Diabetic Foot Exam Form. Web monofilament tuning fork (128 hz) tendon hammer introduction wash your hands and don ppe if appropriate. Web comprehensive diabetes foot examination form name:
Diabetic Foot Exam Form
Web foot screening form foot screen date: Peripheral neuropathy nephropathy retinopathy peripheral vascular disease cardiovascular disease amputation (specify date, side, and level) current ulcer or history of a foot ulcer? The exam is used to check the feet for: Is there a foot ulcer now? Comprehensive foot examination and risk assessment. Is there a claw toe deformity? Web what is it used for? Introduce yourself to the patient including your name and role. Patient's name (last, first, middle) id no.: Signs of damage or injury.
Check your feet every day for cuts, redness, swelling, sores, blisters, corns, calluses, or any other change to the skin or nails. Gain consent to proceed with the examination. Is there swelling or an abnormal shape in the foot? Signs of damage or injury. Web get to the bottom of any foot problems by using a mirror or asking for help. Is there a history of a foot ulcer? Fill in the following blanks with a y or n to indicate findings on the right or left foot. Is there a foot ulcer now? Web comprehensive diabetes foot examination form name: Web systematic screening examinations for neuropathic and vascular involvement of the lower extremities and careful inspection of feet may substantially reduce morbidity from foot problems. Web what is it used for?
