Need some help from a diabetes expert please!!!

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Specializes in Family.

I am currently doing a care plan assignment and I have chosen Ineffective peripheral tissue perfusion as a DX for my pt. He's IDDM, non-compliant, poor wound healing and reports pins and needles when walking. To choose the best "related to" I am trying to find out what exactly diabetes does to affect peripheral perfusion. TIA!

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Specializes in Gerontological, cardiac, med-surg, peds.
I am currently doing a care plan assignment and I have chosen Ineffective peripheral tissue perfusion as a DX for my pt. He's IDDM, non-compliant, poor wound healing and reports pins and needles when walking. To choose the best "related to" I am trying to find out what exactly diabetes does to affect peripheral perfusion. TIA!

Perhaps these resources will be of assistance to you:

http://www.medicinenet.com/peripheral_neuropathy/article.htm

http://www.mayoclinic.com/invoke.cfm?id=DS00131

http://millercenter.uchicago.edu/learnaboutpn/typesofpn/diabetes/prediabetes.shtml

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Specializes in Family.

Thanks for replying! I gave up after searching online for about 2 hours and came up with Ineffective Peripheral Tissue Perfusion r/t Interruption of Venous Flow.

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Specializes in Family.

This pt has DM, obvious fluid volume deficiency, but I'm unsure of which r/t is better. Ineffective tissue perfusion r/t interruption of venous flow or Ineffective tissue perfusion related to the fluid volume deficiency. He has scars on lower legs and one open wound, and with the diabetes (all I could find on diabetes was that it caused atherosclerosis) it seems as if this problem has been around for a while, whereas the fluid problem hasn't. Please help!

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This pt has DM, obvious fluid volume deficiency, but I'm unsure of which r/t is better. Ineffective tissue perfusion r/t interruption of venous flow or Ineffective tissue perfusion related to the fluid volume deficiency. He has scars on lower legs and one open wound, and with the diabetes (all I could find on diabetes was that it caused atherosclerosis) it seems as if this problem has been around for a while, whereas the fluid problem hasn't. Please help!

Maybe Impaired skin integrity r/t interruption of venous flow would be better considing he has an open wound? His wound isn't healing because the tissues aren't getting enough blood flow.

~Crystal

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Specializes in Gerontological, cardiac, med-surg, peds.
This pt has DM, obvious fluid volume deficiency, but I'm unsure of which r/t is better. Ineffective tissue perfusion r/t interruption of venous flow or Ineffective tissue perfusion related to the fluid volume deficiency. He has scars on lower legs and one open wound, and with the diabetes (all I could find on diabetes was that it caused atherosclerosis) it seems as if this problem has been around for a while, whereas the fluid problem hasn't. Please help!

Sounds like you're on the right track :) I agree with your first choice. Peripheral vascular disease is very common in patients with diabetes, especially if the diabetes has not been very tightly controlled (hgb A1C would show this). This website also may be of some help in understanding this:

http://www.epodiatry.com/poor-circulation.htm

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