neuropathy
Patient was instructed on diabetes complications such as nerves damage (diabetic neuropathy). The symptoms depend on which nerves are affected. Most often, diabetes can cause tingling, numbness, or pain that usually begins at the tips of the toes or fingers.
Patient was instructed about how to check both feet daily looking over them carefully every day, and be sure check between all of the toes. Blisters and infections can start between the toes, and with diabetic neuropathy, may not feel them until they've become irritated or infected. If physical challenges occur, ask a family member to help. Further teaching is needed.
Patient was instructed on diabetes symptoms. People with diabetes who have had high blood sugar levels for long periods of time can develop complications, including: Damage to the eyes (retinopathy) which can lead to blindness. Damage to the nerves (neuropathy), which can lead to numbness, tingling or pain in the legs and arms. Damage to the kidneys (nephropathy), which can result in kidney failure.
Instructed caregiver the patient are at high risk if the patient have or do the following: Neuropathy, Poor circulation, A foot deformity (e.g., bunion, hammer toe), Wear inappropriate shoes, Uncontrolled blood sugar, History of a previous foot ulceration.
SN instructed patient / caregiver about Bethanechol. Sometimes given orally or subcutaneously to treat urinary retention resulting from general anesthetic, diabetic neuropathy of the bladder, or a side effect of antidepressants or to treat gastrointestinal atony (lack of muscular tone). Adverse reaction are rare following oral administration of Bethanechol, but are more common following subcutaneous injection. Adverse reactions are more likely to occur when dosage is increased. Adverse reactions that have been observed: Body as a Whole: malaise; Digestive: abdominal cramps or discomfort, colicky pain, nausea and belching, diarrhea, borborygmi, salivation; Renal: urinary urgency; Nervous System: headache; Cardiovascular: a fall in blood pressure with reflux tachycardia, vasomotor response; Skin: flushing producing a feeling of warmth, sensation of heat about the face, sweating; Respiratory: bronchial constriction, asthmatic attacks; Special Senses: lacrimation, miosis.
SN instructed patient about Gabapentin ( Neurontin ). It is a medication used to treat epilepsy, neuropathic pain and hot flashes. It is also used for restless leg syndrome. It is a first line agent for the treatment of neuropathic pain arising from diabetic neuropathy, post-herpetic neuralgia, and central neuropathic pain. Most common side effects of gabapentin in adult patients include dizziness, fatigue, drowsiness, weight gain, and peripheral edema. It may also produce sexual dysfunction in some patients, symptoms of which may include loss of libido, inability to reach sexual climax, and erectile dysfunction. It should be used carefully in patients with renal impairment due to possible accumulation and toxicity. Warning of an increased risk of depression and suicidal thoughts and behaviors in patients taking gabapentin. Report to Physician or nurse if any of those side effect / adverse reaction occurs.
Sn instructed patient about diabetic wounds / ulcers have poor or delayed healing. Healing problems are caused by the peripheral arterial diseases and peripheral neuropathy that can occur with diabetes, wherein the small blood vessels in different parts of the body, especially in the extremities ( hands and feet ), grow narrower and reduce the blood circulation to those areas. A lack of circulation in the extremities can result in a reduced supply of oxygen and nutrients to the body tissue and nerves, which is necessary for healing. Over time, nerves in these areas may become damaged, decreasing the sensation of pain, temperature and touch, making patients vulnerable to injury.
Neuropathy assessment and teaching on management, medication, and alternative therapies to alleviate pain.