Nursing Plan of Care for Infected Toenail

A nursing plan of care for an infected toenail is usually limited to a set of medication and treatment orders set forth by a doctor or other primary health care professional. While nurses cannot implement the use of medications not ordered by a doctor, they can create a detailed care plan, in which patient condition goals and time frames for achievement are included.

Use Standard Precautions

• A nursing plan of care for almost any infection should include standard precautions, which help reduce the risk of infections, and secondary infections, in patients and personnel. When caring for an infected toenail, clean, non-sterile gloves should be used. It is almost important to change gloves between different tasks on the same patient. Washing hands before and after handling the infected toenail is also important.

Taking Proper Care of Toenails

• Toenails can become infected for various reasons, the most common of whichis the result of an ingrown toenail. A doctor will diagnose this condition and either treat it surgically or prescribe medications. It is important that nurses not cut a patient's infected toenail haphazardly, and if the infection is secondary to diabetes, a podiatrist should be consulted. Nurses should inspect the toenails and make note of any abnormal appearance in color or thickness.

Bandaging and Foot Soaks

• Infected toenails should be bandaged lightly, if not contraindicated, to allow for adequate tissue perfusion. The light bandaging also prevents further irritation to the area that can occur during daily activities. Doctors may prescribe an antimicrobial, antifungus or antiseptic medication, which should be applied as often as indicated on the medication administration record. For minor toenail infections or discomfort, foot soaks can be helpful, as they often contain salts or very mild antibacterial solutions to help relieve swelling and pain.