春暉居家護理所

糖尿病足部護理 / The nursing of diabetes mellitus foot

一、目的：1.維持足部外觀皮膚完整。

Purpose: 1. Maintain the skin integrity of the foot appearance.        

     2.促進糖尿病人末稍血液循環。 Promote a diabetic end slightly blood circulation.

          3.預防足部感染。Prevent foot from infecting.

二、足部評估：1.血糖值是否偏高-需調整至合理範圍(飯前血糖250mg/dl以下) The foot evaluates: 1. Blood sugar value whether higher-need to be adjusted to the reasonable score (the blood sugar 250 mgs/dl is following before meal).

         2. 評估患者所穿的鞋子是否合適。 Evaluate the shoes that the sufferer wears whether accommodation.

             3.每天觀察足部皮膚顏色。 Observe the color of foot skin every day.

             4.觸診足背及足底動脈。Palpation instep and feet bottom iliac artery.

             5. 觸診足部溫度。Touch the temperature of palpation foot.

              6.檢查足部皮膚是否完整與足部是否感染。Check foot skin whether intact and foot infects or not.

             7.評估腳踝與腳趾的活動能力。Evaluate the activity ability of ankle and toe.

             8. 檢查足部是否有關節欒縮與變形情形。 / 8. Check foot whether joint contract and deformities situation.}

             9. 檢查趾甲是否太長與藏垢。 / 9. Whether checking digit grows and hides dirt too much or not.

三、           注意事項：Special note:

1. 糖尿病患者盡量不穿深色襪子-因要觀察有無滲液在襪子上；需穿棉襪，最好有止滑效果。 The diabetic as far as possible doesn't wear deep color socks-observe to have because of wanting without the oozing liquid on the socks; Need to wear a cotton sock, had better have slippery effect.
2. 足底傷口只能用磨的；不要用剪刀剪。痂皮用溶解素或Flamazine溶解。 / The feet bottom wound can only use grinding of; Don't shear with the scissors. The scar need to used Flamazine .                    p.1      
3. 每日糖尿病患者最好於睡前溫水(36~40℃)泡足10~20分鐘 。 Everyday diabetic had better in warm water(36~40 ℃ ) before sleeping the bubble feet is 10~20 minutes.
4. 足部有傷口患者亦需溫水泡足；但可用1:100優碘溫水泡足(溫水不需無菌)；照顧者戴工作手套用4×4紗布於水中幫患者按摩雙足，動作輕柔，泡後需擦乾雙足及趾縫，再用一般傷口護理法幫傷口換藥。 用凡士林包在紗布內均勻擦拭足底及足背。If foot has a wound the sufferer also needs bubble feet; But can use 1:100 iodine solution bubble feets;(Wen Shui3 doesn't need asepsis) The caregiver wears work gloves to use 4 × 4 gauzes after helping a sufferer a massage feet in water, acting light and softly, steeping need to wipe a dry feets and digit palatine sutrue, again help the wound transition the medicine with the general wound nursing method. Wrap with the Vaseline even wipe feet bottom and instep in the gauze.
5. 足底腳質層太厚時不要用剪刀剪；可用手把式浮石在水裡磨腳底，其不可摩足背會受傷。If it’s too thick of the feet bottom doesn't want to shear with the scissors; You can use handle float stone to apply foot bottom, but don’t apply foot back , it’s can get hurt.

四、           糖尿病傷口： Diabetes mellitus wound:

1. 將血糖控制在合理範圍。 Control blood sugar in the reasonable scope.
2. 照足部X光與足部血流檢查，壞疽即需截肢；故以上之足部護理非常重要。 Take a foot X-ray and foot blood circulation check, if have gangrene needs to cut a limb; So your foot care is very important.
3. 傷口周圍發紅，須使用1:20優碘濕敷，超過紅腫範圍5㎝。 The wound surroundings redness , must use 1:20 iodine solutions are wet to spread, exceed red and swellings cope 5 ㎝.

五、               以2層工作手套製作水球墊於患者骨突出處、傷口處可減少其壓力，減少壓瘡發生與使傷口癒合良好。 Made a water balloon( use 2 work gloves )It’s can reduce pressure at the skin outstanding, wound of sufferer palatine bone and reduce pressure ulcers occurrence and make the wound heal good.

避免糖尿病人傷口發生非常重要，以免造成患者截肢！Avoid a diabetic wound occurrence is very important, it’s can prevent cut a limb!