Page 1410 - Saunders Comprehensive Review For NCLEX-RN

i. Prepare the client for pancreas
transplant if planned.
C. Diabetic neuropathy
1. Description
a. General deterioration of the nervous
system throughout the body

b. Complications include the

development of nonhealing ulcers of
the feet, gastric paresis, and erectile
dysfunction.
2. Classifications
a. Focal neuropathy or mononeuropathy:
Involves a single nerve or group of
nerves, most frequently cranial nerves
III (oculomotor) and VI (abducens),
resulting in diplopia
b. Sensory or peripheral neuropathy:
Affects distal portion of nerves, most
frequently in the lower extremities
c. Autonomic neuropathy: Symptoms
vary according to the organ system
involved.
d. Cardiovascular: Cardiac denervation
syndrome (heart rate does not respond
to changes in oxygenation needs) and
orthostatic hypotension occur.
e. Pupillary: Pupil does not dilate in
response to decreased light.
f. Gastric: Decreased gastric emptying
(gastroparesis)
g. Urinary: Neurogenic bladder
h. Skin: Decreased sweating
i. Adrenal: Hypoglycemic unawareness
j. Reproductive: Impotence (male), painful
intercourse (female)

3. Assessment: Findings depend on the

classification
a. Paresthesias
b. Decreased or absent reflexes
c. Decreased sensation to vibration or
light touch
d. Pain, aching, and burning in the lower
extremities
e. Poor peripheral pulses
f. Skin breakdown and signs of infection

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