A nurse is caring for a client who has peripheral neuropathy due to diabetes mellitus. Which of the following interventions should the nurse include in the plan of care?

Choice A reason:

This is a correct answer. Low back pain that radiates down the leg is a common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. Radiculopathy is a condition that affects the nerve roots that exit from the spinal cord, causing pain, numbness, tingling, or weakness along their distribution. A herniated intervertebral disc is a common cause of radiculopathy, as it can compress or irritate the nerve roots in the spinal canal or intervertebral foramen. The pain may follow a dermatomal pattern depending on which nerve root is affected.

Choice B reason:

This is a correct answer. Muscle weakness or atrophy in the affected leg is another common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. Muscle weakness or atrophy may result from reduced nerve stimulation or innervation to the muscles in the leg, which can affect their function and appearance. The muscle weakness or atrophy may follow a myotomal pattern depending on which nerve root is affected.

Choice C reason:

This is a correct answer. Diminished or absent deep tendon reflexes in the affected leg is another common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. Deep tendon reflexes are involuntary responses that are elicited by tapping on specific tendons with a reflex hammer, such as the patellar or Achilles tendon. Diminished or absent deep tendon reflexes may indicate damage or dysfunction of the nerve roots that mediate the reflex arc. The diminished or absent deep tendon reflexes may follow a segmental pattern depending on which nerve root is affected.

Choice D reason:

This is a correct answer. Positive straight leg raise test on the affected side is another common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. The straight leg raise test is a physical examination maneuver that involves raising the client's leg while keeping it straight and flexing the foot. A positive test is indicated by pain in the low back or leg that is reproduced or worsened by the maneuver, which suggests nerve root compression or irritation by the herniated disc.

Choice E reason:

This is an incorrect answer. Loss of bladder or bowel control is not a common symptom of radiculopathy due to a herniated intervertebral disc in the lumbar spine. Loss of bladder or bowel control may indicate cauda equina syndrome, which is a rare but serious condition that involves compression of the nerve roots at the end of the spinal cord, causing severe low back pain, saddle anesthesia, sexual dysfunction, and urinary or fecal incontinence. Cauda equina syndrome requires immediate medical attention and surgical decompression to prevent permanent nerve damage or paralysis.

Choice A reason:

This is a correct answer. The nurse should inform the client that the symptoms of peripheral neuropathy may improve after stopping chemotherapy, as chemotherapy is a common cause of peripheral neuropathy. Chemotherapy can damage the peripheral nerves and cause numbness, tingling, pain, or weakness in the extremities. The symptoms may be reversible or permanent depending on the type, dose, and duration of chemotherapy and the individual's response.

Choice B reason:

This is an incorrect answer. The nurse should not tell the client that the risk of peripheral neuropathy can be reduced by taking antioxidants, as there is no evidence to support this claim. Antioxidants are substances that protect the cells from oxidative stress and free radical damage, which may contribute to various diseases and aging. However, antioxidants have not been proven to prevent or treat peripheral neuropathy, and some antioxidants may interact with chemotherapy or other medications.

Choice C reason:

This is a correct answer. The nurse should inform the client that the treatment of peripheral neuropathy may include medications such as gabapentin or duloxetine, which are commonly used to manage neuropathic pain. Gabapentin is an anticonvulsant that modulates calcium channels and reduces nerve excitability. Duloxetine is an antidepressant that inhibits the reuptake of serotonin and norepinephrine and enhances pain inhibition. The nurse should also educate the client about the possible side effects and interactions of these medications.

Choice D reason:

This is a correct answer. The nurse should inform the client that the prevention of peripheral neuropathy includes avoiding alcohol and smoking, which are common risk factors for peripheral neuropathy. Alcohol and smoking can damage the peripheral nerves and blood vessels, impairing blood flow and oxygen delivery to the extremities. The nurse should advise the client to limit or quit alcohol and smoking and seek help if needed.

Choice E reason:

This is a correct answer. The nurse should inform the client that the complications of peripheral neuropathy may include falls or injuries, which can affect their safety and quality of life. Peripheral neuropathy can impair sensation, balance, coordination, and reflexes in the extremities, increasing the risk of falls or injuries. The nurse should teach the client strategies to prevent falls or injuries, such as wearing proper footwear, using assistive devices, removing hazards from the environment, and inspecting their feet daily for any wounds or infections.