Nursing Case Study for Diabetic Foot Ulcer

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Study Tools For Nursing Case Study for Diabetic Foot Ulcer

Diabetic Foot Ulcer (Image)
Diabetes Education (Picmonic)
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Outline

Michael is a 15-yr-old male diagnosed with type I diabetes mellitus (DM) last year. He presents to the acute care clinic with a “sore that will not heal” on the bottom of his right foot. He states that he sees an endocrinologist for his DM but has no other health issues to report at this time. He also says that he exercises frequently under the guidance of a dietician and personal trainer consulted through endocrinology and still wrestles for his high school team

His mother is with him and gives consent for treatment. She says, “The pad of his foot has not even been hurting him but when he was pushing off the wrestling mat in practice, he noticed something there.”

Critical Thinking Check
Bloom's Taxonomy: Analyze

What does the nurse suspect may be going on with Michael today? Why?

VIEW ANSWER
Critical Thinking Check
Bloom's Taxonomy: Evaluate

What does the nurse suspect may be going on with Michael today? Why?

VIEW ANSWER

 

The nurse notices she cannot feel pedal pulses and the feet seem cool, but not cold. However, the area around the wound is warmer and red. Both feet are WNL in regard to color. Michael denies any cramping or pain in his legs.

Critical Thinking Check
Bloom's Taxonomy: Analyze

What should the nurse do now? How would she document this finding?

VIEW ANSWER

 

The wound has a slightly foul odor and has a circular “punched out” shape almost like a red based crater. Michael’s mother asks how this could happen.

Critical Thinking Check
Bloom's Taxonomy: Apply

How should the nurse explain Michael’s risks for this condition?

VIEW ANSWER

 

The provider assesses the patient and advises the staff he has put in orders. He also asks for a set of vital signs (which had not yet been taken).

Critical Thinking Check
Bloom's Taxonomy: Analyze

Why would the provider want vital signs when the patient only has a wound on his foot?

VIEW ANSWER

 

BP 110/68 SpO2 98% on Room Air
HR 92 bpm and regular Pain 0/10 on 1-10 scale with 10 being highest
RR 16 bpm at rest
Temp 37.9°C

Michael’s mother asks why the acute care clinic cannot just take care of her son’s foot. She says, “Can’t we just get some antibiotics and go?”

Critical Thinking Check
Bloom's Taxonomy: Apply

How should the nurse address this issue?

VIEW ANSWER

 

Both patient and mother agree to the prescribed treatments. Before they leave, the provider indicates he wants to talk to them about when to seek a higher level of care.

Critical Thinking Check
Bloom's Taxonomy: Evaluate

What does the nurse expect the provider to discuss?

VIEW ANSWER
Critical Thinking Check
Bloom's Taxonomy: Apply

What should the nurse ensure she does in regard to discharge teaching?

VIEW ANSWER

 

Michael says he will follow the prescriptions and follow up as instructed. He also wants to know how to keep this from happening again.

Critical Thinking Check
Bloom's Taxonomy: Apply

What are some tips the nurse can provide regarding prevention? What about resources to provide?

VIEW ANSWER

 

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Transcript

Hi, everyone. We’re going to go through a case study for a diabetic foot ulcer together. Let’s get started. In this scenario, Michael is a 15-year-old male diagnosed last year with diabetes type one. He presents to the acute care unit with a sore that will not heal on the bottom of his right foot. He states that he sees an endocrinologist for his diabetes type one, but has no other health issues to report at this time. He also says that he exercises frequently under the guidance of a dietician and personal trainer consulted through his endocrinologist and still he wrestles for his high school team. His mother is with him and gives consent for treatment. She says, “The pad of his foot has not even been hurting him but when he was pushing off the wrestling mat in practice, he noticed something there.” Now that we have this information, let’s take a look at critical thinking checks number one and number two below.

Great job. The nurse notices that she cannot feel pedal pulses and the feet seem cool, but not cold. However, the area around the wound is warmer and red. Both feet are within normal limits in regards to color. Michael denies any cramping or pain in his legs. Now that we have these results, let’s take a look at critical thinking check number three below.

Excellent work. The wound has a slightly foul odor and has a circular punched out shape. Almost like a red based crater. Michael’s mother asks how this could happen. Let’s take a look at critical thinking check number four below.

Great job. The provider assesses the patient and advises the staff that he has put in orders. He also asks for a set of vital signs, which weren’t taken before. With all of this in mind, let’s take a look at critical thinking check number five below.

Great job. Let’s take a look at those vitals. His blood pressure came back at 110/68 mmHg, on room air he’s saturating at 98%, looks good. His heart rate is 92 beats per minute with a regular rhythm and a respiratory rate of 16 breaths per minute at rest. Temperature running at 37.9 degree Celsius and he isn’t complaining of any pain. 0 to 10 on the 1 to 10 scale with 10 being a medical emergency. With all of this information, Michael’s mother asks why the acute care clinic cannot just take care of her son’s foot. She says, “can’t we just get some antibiotics and go?” With these results in mind, let’s take a look at critical thinking check number six below.

Excellent work, both the patient and the mother agree to the prescribed treatments. Before they leave, the provider indicates he wants to talk to them about when to seek a higher level of care. With this in mind, let’s take a look at critical thinking checks number seven and number eight below.

Well done. Michael says he will follow the prescriptions and follow up as instructed. He also wants to know how to keep this from happening again. With this in mind, let’s take a look at our last critical thinking check number nine below.

Great work, everyone. This wraps up our case study on the diabetic foot foot ulcer. Please take a look at the attached study tools and test your knowledge with a practice quiz. And as always, we love you guys, now go out and be your best self today and happy nursing!

References:

Clinical manifestations, diagnosis, and management of diabetic infections of the lower extremities
Authors:Amy C Weintrob, MDDaniel J Sexton, MD, updated Jan, 2021; Evaluation of the diabetic foot
Author:Deborah J Wexler, MD, MSc updated Sept 2021; Patient education: Foot care for people with diabetes (Beyond the Basics)
Author:Deborah J Wexler, MD, MSc, updated Feb, 2021

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Endocrine

Concepts Covered:

  • Endocrine System
  • Tissues and Glands
  • Disorders of Pancreas
  • Disorders of the Adrenal Gland
  • Disorders of the Thyroid & Parathyroid Glands
  • Oncology Disorders
  • Pregnancy Risks
  • Respiratory Disorders
  • Terminology
  • Disorders of the Posterior Pituitary Gland
  • Eating Disorders
  • Medication Administration
  • Statistics
  • Female Reproductive Disorders
  • Renal Disorders
  • Substance Abuse Disorders
  • Renal and Urinary Disorders
  • Newborn Care
  • Studying
  • Urinary System
  • Noninfectious Respiratory Disorder

Study Plan Lessons

Pituitary Gland
Pancreas
Glands
Metabolic & Endocrine Module Intro
Metabolic/Endocrine Course Introduction
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Pituitary Adenoma
Thyroid Cancer
Glucose Tolerance Test (GTT) Lab Values
Thyroid Gland
Pituitary Gland
Free T4 (Thyroxine) Lab Values
Glucose Lab Values
Iodine Nursing Considerations
Levothyroxine (Synthroid)
Hypoparathyroidism
Hyperthyroidism Case Study (75 min)
Metabolic & Endocrine Module Intro
Metabolic & Endocrine Terminology
Metabolic/Endocrine Course Introduction
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Thyroid Cancer
Pituitary Adenoma
Pituitary Gland
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Thyroid Cancer
Thyroid Gland
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroxine (T4) Lab Values
Triiodothyronine (T3) Lab Values
Metabolic & Endocrine Terminology
Antidiabetic Agents
Hypoparathyroidism
Iodine Nursing Considerations
Hyperthyroidism Case Study (75 min)
Free T4 (Thyroxine) Lab Values
Levothyroxine (Synthroid)
Metabolic & Endocrine Module Intro
Metabolic/Endocrine Course Introduction
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Nursing Care Plan (NCP) for Thyroid Cancer
Symptoms of Hyperthyroidism Nursing Mnemonic (SWEATING)
Symptoms of Hypothyroidism Nursing Mnemonic (MOM’S SO TIRED)
Thyroid Cancer
Triiodothyronine (T3) Lab Values
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Hypothyroidism
Pituitary Adenoma
Pituitary Gland
Thyroid Gland
Hypoparathyroidism
Magnesium-Mg (Hypomagnesemia, Hypermagnesemia)
Metabolic & Endocrine Terminology
Nursing Care and Pathophysiology for Hyperparathyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care Plan (NCP) for Hyperparathyroidism
Nursing Care Plan (NCP) for Hypoparathyroidism
Thyroid Gland
Thyroid Cancer
Diabetes Mellitus Case Study (45 min)
Glucose Lab Values
Hypoglycemia
Glucagon Lab Values
Glipizide (Glucotrol) Nursing Considerations
Glands
Metabolic & Endocrine Terminology
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Hypoglycemia
Pancreas
Adrenal Gland
Adrenal Gland Hormones Nursing Mnemonic (The 3 S’s)
Cortisol Lab Vales
Cortisone (Cortone) Nursing Considerations
Corticosteroids
Cushing’s Syndrome Case Study (60 min)
Metabolic & Endocrine Terminology
Metabolic/Endocrine Course Introduction
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Cushing’s Disease
Pituitary Gland
Diabetes Insipidus Case Study (60 min)
Free T4 (Thyroxine) Lab Values
Growth Hormone (GH) Lab Values
Metabolic & Endocrine Terminology
Metabolic/Endocrine Course Introduction
Cortisol Lab Vales
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Pituitary Adenoma
Pituitary Gland
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroid Gland
Growth Hormone (GH) Lab Values
Pituitary Adenoma
Pituitary Gland
Cushing’s Syndrome Case Study (60 min)
Diabetes Insipidus Case Study (60 min)
Diabetes Insipidus Nursing Mnemonic (DDD)
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Diabetes Mellitus & Those Dang Blood Sugars! – Live Tutoring Archive
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Glipizide (Glucotrol) Nursing Considerations
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Insulin
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Metabolic & Endocrine Module Intro
Metabolic/Endocrine Course Introduction
Metformin (Glucophage) Nursing Considerations
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Insipidus
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Case Study for Diabetic Foot Ulcer
Nursing Case Study for Type 1 Diabetes
Pituitary Gland
Protein in Urine Lab Values
Urinalysis (UA)
Addisons Assessment Nursing Mnemonic (STEROID)
Addisons Disease
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Cushing’s Syndrome Case Study (60 min)
Cushings Assessment Nursing Mnemonic (STRESSED)
Nursing Care Plan (NCP) for Cushing’s Disease
Diabetes Insipidus Case Study (60 min)
Diabetes Insipidus Nursing Mnemonic (DDD)
Enuresis
Metabolic/Endocrine Course Introduction
Metabolic & Endocrine Module Intro
Nursing Care and Pathophysiology for Diabetes Insipidus (DI)
Urinalysis (UA)
Nursing Care Plan (NCP) for Diabetes Insipidus
Diabetes Insipidus Case Study (60 min)
Nursing Care and Pathophysiology for SIADH (Syndrome of Inappropriate antidiuretic Hormone Secretion)
Nursing Care Plan (NCP) for Syndrome of Inappropriate Antidiuretic Hormone (SIADH)
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Diabetic Ketoacidosis (DKA) Case Study (45 min)
DKA Treatment Nursing Mnemonic (KING UFC)
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Case Study for Type 1 Diabetes
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Diabetes Management
Diabetes Mellitus (DM) Module Intro
Glucose Lab Values
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Adrenal Gland
Antidiabetic Agents
Blood Glucose Monitoring
Diabetes Management
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus for Progressive Care Certified Nurse (PCCN)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Glipizide (Glucotrol) Nursing Considerations
Glucose Lab Values
Glucose Tolerance Test (GTT) Lab Values
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hyperkalemia – Management Nursing Mnemonic (AIRED)
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hypoglycemia
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin
Insulin Mixing
Insulin Drips
Insulin – Short Acting (Regular) Nursing Considerations
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin Mnemonic (Ready, Set, Inject, Love)
Metformin (Glucophage) Nursing Considerations
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Hyperosmolar Hyperglycemic Nonketotic Syndrome (HHNS)
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Case Study for Type 1 Diabetes
Pancreas
Corticosteroids
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care and Pathophysiology for Cushings Syndrome
Cushings Assessment Nursing Mnemonic (STRESSED)
Cushing’s Syndrome Case Study (60 min)
Adrenal Gland
Addisons Disease
Addisons Assessment Nursing Mnemonic (STEROID)
Cortisol Lab Vales
Cortisone (Cortone) Nursing Considerations
Corticosteroids
Adrenal Gland
Addisons Disease
Cushing’s Syndrome Case Study (60 min)
Cushings Assessment Nursing Mnemonic (STRESSED)
Glucose Lab Values
Nursing Care and Pathophysiology for Cushings Syndrome
Nursing Care Plan (NCP) for Addison’s Disease (Primary Adrenal Insufficiency)
Nursing Care Plan (NCP) for Cushing’s Disease
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Pituitary Adenoma
Pancreas
Glucagon (GlucaGen) Nursing Considerations
Glucagon Lab Values
Hypoglycemia
Nursing Care Plan (NCP) for Hypoglycemia
Pancreas
Adrenal Gland
Antidiabetic Agents
Blood Glucose Monitoring
Diabetes Management
Diabetes Mellitus Case Study (45 min)
Diabetes Mellitus Type 1- Signs & Symptoms Nursing Mnemonic (The 3 P’s)
Corticosteroids
Disease Specific Medications
Diabetic Ketoacidosis (DKA) Case Study (45 min)
Glipizide (Glucotrol) Nursing Considerations
Glucose Tolerance Test (GTT) Lab Values
Glucose Lab Values
Hyperglycaemic Hyperosmolar Non-ketotic syndrome (HHNS)
Hyperglycemia Management Nursing Mnemonic (Dry and Hot – Insulin Shot)
Hypoglycemia
Insulin – Intermediate Acting (NPH) Nursing Considerations
Insulin – Long Acting (Lantus) Nursing Considerations
Insulin – Mixtures (70/30)
Insulin – Rapid Acting (Novolog, Humalog) Nursing Considerations
Insulin Mnemonic (Ready, Set, Inject, Love)
Insulin Mixing
Insulin Drips
Insulin – Short Acting (Regular) Nursing Considerations
Metformin (Glucophage) Nursing Considerations
Nursing Care and Pathophysiology of Diabetes Mellitus (DM)
Nursing Care and Pathophysiology of Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Diabetes
Nursing Care Plan (NCP) for Diabetes Mellitus (DM)
Nursing Care Plan (NCP) for Diabetic Ketoacidosis (DKA)
Nursing Care Plan (NCP) for Hypoglycemia
Nursing Case Study for Type 1 Diabetes
Pancreas
Pituitary Gland
Growth Hormone (GH) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroid Gland
Pituitary Gland
Nursing Care Plan (NCP) for Hyperthyroidism
Free T4 (Thyroxine) Lab Values
Triiodothyronine (T3) Lab Values
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Thyroid Gland
Thyroid Cancer
Pituitary Gland
Nursing Care Plan (NCP) for Hypothyroidism
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Free T4 (Thyroxine) Lab Values
Nursing Care Plan (NCP) for Hyperthyroidism
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hypothyroidism
Pituitary Gland
Thyroid Gland
Thyroid Cancer
Triiodothyronine (T3) Lab Values
Thyroxine (T4) Lab Values
Thyroid Stimulating Hormone (TSH) Lab Values
Nursing Care and Pathophysiology for Hyperthyroidism
Nursing Care and Pathophysiology for Hyperparathyroidism