A nurse is planning an in-service about foot care for a group of clients who have peripheral neuropathy. Which of the following information should the nurse include?

Apply foot cream between the toes.

Use a pumice stone to soften calluses.

Inspect the feet daily using a mirror.

Round the toenail edges when clipping.

Answer and Explanation

The Correct Answer is C

A. Apply foot cream between the toes: Moisturizing between the toes can create a warm, moist environment that promotes fungal or bacterial infections. Foot cream should be applied to the tops and bottoms of the feet, avoiding spaces between the toes.

B. Use a pumice stone to soften calluses: Using a pumice stone can cause skin breaks or ulcers in clients with peripheral neuropathy due to reduced sensation. Callus management should be performed by a healthcare professional to prevent injury.

C. Inspect the feet daily using a mirror: Daily inspection helps identify cuts, blisters, or infections early, especially since clients with peripheral neuropathy may not feel injuries due to decreased sensation. Using a mirror allows visualization of hard-to-see areas such as the soles.

D. Round the toenail edges when clipping: Toenails should be trimmed straight across to prevent ingrown nails and reduce the risk of infection. Rounding the edges can increase the likelihood of nail problems in clients with neuropathy.

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Correct Answer is D

Explanation

A. A client who needs assistance when ambulating: Difficulty ambulating increases fall risk and requires physical therapy, but it is not immediately life-threatening. This client needs support but does not take priority over airway or aspiration concerns.

B. A client who consistently has difficulty using utensils while eating: This reflects impaired motor coordination and may require occupational therapy. While important for independence, it does not present an urgent safety or health threat.

C. A client who has expressive aphasia: Expressive aphasia affects communication but does not compromise airway or physical safety directly. Speech therapy is beneficial, but it is not the most urgent referral.

D. A client who consistently coughs after drinking liquids: Coughing after drinking indicates possible aspiration due to impaired swallowing reflex. Aspiration can lead to pneumonia and respiratory compromise, making this client the highest priority for immediate referral to a speech-language pathologist for swallowing evaluation.

A. Apply the pad for 45 min per application. B. Cover the pad with a pillowcase before application. C. Set the temperature of the aquathermia pad to 50° C (122° F). D. Use safety pins to hold the pad in place.

Correct Answer is B

Explanation

A. Apply the pad for 45 min per application: Heat therapy should generally be limited to 20 to 30 minutes to avoid burns and rebound vasoconstriction. Applying for 45 minutes increases the risk of tissue injury and is not recommended.

B. Cover the pad with a pillowcase before application: Placing a thin barrier, such as a pillowcase, between the aquathermia pad and the skin helps prevent direct contact and reduces the risk of burns. This is the safest and most appropriate action.

C. Set the temperature of the aquathermia pad to 50° C (122° F): The typical safe range for aquathermia pads is around 40° C (104° F). Setting the temperature to 50° C poses a high risk of skin injury, especially in clients with impaired sensation or circulation.

D. Use safety pins to hold the pad in place: Safety pins can puncture the tubing of the pad, leading to leaks and malfunction. Straps or covers designed for the device should be used instead to secure it safely.

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A nurse is planning an in-service about foot care for a group of clients who have peripheral neuropathy. Which of the following information should the nurse include?

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