A patient who has type 2 diabetes for 26 years is beginning to experience peripheral neuropathy in the feet and lower leg. The nurse is providing education to the patient to prevent injury to the feet by wearing shoes or slippers when walking. Which statement by the nurse best explains the rationale for this instruction?
Wearing shoes blocks pain perception and helps you adapt to pain, which ends up protecting your feet.
The neurological gates open when wearing shoes, which protects your feet.
If you step on something without shoes, you might not feel it; this could possibly cause injury to your foot.
Shoes provide nonpharmacological pain relief to people with diabetes and peripheral neuropathy.
The Correct Answer is C
Choice A reason: This statement is incorrect. Peripheral neuropathy in diabetes impairs sensory nerve function, reducing pain perception. Shoes don’t block pain or aid adaptation but act as a physical barrier to prevent injury. Misrepresenting neuropathy’s sensory loss could lead to inadequate patient education, increasing risks of undetected injuries like cuts or infections.
Choice B reason: The concept of “neurological gates” opening with shoes is scientifically inaccurate. Gate control theory explains pain modulation via spinal cord pathways, not footwear. Shoes protect feet mechanically, not neurologically. This misstatement fails to address neuropathy’s sensory deficits, which heighten injury risk without protective footwear, misleading patient education.
Choice C reason: This is correct. Peripheral neuropathy diminishes sensation, so patients may not feel injuries like cuts or punctures. Shoes provide a protective barrier, preventing trauma to insensate feet. This reduces risks of infections or ulcers, critical in diabetic foot care due to impaired healing and increased susceptibility to complications.
Choice D reason: Shoes don’t inherently provide nonpharmacological pain relief for neuropathy. While they may reduce discomfort from pressure or injury, their primary role is injury prevention. Neuropathic pain requires specific treatments like gabapentin or physical therapy, not shoes, which primarily address mechanical protection rather than pain modulation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Cranberry juice typically causes pink or reddish urine, not orange. Orange urine is more commonly linked to medications, dehydration, or liver issues. Asking about cranberry juice is less relevant, as it does not directly address the most likely causes of orange discoloration.
Choice B reason: Medications like rifampin, phenazopyridine, or certain vitamins (e.g., B vitamins) can cause orange urine due to their pigments or metabolites excreted renally. Inquiring about new medications is a targeted approach to identify a common, benign cause before escalating to invasive diagnostics.
Choice C reason: Immediately scheduling an appointment assumes a serious condition without exploring benign causes like medications or dehydration. This response may cause unnecessary alarm and overlooks a systematic assessment, which could resolve the issue through history-taking alone.
Choice D reason: Blood in urine (hematuria) typically causes red or brown discoloration, not orange. Asking about blood is less relevant to orange urine and may confuse the patient, as it does not align with the reported symptom’s likely etiology.
Correct Answer is A
Explanation
Choice A reason: Opioids slow gastrointestinal motility by binding to mu-opioid receptors in the gut, reducing peristalsis and increasing water absorption, leading to constipation. This is a common, predictable side effect requiring proactive monitoring to prevent discomfort or complications like impaction.
Choice B reason: Diarrhea is less likely with opioids, which typically cause constipation. While diarrhea could indicate an unrelated issue, it is not a primary concern associated with opioid use, making it a lower priority for assessment.
Choice C reason: Hemorrhoids may result from straining due to constipation but are a secondary concern. Opioids do not directly cause hemorrhoids, so assessing for constipation takes precedence to address the root cause of potential straining.
Choice D reason: Clostridium difficile infection is a risk with antibiotic use, not opioids. While opioid-induced constipation could alter gut flora indirectly, C. difficile is not a primary concern, making constipation the more immediate assessment priority.
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