Nail and Foot Care

NAIL AND FOOT CARE
Incorporates nail and foot care into a persons regular hygiene

routine, routine care involves soaking the hands and feet to soften
cuticles and layers of auricells, thorough, cleaning, drying and proper
nail trimming. The one exception is patients with diabetes mellitus or
peripheral vascular disease who are at risk for tissue ulceration or
infection because soaking cause skin softening or maceration of tissue.
- Take time during the procedure to teach the patient and family
proper techniques for cleaning and nail trimming. Stress the
importance of how through nail care prevents the infection and
promotes good circulation. Patients must learn to protect the feet
from injury, never walk bare foot, keep feet and dry, and ware
footwear that fits properly.
- Instruct the patient in the proper way to inspect all the surfaces
of the feet, enhance for redness, lesion, dryness or signs of
infection.
- Teach foot care to family caregivers for patients who regularly
need foot care and have peripheral vascular disease, visual
difficulties, physical constraints preventing movement of
cognitive problems.
● Purposes
1. To maintain the skin integrity of the feet.
2. To prevent foot infections
3. To prevent foot odors
4. To assess or monitor foot problems
● Special consideration:
1. Assess the client for the following: condition of skin surfaces,

presence of edema or tenderness, circulatory status, usual foot care
practices and self-care abilities;
2. Avoid soaking the hands and the feet of diabetic clients since it
increases risk of infection in such persons.
3. Obtain Physician’s order for cutting nails if agency policy requires

it. Client’s skin may be accidentally cut. Certain clients are more at
risk for.
● Requisites:
● Washbasin containing warm water

● Disposable pad Pillow
● Moisture –resistant Washcloth Towels
● Emery board or nail Emesis basin Soap
● file Nail clippers Body lotion
● Disposable bath mat Orange stick Paper towels
● Disposable gloves
NAIL AND FOOT CARE | RLE NCM 103

Procedure:
Suggested actions Rationale
1. Explain procedure to client, Client must be willing to place
including fact that proper soaking fingers and feet in basins for 10-
requires several minutes. 20 min because client may become
anxious and fatigued.
2. Wash hands. Arrange equipment
on over bed table. Easy access to equipment prevents
delays.
3. Pull curtain around bed or close Maintaining client’s privacy

room door(if desired). reduces anxiety.
4. Assist ambulatory client to sit Sitting in chair facilitates

in bedside chair. Help bed-bound immersing feet in basin. Bath mat
client to supine position with head protects feet from exposure to
of bed elevated. Place disposable debris or soil.
bath mat on floor under client’s
feet or place towel on mattress.
5. Place basin on a moisture-

resistant pad at the foot of the The towel prevents undue pressure
bed for a bed client or on the on the skin.
floor in front of the chair for an
ambulatory client.
For a bed client, pad the rim of

the washbasin with a towel.
Warm water softens nails and
6. Fill washbasin with warm water thickened epidermal cells, reduces
about 40°C to 43°C (105°F to 1 inflammation of skin, and promotes
10°F). local circulation. Proper water
temperature prevents burns.
7. Place basin on bath mat or
towel, and help client place feet Client’s with muscular weakness or
in basin. Place call light within tremors may have difficulty
client’s reach. positioning feet. Client's safety
should always be maintained.
8. Adjust over bed table to low
position, and place it over Easy access prevents accidental
client’s lap.( Client may sit on spills.
chair or lie in bed ).
Warm water softens nails and
9. Fill emesis basin with warm thickened epidermal cells.
water and place basin on paper
towels on over bed table.
Prolonged positioning can cause
10. Instruct client to place discomfort unless anatomical
fingers in emesis basin and place alignment is maintained.
arms in comfortable position.

- Omit soaking in patients with
any of the following
conditions:
● Diabetes mellitus
● Peripheral neuropathy
● Peripheral vascular
disease
Softening of corns, calluses, and
11. Allow client’s feet and cuticles ensures easy removal of
fingernails to soak for 10-20 dead cells and easy manipulation
minutes. Rewarm after 10 minutes. of cuticles.
12. Clean gently under fingernails Orange stick removes debris under
with orange stick while fingers are nails that harbor microorganism.
immersed. Remove emesis basin, and Thorough drying impedes fungal
dry fingers thoroughly. growth and prevents maceration of
tissues.
13. With nail clippers, clip
fingernails straight across and Cutting straight across prevents
even with tops of fingers. splitting of nail margins and
formation of sharp nail spikes
14. Shape nails with emery board that can irritate lateral nail
or file. If client has circulatory margins. Filing prevents cutting
problems, do not cut nails; file nail too close to nail bed.
the nail only.
Push cuticle back gently with Reduces incidence of inflamed
orange stick. cuticles.
15. Move over bed table away from

client. Provides easier access to feet.
16. Put on disposable gloves, and

scrub callused areas of feet with Gloves prevent transmission of
washcloth. fungal infection. Friction removes
dead skin layers.
17. Clean gently under nails with
orange stick. Remove feet from Removal of debris and excess
basin, and dry thoroughly. moisture reduces chances of
infections.
18. Clean and trim toenails using
procedures in step 13 and 14. Do Shaping corners of toenails may
not file corners of toenails. damage tissues.
19. Apply lotion to feet and hands,

and assist client back to bed and
into comfortable position. Lotion lubricates dry skin by
helping to retain moisture.
If the client would want to go
back to bed reassist and place her
in a comfortable position,

otherwise we remove the material
on the overboard table.
20. Remove disposable gloves and

place in receptacle. Clean and
return equipment and supplies to
proper place. Dispose of soiled Reduces transmission of infection.
linen in hamper. Wash hands.
21. Inspect nails and surrounding

skin surfaces after soaking and
nail trimming. Evaluates condition of skin and
- Make sure that the patient is nails. Allows nurse to note any
comfortable before we leave remaining rough nail edges.
his/her room.
22. Record procedure and

observations (¢.g. breaks in skin,
inflammation, ulcerations).
23. Documents procedure, client’s

response, and presence of
abnormalities requiring additional
therapy.
23. Report any breaks in skin or

ulcerations to nurse in charge or Can seriously increase client’s
physician. risk of infection and must be
carefully observed.
● Modification:
1. Prior to soaking the feet, the nurse may cleanse feet with soap and
water paying particular attention to the interdigital areas.
2. May soak one foot at a time.
Health Teaching:
a. Instruct client to wash feet daily, and dry them well especially the
toes.
b. When washing, inspect skin of the feet for breaks or red or swollen
areas. Use mirror if needed to visualize all areas.
c. To prevent burns check the temperature of the water before immersing

the feet.

d. Cover feet, except the toes with creams or lotions to moisten the
skin.
e. To prevent or control unpleasant odor due to excessive perspiration,

wash feet frequently and change socks and shoes at least daily. Avoid
socks with holes or dams that can cause pressure areas.
f. Wear comfortable, well-fitting shoes that neither restrict the foot

nor rub on any area; rubbing can cause corns and calluses.
g. Avoid walking barefoot. Wear slippers in public showers and change

areas to avoid contracting athlete’s foot.
h. Avoid wearing constricting garments such as knee-high elastic

stockings and avoid sitting with legs crossed at the knees which may
decrease circulation.

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NAIL AND FOOT CARE

Incorporates nail and foot care into a persons regular hygiene

1. Assess the client for the following: condition of skin surfaces,

3. Obtain Physician’s order for cutting nails if agency policy requires

● Washbasin containing warm water

NAIL AND FOOT CARE | RLE NCM 103

3. Pull curtain around bed or close Maintaining client’s privacy

4. Assist ambulatory client to sit Sitting in chair facilitates

5. Place basin on a moisture-

For a bed client, pad the rim of

NAIL AND FOOT CARE | RLE NCM 103

15. Move over bed table away from

16. Put on disposable gloves, and

19. Apply lotion to feet and hands,

NAIL AND FOOT CARE | RLE NCM 103

20. Remove disposable gloves and

21. Inspect nails and surrounding

22. Record procedure and

23. Documents procedure, client’s

23. Report any breaks in skin or

2. May soak one foot at a time.

c. To prevent burns check the temperature of the water before immersing

NAIL AND FOOT CARE | RLE NCM 103

e. To prevent or control unpleasant odor due to excessive perspiration,

f. Wear comfortable, well-fitting shoes that neither restrict the foot

g. Avoid walking barefoot. Wear slippers in public showers and change

h. Avoid wearing constricting garments such as knee-high elastic

NAIL AND FOOT CARE | RLE NCM 103

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