Nursing Care Plan for Diabetic Gangrene

Gangrene is a serious and potentially life-threatening condition that arises when a considerable mass of body tissue dies (necrosis). This may occur after an injury or infection, or in people suffering from any chronic health problem affecting blood circulation. The primary cause of gangrene is reduced blood supply to the affected tissues, which results in cell death. Diabetes and long-term smoking increase the risk of suffering from gangrene.

There are different types of gangrene with different symptoms, such as dry gangrene, wet gangrene, gas gangrene, internal gangrene and necrotising fasciitis. Treatment options include debridement (or, in severe cases, amputation) of the affected body parts, antibiotics, vascular surgery, maggot therapy or hyperbaric oxygen therapy.


Nursing Care Plan for Diabetic Gangrene

Nursing diagnosis that appear in diabetic foot gangrene patients are as follows:

Impaired tissue perfusion related to the weakening / decreased blood flow to the area of ​​gangrene due to obstruction of blood vessels.

Objective:

• Maintain peripheral circulation remain normal.

Results Criteria:

• Palpable peripheral pulses were strong and regular
• The color of the skin around the wound is pale / cyanotic
• The skin around the wound felt warm.
• Edema does not occur and injuries from getting worse.
• Improved sensory and motor

Nursing Interventions for Diabetic Gangrene

• Teach the patient to mobilize
  Rational: the mobilization improves blood circulation.


• Teach about the factors that can increase blood flow:
  Elevate the legs slightly lower than the heart (elevation position at rest), avoid tight bandage, avoid using a pillow, behind the knees and so on.
  Rational: to increase blood flow through so that does not happen edema.


• Teach about the modification of risk factors such as:
  Avoid high-cholesterol diet, relaxation techniques, stop smoking, and drug use vasoconstriction.
  Rationale: High cholesterol can accelerate the occurrence of atherosclerosis, smoking can cause vasoconstriction of blood vessels, relaxation to reduce the effects of stress.


• Cooperation with other health team in the provision of vasodilators, regular blood sugar checks and oxygen therapy (HBO).
  Rational: vasodilator administration will increase the dilation of blood vessels so that tissue perfusion can be improved, while the regular blood sugar checks can be up to date and state of the patient, to improve the oxygenation of the HBO ulcer / gangrene.