Vascular and Nervous Complications of Diabetes (Nursing)

by Rhonda Lawes, PhD, RN

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    00:01 Okay, now you'll see a picture of the blood supply on the left and we've got the nerves on the right.

    00:07 I wanted you to have this visual because the next thing I'm going to talk to Mr. Sanchez about is breaking down the complications into two categories.

    00:14 So for you, let's step aside from Mr. Sanchez for just a minute.

    00:18 I want to make this solid in your brain first before we teach Mr. Sanchez.

    00:22 So above the drawing on the left, I just want you to write in the bad news damage to blood vessels.

    00:30 Okay, so write, damage to blood vessels.

    00:34 Above the drawing on the right, I want you to write damage to nerves.

    00:40 Okay good.

    00:41 So so far my most important points that I've taught Mr. Sanchez is the better we can control his blood sugar the less complications he'll have.

    00:51 Then we started teaching him about the complications he could have with his mouth, with his teeth, with his gums.

    00:58 Now, we're going to do another big category and talk about what happens when you have problems with the blood supply or problems with the nerves.

    01:07 So this is a key point I want him to understand because when you have damage to the blood vessel or damage to the nerves his quality of life is significantly going to be impacted.

    01:19 Okay, so I put down your mind this, I've got a big brain up there and a big heart of there, hey, if nobody's told you today, your brain is pretty amazing.

    01:29 Sometimes the nursing school makes you feel like, my brain must not work right.

    01:35 It's not true.

    01:36 Your brain can do incredible things.

    01:39 We just need to work together and figure out the best way for it to take in information, process it and then use it to serve other people.

    01:48 So we've already helped Mr. Sanchez understand well high glucose is going to give me problems with my nerves and with my blood supply but keep in mind, these are really big problems and the longer he has the disease and the less controlled where of that blood sugar the bigger problems we're going to have.

    02:08 Here's the hard truth, people with diabetes tend to develop heart disease at a younger age than people without diabetes.

    02:15 In adults with diabetes like Mr. Sanchez the most common cause of death are heart disease and stroke.

    02:22 So adults with diabetes are nearly twice as likely to die from heart disease or stroke, as people who don't have diabetes Now do you think I'm going to talk to Mr. Sanchez that way? Dear Mr. Sanchez, I just want you to know that you have two times the chance of dying from heart disease or stroke, as someone who does not have diabetes.

    02:44 That's not how I'm going to present it.

    02:46 I want them to know like hey, if we can work together and figure out how to lower your blood sugar notice I didn't say get it perfect, get it in this range.

    02:55 So if we can work together to take steps to lower your blood sugar, we're going to lower your risk of having a stroke or a heart attack, so do you know anyone who's experienced that? Mr. Sanchez is there anyone in your family or your friends that's had a heart attack or they've had a stroke.

    03:11 How did it change their life? What was it like? Give him something visual to attach to that and he will think, oh, I remember when my friend Bob had a stroke.

    03:22 That was horrible.

    03:24 His wife had to take care of him.

    03:25 He got really sad.

    03:27 So help him see there's a direct correlation between the little choices he makes every day about what he eats, and how active he is and how that ends up looking like avoiding what his friend went through that was so difficult.

    03:42 Because one of the main reasons were talking about keeping his blood sugar closer to normal is because we want to keep those blood vessels and those nerves, the ones that help you move your body and control your organs strong.

    03:55 So make that connection for him.

    03:57 You might think doesn't he know that? No, he really doesn't, say he doesn't live in our world where all we think about is healthcare and your body and how it works.

    04:07 He doesn't live in that world, but we can share the right amount of our world with him.

    04:13 So it makes a difference in his life, because we want to help him prevent a stroke or a heart attack.

    04:20 So this is why it is so important for the health care team to look at Mr. Sanchez's feet.

    04:27 Wait a minute.

    04:28 We were just talking about head and heart and vessels and, How did you get two feet? Well, I want Mr. Sanchez to understand, This is an important part of talking about that blood supply and nerve damage.

    04:44 So every day he needs to look at his feet.

    04:47 I mean at the bottoms in betweenees, right? He needs to look in betweenees those toes the bottom, the sides, the top, because if he's experiencing neuropathies talk about more of those later, but if he's experiencing problems with his feet and he can't really feel things, he might have a cut, a wound or even an infection and he would have no idea.

    05:09 Now take a look at Mr. Sanchez.

    05:12 We can't tell for sure from this picture but if it was sitting here with us, I could tell you he's not really flexible.

    05:19 So I cannot expect Mr. Sanchez to be nimble enough to look around at the bottom of his feet.

    05:25 So, you know what my job is think through a practical plan.

    05:30 Can you underline the word practical.

    05:32 Don't use some pre-processed nursing care plan that's printed off and says look at your feet every day.

    05:39 He can't do that physically, so we got to get creative and we have lots of amazing solutions.

    05:45 Do you know that we have small mirrors on an extended rod? It's like those forks that you use at a campfire that are really long, and you can eat off somebody else's plate.

    05:55 Well, we have that with the mirror.

    05:58 So you extend it so Mr. Sanchez can stand up here or he can be seated so he doesn't fall, and he can actually hold that mirror at the bottom of his foot and look at it.

    06:08 Also keep in mind, Mr. Sanchez has strong family support.

    06:12 Now not everyone does, but you know, he could put his he could lay down on the bed, have his bottoms of his feet up and his wife could look in between his toes and really take a good look at his feet every day.

    06:26 Because if we can catch a wound or an infection early, we can save what might be a really bad outcome we can save that from happening.

    About the Lecture

    The lecture Vascular and Nervous Complications of Diabetes (Nursing) by Rhonda Lawes, PhD, RN is from the course Diabetes Type 1 and 2: Complications and Symptoms (Nursing).

    Included Quiz Questions

    1. "You are more at risk for developing heart problems, but working with your healthcare team to keep your sugars low will help to lower this risk."
    2. "Low blood sugar causes problems in your heart and brain, which are permanent. That is why it is better to be hyperglycemic than hypoglycemic."
    3. "Diabetes affects the entire body, but fortunately it has minimal effects on your heart and brain. People with diabetes have the same risk of developing heart and brain conditions as those without diabetes."
    4. "People with diabetes are at higher risk of developing problems in their brain. As there is no way to decrease this risk, it is important to meet with a neurologist regularly."
    1. Heart disease
    2. Cancer
    3. Sepsis
    4. Alzheimer's disease
    5. Stroke
    1. Preventing infection
    2. Keeping toenails short
    3. Keeping the feet clean
    4. Monitoring for edema

    Author of lecture Vascular and Nervous Complications of Diabetes (Nursing)

     Rhonda Lawes, PhD, RN

    Rhonda Lawes, PhD, RN

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    By Erin P. on 25. March 2021 for Vascular and Nervous Complications of Diabetes (Nursing)

    Rhonda... You're making me cry over here- thank for reminding us that our brains aren't broke ! Also, thank you for reminding us that our patients are people!

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