CARE OF HANDS , FEET & NAILS IN NURSING

CARE OF HANDS, FEET AND NAILS

UPDATED 2024

Hands are more contaminated area and soaking in water enables
the nurse to clean them thoroughly

Feet are considered to be the least clean area. Placing the
foot in the water and cleaning facilitates through cleaning

Care nail is done by cut short finger nails and the toe
nails. To prevent skin injury and injection

Purpose

• To keep clean
• To prevent skin injury (% scratching)
• To prevent infection
• To promote comfort
• To improve grooming
• To promote self-esteem
• To detect or examine the
  abnormalities
• To prevent worm infestations

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

Important Key Points (Tips)

• Notice general physical conditions
  that may place the patient at risk for infections
• Prevent interruptions during the
  procedure
• Soak in warm water to soften nails
  and loosen foreign particles
• Prevent spread of microorganisms

Factors Affecting the Care

• Infection and injury
• Vascular insufficiency
• Systemic disease condition
• Poor health practices
• Sociocultural background

Examination Includes

Examination of all skin surfaces, areas between fingers and
between toes, shape, size and number of fingers and toes. The condition of the
nails such as nail plate, nail color, the lunula, shape, thickness, texture,
angle and then tissues around the nails

Common Problems

• Calculus: thickened position of
  epidermis. It is painless
• Corns: eratosis caused by friction
  and pressure from shoes
• Plantar warts: fungal lesions on sole
  of foot
• Ingrown nails: it occurs due to
  improper nail trimming
• Athletics foot: tinea pedis – fungal
  infection of foot
• Rams horn nails: long curved nails
• Paronychia: inflammation of tissues
  surrounds nails

Foot Care

Special Foot Care

Patients with diabetes and peripheral vascular diseases

• Clean the feet daily in lukewarm
  water using soap
• Dry the feet and the part between
  toes
• Do not cut corns of calculus
• Wear shoes with porous uppers
• If dryness is noted along the feet,
  use olive oil or lanolin and rub gently into the skin
• Avoid wearing elastic stocking
• Inspect the feet the soles, the heels
  and the area between toes daily
• Wear clean socks and stockings daily
• Do not walk bare foot
• Wear shoes or chapels, especially
  designed soft ones
• Exercise lower extremities to improve
  circulation
• Avoid burns to feet by hot water or
  hot water bag
• Treat minor injuries immediately
  under strict aseptic techniques
• Consult doctor for even minor
  injuries

Equipment

• Clean basin – 2 with warm water
• Large tray – 1
• Basin to dip foot or hand – 1
• Sponge cloths
• Towel – 1
• Nail clipper – 1
• Mackintosh and towel – 1
• Over bed table – 1
• Bath thermometer – 1

Procedure

• Collect the articles and place near
  the bed side to save time and energy
• Explain the procedures to allay fear
  and anxiety
• Wash hand to prevent cross-infection
• Provide privacy by screening
• Take the warm water 100-110 degree F
  in a basin
• Wash the hands first and then feet
  with soap and water and dry it with clean towel
• Soak the nails in the warm water and
  apply soap
• Brush the nails and place between
  fingers and toes and clean if with water
• Remove the water basin and dry the
  areas with towel
• Cut short the nails and collect it in
  the K-basin or paper bag
• Use wet cotton balls or gauze pieces
  to clean the tips of the nails

After Care

• Place the patients hand, feet
  comfortably
• Replace the articles and equipment
• Discard the dirty water in sluice
  room
• Wash the articles used and keep ready
  for the next use
• Wash hands
• Record and report the date, time,
  procedure and abnormalities noted in the nurse’s record

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IMPORTANT TIPS TO CARE FOR HAND, NAIL AND FEET

Caring for the hands, feet, and nails is an essential part of personal hygiene and overall well-being. Here are key important points for the care of hands, feet, and nails:

Hands:

1. Hand Washing:
   • Wash hands regularly with soap and water, especially before meals and after using the restroom.
   • Use hand sanitizer when soap and water are not available.
2. Moisturizing:
   • Apply moisturizer to prevent dryness and cracking.
   • Pay attention to the skin between the fingers.
3. Nail Care:
   • Keep nails trimmed and clean to prevent dirt and bacteria from accumulating.
   • Use a nail brush to clean under the nails.
4. Protection:
   • Wear gloves when doing household chores or activities that involve exposure to harsh chemicals or rough surfaces.
5. Avoiding Harsh Chemicals:
   • Minimize exposure to harsh detergents and cleaning agents that can dry out the skin.
6. Sun Protection:
   • Apply sunscreen to the hands to protect from sun damage, especially when spending extended periods outdoors.
7. Healthy Habits:
   • Avoid biting nails and cuticles.
   • Keep nails dry to prevent fungal infections.

Feet:

1. Proper Footwear:
   • Wear comfortable, well-fitting shoes to prevent foot pain and deformities.
   • Choose breathable shoes to avoid moisture buildup.
2. Regular Cleaning:
   • Wash feet daily, especially between the toes, and thoroughly dry them to prevent fungal infections.
3. Exfoliation:
   • Use a pumice stone to gently exfoliate rough areas on the soles of the feet.
4. Moisturizing:
   • Apply moisturizer to the feet, especially to dry or cracked areas.
5. Nail Care:
   • Trim toenails straight across to avoid ingrown toenails.
   • Avoid cutting the corners too short.
6. Regular Inspections:
   • Check feet regularly for any signs of cuts, sores, or infections, especially for individuals with diabetes.
7. Foot Elevation:
   • Elevate the feet when sitting to reduce swelling, especially after prolonged periods of standing.

Nails:

1. Regular Trimming:
   • Trim fingernails and toenails regularly to maintain a neat appearance and prevent ingrown nails.
2. Gentle Cleaning:
   • Clean under the nails regularly to prevent the buildup of dirt and bacteria.
3. Avoiding Nail Biting:
   • Refrain from biting or picking at nails and cuticles to prevent infections and damage.
4. Nail Hydration:
   • Apply cuticle oil or moisturizer to keep the cuticles and nails hydrated.
5. Nail Polish Care:
   • If using nail polish, give nails breaks between applications to prevent discoloration and weakening.
6. Healthy Diet:
   • A well-balanced diet rich in vitamins and minerals contributes to the health of nails.