Information about Autonomic Neuropathy

Autonomic neuropathy can profoundly affect your patient's life. She'll need current, accurate information and a great deal of psychological support. Because autonomic neuropathy rarely causes an isolated problem, you'll need to address all of the complications your own patient experiences.

In case your patient has GI symptoms, monitor her bowel status to prevent or treat bowel problems or diarrhea. In the event that she has diarrhea, and particularly if she's incontinent, make sure to keep her skin clean and dry to avoid breakdown. Assess her for signs and symptoms of gastroparesis, such as loss of appetite, abdominal pain, and bloating. Administer drugs because prescribed and keep track of the patient for negative effects. Be sure to refer her to a dietitian who will keep track of her progress.

In case your patient has gastroparesis and experiences hypoglycemia, place an easy sugar, such as jelly, glucose gel, or even cake icing, under her tongue or even against her oral cavity, where it will be absorbed into the bloodstream. Make sure that your patient receives the woman's meals and snacks as planned to prevent hypoglycemia. Remember that her entire body may not respond as fast or effectively to hypoglycemia because of decreased glucagon secretion, so be prepared to give glucagon or parenteral glucose.

To prevent orthostatic hypotension and symptoms of cardiac denervation, tell your patient to perform simple leg exercises before rising from a seated position. This causes the brain to release stimulating catecholamines that raise her blood pressure, preparing the woman's body to adjust to the position change. If she's reclining, she should sit up slowly, then flex and lengthen her legs beside the bed. If she gets dizzy or light-headed, inform her to remain sitting until the symptoms diminish. Monitor orthostatic pulse rate and blood pressure measurements. And stand at the woman's side to support her if needed.

If your individual with autonomic neuropathy also has CAD, let her know that she may not experience the common signs and symptoms of myocardial ischemia or an MI, such as chest pain.

Train her to be alert for other signs and symptoms, such as fatigue, difficulty breathing, and palpitations. Clarify the importance of routine bodily examinations and electrocardiography.

If your patient has bladder dysfunction, palpate her bladder to detect pee retention. If she's urine retention, intend to:

routinely palpate her bladder for fullness

schedule urination every A couple of hours while she's awake

apply manual suprapubic pressure (Crede's method) to ensure that the actual bladder empties sufficiently.

If retention is actually severe, intermittently carry out urinary catheterization.

Monitor your own patient for indications of UTI, such as dysuria and foul-smelling pee. If she evolves urinary incontinence, keep the woman's skin clean and dry to prevent excoriation and break down.

If your patient encounters sexual dysfunction, encourage the woman's to discuss her issues with you or the physician and, if appropriate, obtain a referral to some urologist or counselor.

Should you detect pupil abnormalities in your patient, inform the physician. Also, make sure that her environment is safe and that the lights are adequate to help prevent falls.

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