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 A
Explanation
Choice A reason: Scheduled toileting every 2 hours establishes a routine, compensating for dementia-related cognitive deficits in recognizing bladder cues. This promotes continence, reduces accidents, and maintains dignity, making it the most effective behavioral intervention.
Choice B reason: Indwelling catheters increase risks of urinary tract infections, skin breakdown, and discomfort, especially in dementia patients unable to communicate issues. They are a last resort, not appropriate for managing incontinence without medical necessity.
Choice C reason: Reminding a dementia patient to report urination needs is ineffective, as cognitive impairment limits their ability to recognize or communicate bladder signals. This approach does not address the underlying issue of incontinence.
Choice D reason: Adult diapers manage accidents but do not promote continence or address the behavior. They may reduce dignity and increase skin breakdown risk, making scheduled toileting a more proactive and dignified intervention.
Correct Answer is C
Explanation
Choice A reason: Specific gravity of 1.036 is slightly above the normal range (1.005-1.030), suggesting concentrated urine, possibly from dehydration. While it warrants monitoring, it is not immediately alarming compared to proteinuria, which indicates potential renal pathology.
Choice B reason: Urine output of 80 mL/hr (1920 mL/day) is within normal adult range (800-2000 mL/day). This does not require immediate follow-up, as it reflects adequate renal perfusion and function under normal conditions.
Choice C reason: Protein level of 2 mg/100 mL (20 mg/L) indicates proteinuria, abnormal as normal urine protein is <150 mg/day. This suggests potential glomerular damage, infection, or systemic disease (e.g., diabetes), requiring urgent follow-up to diagnose and manage underlying pathology.
Choice D reason: Urine pH of 6.4 is within the normal range (4.5-8.0), reflecting typical dietary and metabolic influences. It does not indicate an abnormality requiring follow-up, as it aligns with expected physiological variation.
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