Feet Can Last a Lifetime
II. Current History continued...
This question is to determine whether the patient has
experienced any change in the strength or sensation in the feet. If this is the
patient's first visit, enter N/A unless the patient has noticed a change in the
Question 2: Does the patient have a foot ulcer now or a
history of foot ulcer?
A positive history of a foot ulcer places the patient
permanently in the high risk category. This person always has an increased
risk for developing another foot ulcer, progressive deformity of the foot,
and, ultimately, lower limb amputation.
Question 3: Is there pain in the calf muscles when
walking -- i.e., pain occurring in the calf or thigh when walking less than one
block that is relieved by rest?
This question is to determine whether the patient
experiences intermittent claudication when walking. This pain is an indication
of peripheral vascular disease or impaired circulation.
III. Foot Exam
Item 1: Are the nails thick, too long, ingrown or infected
with fungal disease?
Thick nails may indicate vascular or fungal disease. If
severe nail problems are present, refer the patient to a podiatrist or a nurse
foot care specialist.
Item 2: Foot Deformities
Indicate foot deformities listed or specify the type and
date of amputation(s). The more serious deformities are illustrated below.
Prominent metatarsal heads are evidence of major deformity such as midfoot
a.Toe Deformities (Hammer/Claw Toes)
b. Bunions (Hallux Valgus)
c. Plantar View of Charcot Joint
Item 3: Pedal Pulses
Check the pedal pulses in both feet and note whether they
are present or absent.
Item 4: Skin Condition
Examine each foot and record the problems identified by
drawing or labeling the condition on the foot diagram. If there are calluses,
pre-ulcerative lesions (a closed lesion, such as a blister or hematoma), or
open ulcers, measure and draw them in and use the appropriate symbol to
indicate what type of lesion is present. Label areas that are significantly
red, warm (warmer than the other parts of the foot or the opposite foot), dry,
or macerated (friable, moist, soft tissue).