Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition LeMone, Burke, Bauldoff

Medical Surgical Nursing Clinical Reasoning in Patient Care 6th Edition LeMone, Burke, Question 1 Type: MCSA A patient with diabetes mellitus and poor circulation has thick and ingrown toenails. What should the nurse instruct the patient to do? 1. Soak feet in Epsom salts daily. 2. Use a clean sharp razor blade to trim nails. 3. Make an appointment with a podiatrist. 4. Cut toenails immediately prior to bathing. Correct Answer: 3 Rationale 1: There is no indication for this patient to soak feet daily in Epsom salts. Rationale 2: The use of a clean sharp razor could cause an injury. Rationale 3: The toenails of the patient with diabetes require close care. If the nails are thick or ingrown, they require the attention of a podiatrist. Rationale 4: Cutting the nails before a bath would be difficult because the nails are thick and ingrown. Global Rationale: The toenails of the patient with diabetes require close care. If the nails are thick or ingrown, they require the attention of a podiatrist. Cutting the nails before a bath would be difficult because the nails are thick and ingrown. There is no indication of a need for soaking feet daily in Epsom salts. Cognitive Level: Applying Client Need: Physiological Integrity Client Need Sub: Reduction of Risk Potential QSEN Competencies: I.A. 1. Integrate understanding of multiple dimensions of patient centered care AACN Essentials Competencies: IX. 7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care NLN Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions Nursing/Integrated Concepts: Nursing Process: Implementation