Hair Care and Foot Care

PROVIDING FOOT CARE
PURPOSES
 To maintain the skin integrity of the feet
 To prevent foot infections
 To prevent foot odors
 To assess or monitor foot problems
ASSESSMENT
Determine
 History of any problems with foot discomfort, foot odor, foot mobility, circulatory
problems (e.g., swelling, changes in skin color and/or temperature, and pain), structural
problems (e.g., bunion, hammer toe, or overlapping digits)
 Usual foot care practices (e.g., frequency of washing feet and cutting nails, foot hygiene
products used, how often socks are changed, whether the client ever goes barefoot,
whether the client sees a podiatrist).
Assess
 Skin surfaces for cleanliness, odor, dryness, and intactness
 Each foot and toe for shape, size, presence of lesions (e.g., corn, callus, wart, or rash),
and areas of tenderness, ankle edema
 Heels for erythema, blisters, or breaks in skin integrity Skin temperatures of both feet to
assess circulatory status:
- Pedal pulses: dorsalis pedis and posterior tibialis
- Feet of bedbound clients for foot drop
 Self-care abilities (e.g., any problems managing foot care)
EQUIPMENTS
 Washbasin containing warm water
 Pillow
 Moisture-resistant disposable pad
 Towels Soap
 Washcloth
 Toenail cleaning and trimming equipment if agency policy permits
 Lotion or foot powder
PLANNING DELEGATION
Foot care for the nondiabetic client can be delegated to UAP. Remind the UAP to notify the
nurse of anything that looks out of the ordinary. Review with the UAP the agency policy about
cutting or trimming nails.
IMPLEMENTATION
PROVIDING FOOT CARE
PROCEDURE RATIONALE
1. Prior to performing the procedure, To establish rapport, ensures correct patient,
introduce self and verify the client's and reduce anxiety.
identity using agency protocol.
Explain to the client what you are
going to do, why it is necessary, and
how he or she can participate.
2. Perform hand hygiene and observe Reduce transmission of microorganisms.
other appropriate infection prevention
procedures.
3. Provide for client privacy by drawing Reduce embarrassment and anxiety.
the curtains around the bed or closing
the door to the room. Some agencies
provide signs indicating the need for
privacy.
4. Prepare the equipment and the client.:
 Fill the washbasin with warm Warm water promotes circulation, comfort,
water at about 40°C to 43°C and relaxation.
(105°F to 110°F).
 Assist the ambulatory client to
a sitting position in a chair, or
the bed client to a supine or
semi-Fowler's position.
 Place a pillow under the bed This provides support and prevents muscle
client's knees fatigue
 Place the washbasin on the
moisture-resistant pad at the
foot of the bed for a bed client
or on the floor in front of the
chair for an ambulatory client.
 For a bed client, pad the rim of The towel prevents undue pressure on the
the washbasin with a towel. skin.
5. Wash the foot and soak it.
 Place one of the client's feet in Prolonged soaking may remove natural skin
the basin and wash it with oils, thus drying the skin and making it more
soap, paying particular susceptible to cracking and injury.
attention to the interdigital
areas. Prolonged soaking is
generally not recommended
for clients with diabetes or
individuals with peripheral
vascular disease.
 Rinse the foot well to remove Soap irritates the skin if not completely
soap. removed.
 Rub callused areas of the foot This helps remove dead skin layers.
with the washcloth.
 If the nails are brittle or thick Soaking softens the nails and loosens debris
and require trimming, replace under them.
the water, and allow the foot to
soak for 10 to 20 minutes.
 Clean the nails as required This removes excess debris that harbors
with an orange stick. microorganisms.
 Remove the foot from the
basin and place it on the
towel.
6. Dry the foot thoroughly and apply Harsh rubbing can damage the skin.
lotion or foot powder. Thorough drying reduces the risk of infection.
 Blot the foot gently with the
towel to dry it thoroughly,
particularly between the toes.
 Apply lotion or lanolin cream to This lubricates dry skin and keeps the area
the foot but not between the between the toes dry.
toes.
 Apply a foot powder containing Foot powders have greater absorbent
a nonirritating deodorant if the properties than regular bath powders; some
feet tend to perspire also contain menthol, which makes the feet
excessively. feel cool.
7. Document any foot problems
observed.
Contrast and comparison from the book and the videos given:
The nurse was able to do all the steps in the book except the following:
1. The nurse asked the patient if the water is not too cold or hot for him.
2. The nurse emphasized the importance of using gloves.
3. The nurse did not place a pillow under the client’s knees.
4. The nurse did trim or cut client’s nails. His nails are long.
5. The nurse did not use an orange stick.
6. The nurse demonstrated the proper basin cleaning and disposal of used equipment such
as gloves.
7. At the end of the procedure, the nurse ask the level of comfort of the client.
PROVIDING HAIR CARE
PURPOSES
 To stimulate the blood circulation to the scalp
 To distribute hair oils and provide a healthy sheen
 To increase the client's comfort
 To assess or monitor hair or scalp problems (e.g., matted hair o dandruff)
ASSESSMENT
Determine
 History of the following conditions or therapies: recent chemotherapy, hypothyroidism,
radiation of the head, unexplained hair loss, and growth of excessive body hair
 Usual hair care practices and routinely used hair care products
 Whether wetting the hair will make it difficult to comb. Kinky hair is easier to comb when
wet and is very difficult to comb when it dries.
Assess
 Condition of the hair and scalp. Is the hair straight, curly, kinky? Is the hair matted or
tangled? Is the scalp dry?
 Evenness of hair growth over the scalp, in particular, any patchy loss of hair; hair
texture, oiliness, thickness, or thinness; presence of lesions, infections, or infestations on
the scalp; presence of hirsutism
 Self-care abilities (e.g., any problems managing hair care) shampoo, conditioners, hair ol
preparation, hair dye, curling or straightening preparations)
IMPLEMENTATION
PROVIDING HAIR CARE

PROCEDURE RATIONALE
1. Prior to performing the procedure, To establish rapport, ensures correct patient,
introduce self and verity the client's and reduce anxiety.
identity using agency protocol.
Explain to the client what you’re going
to do, why it is necessary, and how he
or she can participate.
2. Perform hand hygiene and observe Reduce transmission of microorganisms.
other appropriate infection prevention
procedures.
3. Provide for client privacy by drawing Reduce embarrassment and anxiety.
the curtains around bed or closing the
door to the room. Some agencies
prove signs indicating the need for
privacy.
4. Position and prepare the client
appropriately.
 Assist the client who can sit to Hair is more easily brushed and combed
move to a chair. when the client is in a sitting position.
 If health permits, assist a client
confined to a bed to a sitting
position by raising the head of
the bed. Otherwise, assist the
client to alternate side-lying
positions, and do one side of
the head at a time.
5. Remove any mats or tangles
gradually.
 Mats can usually be pulled
apart with fingers or worked
out with repeated brushings.
 If the hair is very tangled, rub
alcohol or an oil, such as
mineral oil, on the strands to
help loosen the tangles.
 Comb out tangles in a small
section of hair toward the This avoids scalp trauma.
ends. Stabilize the hair with
one hand and comb toward
the ends of the hair with the
other hand.
6. Brush and comb the hair To easily brush the client’s hair.
 For short hair, brush, and
comb one side at a time.
Divide long hair into two
sections by parting it down the
middle from the front back. If
the hair is very thick, divide
each section front and back
subsections or into several
layers.
7. Arrange the hair as neatly and Maintains rapport with the client.
attractively as possible, according to
the individual's desires.
 Braiding long hair helps
prevent tangles.
8. Document assessments and special Evaluates the effectiveness of the given care.
nursing interventions. Daily combing
and brushing of the hair are not
normally recorded.
9. Conduct ongoing assessments f To assess the need of giving medications.
alopecia, pediculosis, scalp lesions, or
excessive dryness or matting.
10. Evaluate effectiveness of medication To determine the capability of the medication
(e.g., for treating pediculosis), if to treat the patient’s complications/
appropriate. conditions,
Contrast and comparison from the book and the videos given:
The nurse was able to do all the steps in the book except the following:
1. The nurse determines any contraindication to the procedure.
2. The nurse asked the client’s hair preferences (if combed or styled)
3. The nurse placed a towel over client’s shoulder or under the head.
4. The nurse determined to need to proceed the care as per the doctor’s order.

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PROVIDING FOOT CARE

PROVIDING HAIR CARE

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