Nursing care of patients with long, dirty nails

1. Nail care
Prepared by: Pooja Koirala
Lecturer
NMCTH

6. 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

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

8. 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

9. 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

10. • 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

11. 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

12. 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

13. 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

14. 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

15. 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

18. • 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

19. 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

20. • 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

21. 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

22. Any queries???

23. Thank you