A patient who has had type 2 diabetes for 26 years is beginning to experience peripheral neuropathy in the feet and lower legs,which is causing the patient to have a decreased ability to feel pain in the lower extremities.The nurse is providing education to the patient to prevent injury to the feet.The nurse tells the patient to always wear shoes or slippers when walking.Which of the following statements made by the nurse best explains the rationale for this instruction?

A) "Wearing shoes blocks pain perception and helps you adapt to pain,which ends up protecting your feet."
B) "Shoes provide nonpharmacological pain relief to people with diabetes and peripheral neuropathy."
C) "Since you cannot feel pain as much in your feet,you need to open your neurological gates to allow pain sensations to come through.Wearing shoes helps to open those gates,which protects your feet."
D) "You have lost the ability to withdraw from pain because of your peripheral neuropathy.If you step on something and are not wearing shoes,you will not feel it;this could possibly cause injury to your foot."

Question

Autumn Coulthard · Accepted Answer

Final Answer : D, Explanation :  This patient is losing the ability to feel pain because of peripheral neuropathy.The patient will no longer have protective reflexes to prevent injury to the feet.Wearing shoes prevents the patient from injuring the feet because they protect the feet.Shoes do not block pain perception,nor do they help people adapt to pain.Shoes are not a form of nonpharmacological pain relief.Wearing shoes will not have an effect on opening or closing the pain gates.

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