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COMPREHENSIVE DIABETIC FOOT EXAM (Café)
Patient Name:PLEASE COMPLETE, SIGN, DATE AND FAX TO 2033063161
Name of MD/DO Supervise Diabetes Management:(Please sign Certifying Physician Acknowledgment
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How to fill out comprehensive diabetic foot exam
How to fill out comprehensive diabetic foot exam
01
To fill out a comprehensive diabetic foot exam, follow these steps:
02
Begin by collecting the patient's medical history including diabetes-related information, previous foot ulcers or amputations, and any symptoms or concerns related to their feet.
03
Perform a thorough physical examination of the patient's feet including assessing skin health, sensation, muscle strength, and blood flow to check for any abnormalities or signs of complications.
04
Inspect the patient's shoes to ensure they are appropriate for their foot biomechanics and provide sufficient protection.
05
Conduct a neurological examination to evaluate the patient's ability to feel sensations in their feet using tools like a monofilament.
06
Assess the patient's vascular status by checking pulses, listening for bruits, and examining skin color and temperature.
07
Examine the patient's feet for any structural abnormalities, deformities, or signs of infection.
08
Take specialized tests if necessary, such as X-rays or Doppler ultrasound, to further evaluate the patient's foot health.
09
Document all findings accurately and thoroughly in the patient's medical records.
10
Create a comprehensive treatment plan based on the exam results and the patient's individual needs.
11
Schedule regular follow-up appointments to monitor the patient's foot health and make necessary adjustments to the treatment plan.
Who needs comprehensive diabetic foot exam?
01
Comprehensive diabetic foot exams are recommended for individuals who have been diagnosed with diabetes, especially those who:
02
- Have had diabetes for many years
03
- Have poor blood sugar control
04
- Have a history of foot ulcers, infections, or amputations
05
- Have nerve damage or peripheral neuropathy
06
- Have poor circulation or peripheral arterial disease
07
- Have structural foot abnormalities or deformities
08
- Wear inappropriate or ill-fitting footwear
09
- Are older adults and may have difficulties with foot care
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What is comprehensive diabetic foot exam?
Comprehensive diabetic foot exam is a thorough evaluation of a diabetic patient's feet to assess for any signs of neuropathy, vascular disease, or infection.
Who is required to file comprehensive diabetic foot exam?
Diabetic patients are required to undergo comprehensive diabetic foot exams on a regular basis to monitor their foot health.
How to fill out comprehensive diabetic foot exam?
A healthcare provider will conduct a comprehensive diabetic foot exam by performing a visual inspection, checking for sensation, and evaluating blood flow to the feet.
What is the purpose of comprehensive diabetic foot exam?
The purpose of a comprehensive diabetic foot exam is to prevent complications such as ulcers, infections, and amputations in diabetic patients.
What information must be reported on comprehensive diabetic foot exam?
The comprehensive diabetic foot exam should include documentation of skin integrity, sensation, pulses, and any abnormalities present.
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