Nail care, Fundamentals of Nursing

Nursing care of patients with long, dirty nails

1. Nail care Prepared by: Pooja Koirala Lecturer NMCTH

2. Introduction The nail is the modified epidermis that is firmly attached to the nail bed which is richly supplied with nerves and blood vessels The nail consists of lunula , the white part of proximal end The body The end: free ends at the distal part The nail supports and protects the finger tips

3. Definition Care of the nails includes trimming the nail short periodically and keeping the nails clean through frequent washing

4. Purposes To make the nail clean and harmless To prevent from infection and injury to the body To prevent accumulation of dirt and microorganisms underneath the nails Enhance the patient’s general appearance To detect or examine the abnormalities To maintain the skin integrity around the nail

5. Principles The average growth of nails per week is 1 mm Excessive alkalis, acids and hot water loosen nails from their beds Nails should be cut off close to the skin Clean nails in clean hands give the patient a sense of cleanliness Dirt under the finger nails provides an excellent place for all kinds of bacteria to grow

6. Finger nails can transmit bacteria to the person though the food and scratching Soaking nails in warm water helps to soften the nails and thus prevents the nails flying off

7. Articles A clean tray containing: Mackintosh: 1 Small towel :1 Nail cutter with file: 1 Cotton swabs Kidney tray:1 Water in a bowl Gauge piece: some amount

8. Procedure Assess the condition of the surfaces of fingers, toes and nails Pay particular attention to areas of dryness, inflammation and cracking Also inspect areas between fingers, toes, heels and soles of feet Explain the purpose and procedure to the patient and visitor

9. Procedure cont… Wash hands with soap and water Prepare all required articles and bring the article to the patient’s bedsides Maintain privacy Assist the ambulatory patient to sit on a bed side chair or maintain fowler position in bed. Help the bed ridden patient to the supine position

10. Procedure cont… Spread a mackintosh on the bed and place a bowl with warm water Instruct the patient to place his fingers in the bowl in a comfortable position for 3 – 5 minutes or necessary time period Dry the hands with towel Start to trim the finger nails and cut free end of the finger nails straightly

11. Procedure cont… Avoid trimming or digging into nails at the lateral corners. At that time, always give attention that the nails should be covered with gauge piece and put the nail on kidney tray Clean under the surface of the nail with a blunt instrument or the longer end of the tooth pick taking care not to injure the nail bed

12. Make the cut edge of the nail smooth by brushing them with a file Wipe all fingernails from thumb to 5th nail side by side by wet cotton ball. One cotton ball is used for one nail finger. Cut the opposite hand nails in the same manner

13. In toe nail care Soak the feet nails with wet swabs or if the patient can sit, put the patient in a comfortable position and soak the feet nail in the bowl for 10 – 15 minutes Dry the feet and nails Start to trim the feet nails in such a manner that cutting the toe nail straight to prevent them from growing in ward and removing the dirt under surface of the nail Do not cut the nail too short as it nay injure the nail bed

14. Place the nail in a kidney tray and cut the opposite feet nails in the same manner Remove the mackintosh Keep the patient in a comfortable position Give health education regarding nail care to the patient Replace the articles after cleaning

15. Procedure cont… Wash hands Record the date, time, condition of the nails, abnormalities of the nails and nail bed etc Report to the senior staff if any abnormalities are found

16. Any queries???

17. Thank you