Is this peripheral neuropathy?

  1. 0
    Hello!

    I don't usually do this but I need help with this assignment! Does this patient have peripheral neuropathy?

    She has had history of high blood sugar and high levels of cholesterol. She is significantly overweight and does not manage her glucose levels. she has had a number of "female infections".

    She complains that her left foot feels weak and numb and having a hard time pointing her toes up. She has been very thirsty lately and gets up often at night to urinate. Her feet are cold to touch and dry with cracking. Peripheral pulses are diminished +1 in feet bilaterally. Patient has increased urinary frequency and lightheadedness upon standing. Glucose is positive in urinalysis.

    She obviously has symptoms of hyperglycemia but is she also suffering from peripheral neuropathy in her feet? The high cholesterol thing is throwing me off because she has low HDL and high LDL. Why is it important that she has high cholesterol? Please help me understand. Thanks

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  2. 10 Comments...

  3. 2
    Think about what high blood sugar does to the vessels. That coupled with high cholesterol. Think. :-)
    Regarding cholesterol: LDL is the 'lousy' cholesterol. If it's high, it's lousy...your cholesterol is a problem. HDL is the 'healthy' cholesterol and the higher it is, the more cardio protective qualities. So if that's low, the LDL can clog up your vessels or 'pipes'. What happens if your blood vessels are 'clogged'?
    Good luck. Nursing is about critical thinking and being able to apply the science. You'll get it:-)
    mikasa and uRNmyway like this.
  4. 2
    Quote from mikasa
    Hello!

    I don't usually do this but I need help with this assignment! Does this patient have peripheral neuropathy?

    She has had history of high blood sugar and high levels of cholesterol. She is significantly overweight and does not manage her glucose levels. she has had a number of "female infections".

    She complains that her left foot feels weak and numb and having a hard time pointing her toes up. She has been very thirsty lately and gets up often at night to urinate. Her feet are cold to touch and dry with cracking. Peripheral pulses are diminished +1 in feet bilaterally. Patient has increased urinary frequency and lightheadedness upon standing. Glucose is positive in urinalysis.

    She obviously has symptoms of hyperglycemia but is she also suffering from peripheral neuropathy in her feet? The high cholesterol thing is throwing me off because she has low HDL and high LDL. Why is it important that she has high cholesterol? Please help me understand. Thanks
    High cholesterol is relevant because there is probably some atherosclerosis present. What does this mean? Narrowed blood vessels means less circulation, right?
    mikasa and KariZayBSN like this.
  5. 1
    While PVD and neuropathy might be comorbid, did the pt have ABI (would show the first one) or a monofilament exam (would more specifically show the second).
    Sometimes extra data can throw you.
    Cholesterol clogs vessels...high glucose can hurt the nerves. All of which is found clustered together. I would guess this person has hypertension as well but is that neuropathy-specific? No.
    mikasa likes this.
  6. 1
    Yes, this is peripheral neuropathy and it's related to damage to the blood vessels after exposure to high levels of sugar in the blood.
    Last edit by bella14k on Mar 1 : Reason: Inaccurate information
    mikasa likes this.
  7. 0
    Thank you sooo much for all the comments. They were all very helpful! I understand now why cholesterol, hyperglycemia, and yes, she does have hypertension would all contribute to atherosclerotic plaques!
  8. 0
    What are the symptoms of diabetic neuropathy and does this sound like your patient?

    Diabetic neuropathy Definition - Diseases and Conditions - Mayo Clinic
  9. 0
    The only symptoms that sounds like my patient is left foot weakness and numbness for three weeks. Also, her feet are cold to touch and dry with cracking. Those are the only symptoms that seem to relate to neuropathy.
  10. 2
    Diabetic and other peripheral neuropathies, as classically seen, tend to be bilateral, since the things that cause them are pretty systemic. Neuro symptoms of weakness and numbness in just one foot, with difficulty pulling the toes up, argues for something else, perhaps a specific nerve root injury (radiculopathy) (L4-5) or other CNS thing, or even a local (peroneal or ... ) nerve injury.

    Remember, it's always possible to have more than one thing wrong with you ...
    SHGR and uRNmyway like this.
  11. 0
    I don't need to identify exactly what is wrong with the patient but what is happening in her body and why. So yes there could be many things wrong with her but for now, I just need to understand the pathophysiology. But thank you for making me think beyond diabetes.


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