Today’s NCLEX-RN® question of the day focuses on diabetic neuropathy. Do you know the answer? Let’s find out!
The home health nurse is caring for a 65-year-old patient with type 2 diabetes mellitus (DM) and diabetic neuropathy.
The patient has missed several medical appointments, reports taking their glyburide inconsistently, and has been hospitalized twice in the last three months for complications of DM.
Based on this information, the nurse chooses a priority hypothesis of ineffective health management.
Which outcome statement is most appropriate for this patient?
A. The patient will visit the ophthalmologist every two years
B. The patient will take their glyburide for blood glucose levels less than 70 mg/dL
C. The patient will learn to self-administer insulin once daily
D. The patient will visit a podiatrist monthly for foot care
Scroll down for the correct answer!
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The correct answer to today’s NCLEX-RN® Question is…
D. The patient will visit a podiatrist monthly for foot care
Rationale: This is an appropriate outcome statement since patients with type 2 DM are at risk for foot injuries due to diabetic neuropathy. Diabetic neuropathy occurs when chronic hyperglycemia leads to vascular and nerve damage, leading to numbness in the periphery. As a result, patients may sustain a wound and not be aware – leading to delayed healing and infection. Further, this outcome is patient-centered, realistic, time-based, measurable and achievable.
Main Takeaway
Diabetes mellitus (DM) is a condition where glucose cannot be properly moved from the blood into the cells. In patients with type 2 DM, the pancreas is able to produce and secrete insulin, but the tissue cells tend to be insulin resistant, meaning they are unable to respond well to insulin stimulation. The nurse caring for a patient with type 2 DM will practice clinical judgment by identifying expected outcomes and using hypotheses to define a set of interventions. Visiting the podiatrist monthly for foot care is a patient-centered, realistic, time-based, measurable and achievable goal for the priority hypothesis of ineffective health management to prevent foot injuries related to DM and diabetic neuropathy. Diabetic neuropathy occurs when chronic hyperglycemia leads to vascular and nerve damage, causing numbness in the periphery. As a result, patients may sustain a wound and not be aware – leading to delayed healing and infection.
Incorrect Answer Explanations
A. The patient will visit the ophthalmologist every two years
Rationale: Although it is important for patients with DM to visit the ophthalmologist due to the risk for diabetic retinopathy, they should go at least once per year rather than every two years.
B. The patient will take their glyburide for blood glucose levels less than 70 mg/dL
Rationale: This is not an appropriate outcome since blood glucose levels less than 70 mg/dL are considered hypoglycemia and taking glyburide, a sulfonylurea anti-diabetic medication, will further reduce blood glucose levels.
C. The patient will learn to self-administer insulin once daily
Rationale: This is not an appropriate outcome since this patient is not prescribed insulin, instead they are prescribed an oral antidiabetic agent.
Want to learn more about this topic?
Watch the Osmosis video: Diabetes mellitus (DM): Nursing process (ADPIE)
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