Trimming Those Tricky Diabetic Toenails

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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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