The nurse is providing community health screening. Which of the following clients should be referred to a health care provider for further evaluation?

Question

The nurse is providing community health screening.  Which of the following clients should be referred to a health care provider for further evaluation?

Quizplus · Accepted Answer

11ecbb05_c921_5ca0_b433_df62e6ad4c5a_MD0009_00 Failure of pinprick testing indicates peripheral neuropathy. Loss of hair on the lower extremities indicates poor perfusion. The combination of these suggests peripheral neuropathy and peripheral arterial disease, likely from undiagnosed diabetes mellitus and atherosclerosis. Nearly a third of clients diagnosed with diabetes mellitus will already have complications from years of uncontrolled hyperglycemia. Diabetes mellitus dramatically accelerates the buildup of plaque on the arterial walls (atherosclerosis) when blood glucose levels are uncontrolled. (Option A) Asymptomatic bradycardia in a healthy young adult is rarely pathological. Professional-level athletes will commonly develop athletic heart syndrome; increased efficiency results in resting sinus bradycardia (40-60/min). (Option B) Fasting blood glucose of 150 mg/dL (8.3 mmol/L) would need to be evaluated for diabetes. However, in this case it would be important to verify whether the client has eaten recently. (Option D) The Joint National Committee guidelines recommend against treating blood pressure readings <150/90 mm Hg in clients age >60. Educational objective: The impaired perfusion from severe atherosclerosis results in skin atrophy, poor wound healing, and widespread hair follicle death (hair loss).

The Nurse Is Providing Community Health Screening