An older woman has diabetes mellitus. Which patient assessment validates the nurse's conclusion that she is in the foreground perspective of the shifting perspectives model of chronic illness?
a. Has an amputation of two toes.
b. Lives at home with her husband.
c. Frequently self-checks her blood sugar.
d. Changes the battery in her glucometer.
A
An older adult thinks and acts about diabetes mellitus in the foreground perspective when signs of disease progression occur, which is evidenced by the need for the amputation of two toes, be-cause hyperglycemia damaged the lining of vessels and led to peripheral artery disease. The per-fusion to this woman's toes deteriorated to the extent that the tissue died; the dead tissue had to be removed to avoid infection.
Living at home indicates she has a functional status that is sufficient to maintain independent living. This woman is able to monitor her blood sugar independently and retains enough func-tional ability to change a battery.
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