A home care nurse is working with a diabetic patient who has a nursing diagnosis of Ineffective Tissue Perfusion related to elevated blood glucose levels. Based on the nurse's knowledge of this diagnosis, which of the following effects would the nurse most likely see in the patients extremities?

 

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Correct

- Poor hair and nail growth

- 3+ peripheral pulses

- Increased venous return

- Sweaty skin

Rationale

A patient with ineffective tissue perfusion would most likely have abnormal patterns of hair and nail growth on the hands and feet. The decreased blood flow to the extremities not only affects the skin, but also the hair and nails. The nurse can assess for these changes as another sign that the patient has inadequate tissue perfusion.

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