Copyright 1999.doc

Copyright 1999 Helen Hodges, RN, PhD Ann Keeley, RN, CS, MN Lorie Gassel, RN, BSN Definition of Foot Care The basic care of the lower leg, foot, and nails, including mobility and health assessment, and interventions of trimming nails; buffing corns, calluses; debriding thickened nails; and patient teaching. Purpose To maintain mobility and function in the well elderly Principles 1. Foot care that includes lower extremity assessment, toenail, and skin care is essential nursing care. Proper care of the feet increases body defenses against immobility, pain, and infection. Systemic disease processes affect sensation and circulation, putting the patient at risk for injury and infection. Foot care patient education focuses on self-care, properly fitting footwear, early warning signs, and health habits (including nutrition, smoking cessation, exercise), and treatment compliance. 5. The well elderly commonly have decreased range of motion, vision impairment, and diminished manual dexterity, making bending, visual acuity, and fine instrument handling needed for proper self-footcare difficult. Scope of Practice: Foot Care Clinic I. Assessment: includes patient history, reason for clinic visit, observation of mobility function. Circulatory status includes color, temperature, edema, capillary refill, and dorsalis pedis pulse (palpation or Doppler, if available). Neurological status includes protective (monofilament, pin) and vibratory sensation (tuning fork 128 Hz. Musculoskeletal status includes structural deformities (bunion, hammertoe, dorsiflexed toes, crossover toes) and fat pad at metatarsal heads. Toenail status includes hygiene, length, thickness, and fungal (onychomycosis) involvement. Skin assessment includes calluses, corns, fissures, lesions, and wounds. Footwear is evaluated for condition, fit, stability, and protection (corns, calluses, and blisters indicate poorly fitting footwear). II. Intervention: determined based on analysis of assessme