Posts Tagged ‘diabetic toenails’

Diabetic Toenails: Watch for Change

Thursday, February 23rd, 2017

Changes in the diabetic foot can happen fast: here are the signs and types clinicians in wound care need to look for.

Diabetic Toenails: Watch for Change

 

As a wound care professional, chances are you’ve treated a number of nail conditions and abnormalities that occur among the general population. But when you’re working with diabetic patients, noticing and identifying variations is even more crucial. This is because change can happen more rapidly in the diabetic foot, and pathologies can ultimately lead to skin breakdown, foot ulcerations and infection. So, what causes the nails to change, and what exactly should you look for? We’ve got you covered.

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Diabetic Patient Education

Monday, December 29th, 2014

Patient education plays a vital role in positive outcomes for our diabetic patient. Diabetic patients need to understand the importance of proper foot care and importance of good blood glucose control to maintain the integrity of their feet.

So what do our patients need to know? They need to work closely with their physician and the dietician to be sure their blood glucose levels are properly controlled. foot_mirror_between_toesThe ADA recommends an A1c below 7%.  They need to know how important it is to check their feet daily to catch any problems early. We as clinicians need to teach them how to do this and what to look for. Teach your diabetic patients to inspect their feet everyday. They can do this by having family members or caregivers check their feet, or they can use a mirror and do it themselves.

Explain to your patients what exactly they are looking for; cuts, sores, red spots, swelling, infected toenails, blisters, calluses, cracks, excessive dryness or any other abnormality. They should check all surfaces of the feet and toes carefully, at the same time each and every day. Explain to your patients to call their physician right away if they notice any abnormalities or any open areas. Other problems the diabetic patient should be aware of with their feet and report to their physician include tingling or burning sensation, pain in the feet, cracks in the skin, a change in the shape of their foot, or lack of sensation – they might not feel warm, cold, or touch. The patient should be aware that any of the above could potentially lead to diabetic foot ulcers.

Instruct your patients to wash their feet every day, but not soak their feet. Use warm, NOT hot water – be sure they check the water temperature with a thermometer or shoe_fittheir elbow. Dry feet well, especially between toes. Apply lotion on the tops and bottoms of their feet but not between toes. Trim toenails each week and as needed after bath / shower, trim nails straight across with clippers, smooth edges with emery board.

Wear socks and shoes at all times, the diabetic patient should never be barefoot, even indoors. Have them check their shoes prior to wearing, be sure there are no objects inside and the lining is smooth.  Instruct them to wear shoes that protect their feet; athletic shoes or walking shoes that are leather are best, be sure they fit their feet appropriately and accommodate the foot width and any foot deformities.

For our diabetic patients, glucose control is a key factor in keeping them healthy, but patient education and understanding of proper foot inspection and what findings to report to their physician are just as important for the well being of our diabetic patient.

Free Webinar “How-To: Diabetic Foot Exam Made Easy”. Use Promo Code: DFOOT  through 12/31/15.

Trimming Those Tricky Diabetic Toenails

Thursday, March 7th, 2013

diabetic blog pic

You are getting ready to trim your diabetic patients toenails.  What exactly does that all involve?  Well, first you need the proper tools.  A set of toenail nippers, nail file, and orange stick are typically used.   Always follow your facility or healthcare’s settings policy for infection control.  Single use disposable equipment is favorable.

You have gathered your equipment to trim the patients toenails, now what?  Nails are easiest to trim after a bath or soak for 10min to soften nails.  The soaking of diabetics feet should only be done by a healthcare professional. You can clean under the patients toenail with an orange stick (wearing gloves), wiping on a clean washcloth in between each toe during soaking. .

After soaking and washing of the feet are completed, dry the patients feet completely.  Wash your hands and put on gloves to trim the toenails.  Use your dominant hand to hold the nipper.  Start with the small toe and work your way medial toward the great toe.  Squeeze the nipper to make small nips to cut along the curve of the toenail.  Be careful not to cut the skin.  Use your index finger to block any flying nail fragments.  Nippers are used like a pair of scissors – make small cuts, never cut the nail in one clip all the way across the nail.  Never use two hands on the nipper.  The nail is trimmed in small clips in a systematic manner.  The nail should be cut level with the tips of the toes, never cut so short or to break the seal between the nail and the nail bed.  The shape of the nail should be cut straight across and an emery board should be used to slightly round the edges.  When filing nails always use long strokes in one direction, avoid using a back and forth sawing motion.

When all toes have been trimmed and filed, remove gloves and wash hands.  Apply clean gloves and apply lotion to the top of the foot and to the soles of the feet, rubbing lotion in well, wipe excess lotion off with a towel.  Put patients socks and shoes back on as needed.  Wash hands and smile, you are done!

For your patients who are trimming their own toenails at home teach them the following simple instructions:  Be sure you have good lighting. Trim toenails after bathing, dry feet well, especially in between the toes.  Start with the little toe and work your way into the great toe.  Use small cuts, never cut the toenail across all at once.   Cut straight across and use a nail file to smooth edges.  Apply lotion to the bottom and tops of the feet, never in between the toes.  For patients with thickened toenails or yellowed toenails, recommend a foot care specialist like a podiatrist cut their toenails.

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