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How to carry out fingernail care?

Nails are the storehouse of dirt and infections, so they must be trimmed down and cleaned at regular intervals. Due to illness, patients are not able to take care of their hands and toe nails. It is the duty of CNAs to help them cut their nails from time to time. Due to big nails, patients can unconsciously scratch their own skin which can result in serious infections. If a person is under anti-coagulation therapy then nail cutting may lead to heavy bleeding. Therefore, such patients must never be provided with nail care. If a patient is diabetic, then only doctors must provide nail care because a slight scratch may lead to ulcer over the skin.

Steps to be Taken while Providing Nail Care to the Patient

Step 1 – Before coming close to the patient, rinse your hands properly with antiseptic soap and lukewarm water.

Step 2 – Wear gloves.

Step 3 – Greet the patient and explain him/her the nail care activity that you are going to perform.

Step 4 – Ensure that the patient is in a comfortable position. If the patient is not able to sit on a chair, allow them to lie on the bed and adjust the bed to a comfortable level.

Step 5 – In order to prevent the danger of falling, place a foot mat on the floor before shifting the patient on chair. In case of bedridden patients, put a sheet or towel on the table near him/her and place the nail care equipment on this table.

Step 6 – Fill the basin with soapy warm water. Ask the patients to check the temperature of the water themselves. If the patient is unconscious or frail, check the temperature on your own and keep it normal.

Step 7 – Immerse the fingers of the patient in the soapy water for a few minutes.

Step 8 – After some time, take out the fingers from the water and gently clean the nails with an orange stick. Put the stick on the nail’s edge and move it slowly from the right to left direction.

Step 9 – Remove dirt from the nails and put it on the cloth.

Step 10 – Once the cleaning procedure is completed, use a clean towel or washcloth to wipe the hands of the patient.

Step 11 – Gently file the nails with the help of an emery board stick.

Step 12 – Trim the sharp and extended edges of the nails. Collect the cut nails in a small cloth or a separate tray and dispose of them.

Step 13 – Once you are done with filing and cutting of the patient’s nails, apply some lotion on his/her hands from wrist to the fingertips.

Step 14 – Wash the basin and clean the nail care equipment.

Step 15 – Dispose of the washcloth and gloves.

Step 16- Rinse your hands to prevent germ transmission.

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Things that Examiner Notices while You Perform this Skill

  • An examiner will notice whether you have wash your hands before beginning the activity.
  • Whether you wash the patient’s hands properly before cutting the nails.
  • Whether you clean the nail area properly and cut one nail at a time.
  • Whether you ensure that there are no rough edges and nails are cut smoothly.
  • If you file and level the rough edges of the nails (if any).
  • If you consider the patient’s opinion while cutting the nails.
  • Whether you apply some antiseptic lotion / ointment after cutting the nails.
  • Do you wash your hands after the completion of task?

Expert’s Tips

  • Proper nail care of the patient by the CNA or doctor is very important because hands and legs remain exposed to dust most of the time. While dealing with the patient, you will have to be calm and firm, as they are already irritated by their disease and have more fragile body parts.
  • The nail cutting instruments that you are going to use must be clean and sterilized; otherwise, infections may spread.
  • Start cutting nails one by one. The edges must be smooth and must not be left pointed as the patient can unknowingly scratch himself.
  • Observe the nail beds of the patients, there must be no infection or eruption as this may lead to infections. If you think that there is any fungus, swelling or discoloration, then inform the supervisor nurse immediately.