Proceso de atención de enfermería en un paciente con Pie Diabético

Abstract

Introduction: Diabetes mellitus according to the OMS is an endocrine disorder that encompasses a number of metabolic pathologies manifested by the increase of blood sugar levels due to: a resistance to the action of insulin, deficient insulin secretion, or a combination of the two; producing complications such as blindness, diabetic nephropathy, atherosclerosis with the presence of ischemic heart disease and cerebrovascular accidents, considering it to be a major health problem because it is the main cause of deaths associated with poor healthcare attention, which is why it is necessary to undertake health promotion activities and prevention of this pathology. The diabetic foot is the affectation or injury of the soft tissues that conform the plantar area with neurotic damage leading to ulcerations, infection and necrosis of the lower limbs evidencing with a high mortality rate in the adult population of 45 to 70 years presenting as complications most frequent amputations of affected lower limbs altering the individual's standard of living, where the objective of the case study is to analyze the clinical evolution of a 67-year-old patient who presented Wagner Diabetic Foot 5 having a pathological and surgical background: Diabetes mellitus II, Arterial Hypertension and Chronic Renal Failure terminal stage and amputation of the lower right extremity attended at the Machala General Hospital (IESS) since 2014, having as last re-entry on August 5, 2018 through the analysis of the clinical picture, proposing a plan of nursing care based on the application Theory of Nursing by Marjory Gordon to identify the altered functional patterns using for this research qualitative descriptive type methodology acquiring information of all the necessary data to develop this case study by reviewing the clinical history, bibliographical citations and interviewing the family. Obtaining as a result that among the factors of Risk present in the patient are: hypertensive vascular disease, history of amputation, smoking habit toxico - drink; where an alteration of the Maintenance Pattern - Health Perception due to the deficit of self-care and the lack of adherence to the pharmacological treatment was evidenced, which was what complicated his state of health after clinically presenting signs of soft tissue infection after the transfemoral amputation supracondyla of her left lower limb concluding with her death at 13 days of hospitalization, on the ninth day after surgery in the Surgery Area. The complications associated with Diabetic Foot that were found in the patient were: Neuropathy, Ischemia and infection resulting in the amputation of their lower extremities. The nursing care process was applied, which is an instrument used worldwide in the hospital area because it is a systematic, orderly, coherent method that allows the foundation of the care applied in a scientific manner for decision-making, solving the problems of the individual, the family and the community with the objective of reducing or eliminating risks of getting sick. Individualized care plans were developed for Diabetes Mellitus II patients to provide comprehensive care.