restrictions of the therapeutic regimen and pain
B) Impaired skin integrity related to compromised circulation
C) Altered tissue perfusion related to diabetes
D) Imbalanced nutrition, less than body requirements, related to increased need for nutrients that promote wound healing

Answer 1

Ans: B
Feedback: The leg ulcerations that are weeping and open represent impaired skin integrity that has resulted from a lack of blood flow to the tissue in the patient's legs resulting in tissue death and compromising circulation. Therefore, the most appropriate nursing diagnosis is impaired skin integrity related to compromised circulation. Option A is incorrect; no activity restrictions have been identified that relate to the compromised circulation. Option C is incorrect; it is a collaborative nursing diagnosis that fails to address the new diagnosis of vascular insufficiency. Option D is incorrect; imbalanced nutrition of less than body requirements fails to address the cause of the problem, which is compromised circulation.