Diabetic Foot care

Meaning – Diabetic foot care involves all aspects of preventive and corrective care of the foot and ankle.
These patients are especially at risk for foot and nail problem because of poor peripheral blood supply
to the feet. As a result, sensation in the feet is reduced. Trauma to a diabetic foot can go unnoticed with
a break in the skin , infection can easily develop due to poor circulation.

Definition- The feet require special attention to prevent infection, odours and injury to the tissues.
Problems usually result from abuse or poor care of the feet. Such as

 Exposure to hard chemicals

 Wearing poorly fitted shoes.
 Biting nails or trimming them improperly.

Purpose-

 To maintain mobility and function in the well elderly.

 To prevent foot infections

Patients at the risk for foot problems are:

 older adults
 Patients with diabetes
 Patients with heart failure or renal disease
 Patients who had an attack of CVA

Preparation-

 Examination of all skin surface , including the shape, size and number of toes, is done.
 Inspection is done for lesions and also for Ares of dryness, inflammation or cracking.
 The areas between the toes should be carefully checked for fungus.
 Assessment of the gait.

Preparation of articles

 Sterile

Articles Rationale
Sponge cloth-1 To clean the calloused area of feet.
A small bowl with warm water To soak the fingers.
A big basin with warm water To dip the feet of the patients.
A nail cutter/nail file To trim or cut nails.
A pair of gloves To prevent cross-infection at the time of cleaning
 feet.

 Clean articles
articles rationale
A mackintosh with a towel To protect the bed linen and garments.
hand towel-1 or bath towel To dry the skin.
Vaseline/or cream To apply on the skin to prevent dryness.
A kidney tray and a paper bag To receive waste.
A set of new linen To change in case of the linen gets soiled.

Preparation of the patient-

 Give proper explanation to the patient.
 If possible, let the patient sit on a chair/stool.
Procedures
S Steps Rationale
.No
1 Wash hand with soap and water. To prevent cross infection.

2 Arrange all the articles. For easy and convenient access.

3 Place the patient on a chair in a sitting
position
4 Fill the basin with warm water at 43∙C-
44∙ C (100∙F-101∙F)
5 Place the mackintosh lined with towel
and bowl of water
6 Place the basin on the paper lining on
the floor. ask the patient to dip his feet
in the basin filled with warm water for
10-20minutes.
7 Remove the basin and dry fingers
thoroughly.
It makes the patient and nurse comfortable to carry
out procedure.
Warm water softens nails and thickens epidermal
cells.
Also helps in reducing inflammation of the skin and
promotes local circulation.
To protect the patient’s cloths.
To softens the nails and thickened epidermal cells, to
promote local circulation.
To dry the fingers.
To prevent fungal growth and maceration of tissues.

8 Put on gloves clean the calloused area of to prevent transfer of infection.

feet with sponge cloth. Dry the feet and
cut the toe nails.
9 Apply Vaseline/cream to the feet . To lubricate dry skin by retaining moisture.

10 Inspect nails and surrounding skin after To evaluate the condition of skin.
soaking and nail trimming.

Do’s of care of feet and nails of diabetic patients –

 Notice and feel your daily for blisters, open sores ,cuts , colour changes or in-grown toe nails
 Cut toe nails straight across.
 Wash your feet daily with soap and lukewarm water. Take care to wash between toes.
 Change daily into clean socks which must fit well and have no holes or tears.
 Examine your shoes everyday for pebbles, nails or any irritating objects.
 Keep your feet dry especially between toes. Use powder, if needed.
 Wear comfortable shoes that fir well.
 Keep your skin soft. Put lotion on top and bottom of your feet. Do not apply between toes.
 Have your feet checked by your doctor.

Dont’s of care of feet and nails of diabetic patients –

 Don’t let your feet get dry and cracked.
 Don’t wear tight socks or knee highs.
 Don’t use hot water to wash your feet.
 Don’t use corn medicine or blades.
 Don’t wear torn or tight shoes.
 Don’t use heater or hot water bottles to warm your feet; they can use cause harm.

Termination of articles –

 Take all the articles to the utility room, clean them with soap and water. Dry and replace at the
respective places.
 Disinfect the linen and other articles in case the patient is suffering from any communicable
disease.

Documentation - Record the procedure and observation. Report if any break in the skin is observed.
 Important guidelines:
 Wash and soak the feet daily using lukewarm water. Thoroughly pat the feet dry. Also
dry well between the toes.
 Do not cut corns or use commercial removers. Consult a physician.
 If dryness is noted along the feet or between the toes, apply Lanolin, baby oil or corn oil
and rub gently into the skin.
 File the toe nails straight across and square. Do not use scissor or nail cutter.
 Avoid wearing elastic stocking, knee high hosiery. Do not cross the legs, these impair
circulation of blood to the lower extremities.
 Inspect the feet daily including their top and sole, the heel and areas between the toes.
 Wear clean socks or stocking daily. Socks should be free of holes that might cause
pressure.
 Do not walk bare foot.
 Wear properly fitting shoes. The soles should be flexible and not slipping.
 Take exercise daily to improve circulation of blood to the lower extremities. Walk
slowly, elevate, rotate, flex and extend the feet at the ankles. Dangle the feet over the
sides of the bed for one minute and then extend both legs.
 Avoid applying hot water bottles or heating pads to the feet. Use warm socks or extra
coverings.
 Immediately wash minor cuts and dry them thoroughjy. Only mild antiseptics should be
applied to the skin. Avoid iodine or Mercurochorme application.
 Contact a physician for the treatment of cuts and lacerations.

SS