A common pain in the foot

APatient ~~u(ation Notebook

BY ADI KURCAN, MD, PhD, AND JANICE D. NUNNELEE, RN, MSN, CS

Fig. I. Untreated

inflammation

caused

by ingrown

toenail.

Ingrown toenails are as old as wearing shoes. If we did not wear shoes, we would not get ingrown nails very often. Because we do wear shoes, though, we need to be aware that there are precautions we can take to help treat or prevent ingrown nails. First, wear shoes that are loose around the toes. This means you must buy shoes that fit and that are not tapered toward the toes. For women, it means not buying high-heeled shoes and getting an adequate toe box (height over the toes inside the shoe). Second, cut the nails straight across. Do not cut down in the corners. This causes the nails to grow inward and into your skin. The nail acts like a splinter or other “foreign body,” and the body tries to get rid of it by becom-

ADDRESS FOR CORRESPONDENCE: Janice D. Nunnelee,RN, MSN,CS 14377Woodlake. Suite 300

Fig. 2. Ingrown

toenail.

Fig. 3. Cotton wisp run underneath

corner of nail.

ing inflamed. This causes the pain in the toe (Figs. 1 and 2). Third, if the edges of the nails are growing in toward the skin, do not cut them to relieve the pressure. This makes the situation worse. Instead, put a tiny piece of cotton under the edge of the nail. It is easiest if the cotton is

Chesterfield, MO 63017

J-ILY/AUCUST

1996,

VOL.

1 NO. 4

HOME

CARE PROVIDER

2 I7

KURGAN

AND NUNNELEE

wet with alcohol first and then pulled into a thin thread. It must be long enough to go under the corner of the nail (Fig. 3). This raises the nail and causes it to grow up and not inward. The cotton must be changed daily until the nail has grown beyond the skin. To relieve any discomfort, you may put lamb’s wool or foam padding around the toe to take pressure off of it. If the skin around the nail becomes red or swollen as seen in Fig. I, check with your health care provider. Do not try to treat this on your own. If you have diabetes, poor vision, or poor circulation, you should get all of your foot care from a professional. Your health care provider is the best source of information for your foot care. If you have questions, talk with your home care provider or primary care provider. Reprint no. 69/l/75916

Nursing

Tips--continued

from page I97

as an interested, caring friend. Your visits will become an important and awaited part of your patient’s day. This is an opportune time to involve your patient in the healing process.

NOTE ON MRS. JONES’ OUTCOME With the help of h er supportive family and home health nursing care, Mrs. Jones was able to make a speedy recovery. Armed with the facts, skills, and knowledge with which you, the home health nurse, have supplied her, she is more optimistic and ready to continue her life with a positive outlook.

CONCLUSION Today’s opportunities for nurses in the home health field and community-based agencies are bountiful. Qualities necessary for transition into this area of nursing are many, including being self-reliant, innovative, and versatile. In an uncertain world, home health nurses face one certainty, and that is that their patients will need on-going, updated information to manage their changing health care concerns. You, as their home health nurse, will be expected to accomodate your patients and provide accurate, comprehensive, meaningful teaching about inumerable subjects, as well as answer inumerable questions about their health status. Meeting this challenge and surpassing your own expectations will make you the best patient advocate and home health care provider possible. Francine Zabkar, home

health

nurse

RN,

BSN,

at Cape

is a coronary Coral

Hospital

intensive

care

in Cape

Coral,

1996,

VOL.

and

Florida. Reprint no. 69/l/15419

2 18

HOME

CARE PROVIDER

JULY/AUGUST

1 NO.4