MNT Foot Care for Elderly Patients 2 — Questions and Answers
Question 1: Which medication commonly prescribed to elderly patients can cause nail and foot changes, increasing treatment risk?
- Multivitamins
- Warfarin, antihypertensives (causing edema), and immunosuppressants (Correct answer)
- Calcium supplements
- Probiotics
Correct answer: Warfarin, antihypertensives (causing edema), and immunosuppressants
Warfarin increases bleeding risk; antihypertensives (e.g., calcium channel blockers) can cause peripheral edema; immunosuppressants impair healing and infection resistance—all affecting nail care safety.
Question 2: Falls prevention in elderly patients receiving foot care includes:
- Recommending high-heeled slippers for grip
- Advising well-fitting footwear, addressing callus and nail pathology, and recommending balance exercises (Correct answer)
- Telling patients to avoid walking after treatment
- Applying heavy emollient to the foot sole for slip protection
Correct answer: Advising well-fitting footwear, addressing callus and nail pathology, and recommending balance exercises
Foot pain from callus and nail conditions affects gait and balance; proper nail and callus management combined with appropriate footwear significantly reduces fall risk.
Question 3: A corn (heloma durum) on the dorsum of an elderly patient's hammer toe should be:
- Excised with a scalpel to the bone
- Carefully debrided with a scalpel blade and protected with a silicone toe orthosis to redistribute pressure (Correct answer)
- Left untreated as it is normal in elderly patients
- Treated with OTC salicylic acid only
Correct answer: Carefully debrided with a scalpel blade and protected with a silicone toe orthosis to redistribute pressure
Hard corns over pressure points require professional debridement and pressure relief via silicone orthoses; salicylic acid risks chemical burns in elderly/diabetic patients.
Question 4: When treating nail pathology in a patient taking long-term systemic corticosteroids, the technician should be aware of:
- Increased nail growth rate requiring more frequent visits
- Fragile, thin skin prone to easy bruising and tearing, impaired wound healing, and increased infection risk (Correct answer)
- Improved circulation facilitating faster healing
- No special precautions needed
Correct answer: Fragile, thin skin prone to easy bruising and tearing, impaired wound healing, and increased infection risk
Chronic corticosteroid use causes skin atrophy, fragility, impaired healing, and immune suppression—all requiring ultra-gentle technique and heightened infection vigilance.
Question 5: Subungual corns (heloma subunguale) are most commonly found:
- Under the toenail of the 5th digit due to footwear pressure
- Under the nail of any toe where bony prominence creates chronic pressure (Correct answer)
- On the dorsal nail fold
- In patients with onychomycosis only
Correct answer: Under the nail of any toe where bony prominence creates chronic pressure
Subungual corns develop wherever a bony exostosis or deformity causes chronic pressure beneath the nail plate, most often under the great toenail or 5th digit nail.
Question 6: Bursa formation over a bunion (hallux valgus) deformity can complicate nail care because:
- It directly infects the nail plate
- Inflammation and swelling alter foot mechanics, changing pressure distribution and increasing fall risk during and after treatment (Correct answer)
- It causes nail discoloration
- It prevents nail brace application on any toe
Correct answer: Inflammation and swelling alter foot mechanics, changing pressure distribution and increasing fall risk during and after treatment
Bunion-related bursitis causes swelling and pain that affect gait; understanding this helps the technician position patients safely and advise appropriate footwear.
MNT Foot Care for Elderly Patients 2
Which medication commonly prescribed to elderly patients can cause nail and foot changes, increasing treatment risk?