SOLVED22

answer the following based on the information below A client arrives to the clinic reporting excessive sweating. The nurse reviews the client’s medical record and notes a diagnosis of peripheral artery disease, resulting in autonomic nerve damage. Which of the following findings should the nurse expect during the assessment? (Select all that apply). Foot drop Diarrhea Weak hand grasp Constipation Sexual dysfunction Peripheral neuropathy (PN) is a condition that is caused by damage to the peripheral nervous system, resulting from an underlying pathological condition. Nerves involved include cranial nerves, spinal nerve roots, ganglia, nerve trunks, and nerves of the autonomic nervous system. There is thought to be segmental demyelination, Wallerian degeneration, and axonal degeneration of the peripheral nerve, which can result in PN. Segmental demyelination is the degeneration of the myelin sheath, accounting for approximately 20% of peripheral neuropathies. Wallerian degeneration is damage to the nerve axon due to a lesion or compression causing the axon to waste away. Axonal degeneration accounts for approximately 80% of peripheral neuropathies and causes weakness in the foot and ankle. Degeneration of the axon starts distally and progresses proximally. Therefore, this demyelination and degeneration can cause a disruption in the communication network that sends signals from the brain and spinal cord to other parts of the body. This disruption in signaling associated with PN can affect the motor, sensory, or autonomic nerves. PERIPHERAL NEUROPATHY Epidemiological and Etiological Risk Factors Etiology PN is thought to be caused by nerve dysfunction as a result of stress or inflammation. PN can be either genetic, acquired, or idiopathic, which means the cause is unknown. One of the most common causes of PN is diabetes mellitus. Other causes include autoimmune diseases, inflammatory or vascular conditions, infections, alcohol use disorder, nutritional deficiencies (deficiencies in B1, B6, B9, B12, and E vitamins, folic acid), tumors, chemotherapy. Environmental exposure to lead, mercury, arsenic, thallium, pesticides, solvents, and other toxic chemicals can cause PN. It can also occur as the result of physical trauma or injury or surgery. Genetic causes include amyloidosis, Fabry disease, and Charcot-Marie-Tooth disease. In some cases, the exact cause of PN may not be known. Etiologies of PN Autoimmune diseases: Lupus, rheumatoid, and Guillain-Barre syndrome Metabolic: Diabetes (the most common cause of PN) Infections: Lyme disease, shingles, hepatitis C, HIV Inherited disorders: Charcot-Marie-Tooth disease Toxins: Exposure to chemicals/heavy metals Medications: Chemotherapeutic agents Tumors: Growths, malignant/benign Bone marrow disorders: Monoclonal gammopathies, myeloma, lymphoma Other conditions: Hypothyroidism, alcohol use disorder, nutritional deficiencies Risk Factors and Incidence PN is a common condition affecting approximately 2.4% of the global population. The highest incidence of this disease occurs in Southeast Asia because of the high occurrence of leprosy, a predisposing factor in the development of PN. More than 20 million individuals in the United States have some form of PN. Diabetic PN is estimated to affect approximately 50% of adults who have diabetes mellitus at some point during their life. PN is among the most common neurological diseases and occurs more frequently in older adults. More than 5% of adults, 45 years of age and older, have PN. The risk of developing PN increases as clients age because of age-related illnesses and diseases. Other risk factors for PN include obesity, a low education level, smoking, and peripheral artery disease.​​​​​​​ Epidemiology Studies suggest that Black clients and male clients have a higher prevalence of developing PN than do white or female clients. A correlation may exist between low SES status and experiencing racial discrimination and the developmen
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HEALTH SCIENCE
NURSING

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