CARE OF THE HANDS AND FEET

a. General.

Special attention is often required to prevent infection, odor, and injury of the patient’s hands and feet. Problems often arise from abuse or poor care of hands and feet, such as biting the nails and wearing ill-fitted shoes. Assessment of the feet involves a thorough examination of all skin surfaces. Areas between toes should be carefully checked.

Patients with diabetes mellitus or peripheral vascular disease should be observed for adequate circulation of the feet. Because of poor vision and decreased mobility, the elderly are at risk for foot disorders. Care of hands and feet can be administered during the morning bath or at another convenient time.

b. Important Points.

(1) Notice general physical conditions that may place the patient at risk for infections.

(2) Prevent interruptions during the procedure.

(3) Soak in warm water to soften nails and loosen foreign particles.

(4) Prevent spread of microorganisms.

c. Procedure.

(1) Obtain physician’s order if necessary.

(2) Explain procedure.

(3) Prepare equipment:

(a) Washbasin.

(b) Emesis basin.

(c) Washcloth.

(d) Hand towel.

(e) Nail clippers, emery board, and orangewood stick.

(f) Lotion.

(g) Disposable bath mat.

(h) Disposable gloves (optional).

(4) Wash hands, and arrange supplies within easy reach.

(5) Position patient in chair, place disposable mat under patient’s feet if possible, and provide patient with privacy.

(6) Fill the basin with water at 100º to 110ºF (38º to 44ºC). Place the basin on a disposable mat and help patient place feet into basin. Soak feet for 15 to 20 minutes, rewarming water as necessary (figure 1-8).

(7) Place overbed table in low position in front of the patient. Fill emesis basin with water at 100º to 110ºF (38º to 44ºC). Place the basin on the table and place patient’s fingers into basin. Soak fingernails 10 to 20 minutes; rewarm water as necessary (figure 1-9).

Figure 1-8. Care of feet.

Figure 1-9. Care of fingernails.

(8) Clean under fingernails with orange stick. Trim nails straight across and even with clippers. Shape fingernails with emery board. Push cuticles back gently with washcloth or with orangewood stick.

(9) Don glove and wash areas of the feet that are calloused with washcloth.

(10) Trim and clean toenails as in step 8 for fingernails.

(11) Apply lotion or cream to hands and feet. Return patient to bed and position for comfort.

(12) Remove gloves and store them in proper container. Clean all equipment and store. Place soiled linen in laundry bag. Wash your hands.