A 68-year-old client with type 2 diabetes and peripheral neuropathy is being taught foot self-care before discharge from a diabetes education clinic. The client has intact skin, no ulcers, and reduced sensation to monofilament testing bilaterally. The nurse evaluates the teaching session. Which statements indicate correct understanding of daily foot care? Select all that apply.
Select All That Apply
Choose your responses, then check the answer.
Explanation
Effective diabetic foot self-care teaching shows that the client can compensate for diminished protective sensation and prevent unnoticed injury. Correct behaviors include daily visual inspection using a mirror for hard-to-see areas, washing with lukewarm water followed by thorough drying between the toes, and moisturizing intact skin while avoiding the web spaces. Statements suggesting the client will rely on pain to trigger shoe checks, will trim nails to follow the toe's curve, or will choose restrictive footwear for cosmetic reasons reveal gaps in understanding, since each practice could allow unnoticed trauma, ingrown nails, or pressure injury. The nurse should reinforce sensation-independent, protective habits rather than comfort- or appearance-based choices for a client with peripheral neuropathy.
Clinical Reasoning Effective diabetic foot self-care teaching shows that the client can compensate for diminished protective sensation and prevent unnoticed injury. Correct behaviors include daily visual inspection using a mirror for hard-to-see areas, washing with lukewarm water followed by thorough drying between the toes, and moisturizing intact skin while avoiding the web spaces. Statements suggesting the client will rely on pain to trigger shoe checks, will trim nails to follow the toe's curve, or will choose restrictive footwear for cosmetic reasons reveal gaps in understanding, since each practice could allow unnoticed trauma, ingrown nails, or pressure injury. The nurse should reinforce sensation-independent, protective habits rather than comfort- or appearance-based choices for a client with peripheral neuropathy.
Option Review
Correct — Daily visual inspection, including between the toes and on the soles, allows early detection of skin breakdown or injury that this client may not feel because of neuropathy.
Correct — Washing with lukewarm water rather than hot water or prolonged soaking, then drying thoroughly between the toes, prevents burns, maceration, and fungal infection that reduced sensation could mask.
Correct — Moisturizing intact skin keeps it supple and less prone to cracking, while avoiding the web spaces limits excess moisture that promotes fungal growth and breakdown.
Incorrect — Trimming nails in a curved shape that follows the toe contour raises the risk of ingrown nails and skin injury; nails should instead be trimmed straight across.
Incorrect — Waiting for pain to prompt a shoe check is unsafe because diminished sensation means the client may not feel a foreign object causing pressure injury before it worsens.
Incorrect — Selecting snug or pointed-toe shoes for appearance increases friction and pressure on the toes, raising the risk of blisters or ulcers in skin that cannot signal early discomfort.
Sources
12026 NCLEX-RN Test Plan
2CDC: Your Feet and Diabetes
A 68-year-old client with type 2 diabetes and peripheral neuropathy is completing discharge teaching on daily foot self-care after a diabetes education clinic visit; the client's skin is intact with no ulcers, but monofilament testing shows reduced sensation bilaterally.