NDX for Diabetes Mellitus Type 2

[123_y_321]

it seems like I still have problem with NDx. I have my patient is 85yr old; male;

diagnosis: DM type 2, hypertension, leukocytosis, generalized weakness

have edema +1 at low extremities, and complaint pain at low extremities (level 4), using dentures (have swelling gum line), fall last week due to dizziness

base on those I do my ndx like:

1. activity intolerance r/t generalized weakness aeb fall due to dizziness, pain (level 4) and edema on low extremities.

2. impaired oral mucous membrane r/t inflammation secondary to DM aeb difficulty wearing dentures (swelling gum line), decrease tastes.

I dont know y but its just bugging me and I dont fell I do it right.

Any suggestion will help and u make me a better nurse.

[sephine, LPN]

Maybe you can try this:

1. activity intolerance r/t generalized weakness secondary to disease process of DM type 2 secondary to physiologic age of 85 as manifested by falls, presence of pain (level 4>>you can also expound this part using the code OLDCARTS .....Onet,Location,Duration,Characteristic,Aggravating factors, Relieving factors, Treatment, Scale on 1 to 10) and edema( pitting or non-pitting?) on both lower extremities as well as verbalization of any intolerance( if any).

2. Impaired oral mucous membrane r/t disease process secondary to DM type 2 and decreased oral tissue defenses secondary to old age of 85 aeb swollen gum line and verbalization of decreased taste sensations.

[123_y_321]

Maybe you can try this:

1. activity intolerance r/t generalized weakness secondary to disease process of DM type 2 secondary to physiologic age of 85 as manifested by falls, presence of pain (level 4>>you can also expound this part using the code OLDCARTS .....Onet,Location,Duration,Characteristic,Aggravating factors, Relieving factors, Treatment, Scale on 1 to 10) and edema( pitting or non-pitting?) on both lower extremities as well as verbalization of any intolerance( if any).

2. Impaired oral mucous membrane r/t disease process secondary to DM type 2 and decreased oral tissue defenses secondary to old age of 85 aeb swollen gum line and verbalization of decreased taste sensations.

Thanks for replying! I just have a few questions here

activity intolerance r/t generalized weakness secondary to disease process of DM type 2 we dont know that DM cause this generalized weakness so how can you put it in secondary? we also dont know the DM type 2 cause the swollen gum line that is why I feel my diagnosis is wrong.

[sephine, LPN]

You’re right….sorry about that. Maybe this will do… it’s simpler though.

>>>>activity intolerance r/t decreased muscle tone secondary to advanced physiologic age of 85 as manifested by generalized weakness, occurrence of fall , as well as verbalization of any intolerance( if any).

as for the, Impaired oral mucous membrane, I think it would be better to use the dx ACUTE PAIN instead….. you have more data for it I guess since you don’t exactly know the cause of the swelling….could be ill-fitting dentures ..depends on the assessment..

[123_y_321]

I look at my NDX about acute pain but I could not find any possible DX for my pt