For last week’s practice question, we quizzed participants on Best technique to assess Protective Sensation in feet? 44% of respondents chose the best answer. We want to clarify and share this important information, so you can pass it on to people living with diabetes and your colleagues, plus prepare for exam success!
Before we start though, if you don’t want any spoilers and haven’t tried the question yet, you can answer it below:
Question: Best technique to assess Protective Sensation in feet? Which of the following best describes the proper technique for using a 10-gram monofilament to assess protective sensation in a person with diabetes?
Answer Choices:
- Press the monofilament firmly against the skin until it bows for at least 2 seconds, then ask if the person if they feel pressure.
- Stroke the monofilament across the skin surface to assess for light touch sensation.
- Apply the monofilament to the dorsal surface on random sites without informing the individual when contact is made.
- Press the monofilament until it bends into a “C” shape at selected sites, holding for about 1 second before lifting.
Getting to the Best Answer
Answer 1 is incorrect. 18% chose this answer, “Press the monofilament firmly against the skin until it bows for at least 2 seconds, then ask if the person if they feel pressure.” This answer is tempting. You only need to apply the monofilament for one second and you don’t want to ask the person if they feel pressure when you are bending the monofilament into a C-shape on the plantar surface of four sites (as noted in the image below) . This could lead to them simply saying “yes” when you ask if “they feel it”.
Answer 2 is incorrect. 15% of you chose this answer, “Stroke the monofilament across the skin surface to assess for light touch sensation.” When using the monofilament, you only need to apply the monofilament for one second by bending it into a C-shape on the plantar surface of their feet on the four sites (as noted in the image below) to evaluate for sensation. This evaluation does not include stroking the monofilament.
Answer 3 is incorrect. About 22% of respondents chose this, “Apply the monofilament to the dorsal surface on random sites without informing the individual when contact is made.” You need to apply the monofilament for one second by bending it into a C-shape on the plantar surface of their feet on the four sites (as noted in the image below) to evaluate for sensation.
Finally, Answer 4 is correct. 44% chose this answer, “Press the monofilament until it bends into a “C” shape at selected sites, holding for about 1 second before lifting.” Yes, GREAT JOB. Simply apply the monofilament for one second to the sites on the image below, going above or below calluses. Ask the person to close their eyes and say yes when they feel the pressure as you bend the monofilament into a C-shape on the four plantar surfaces sites (as noted in the image below). If they can’t feel on one or more touch points, this is a sign they have “loss of protective sensation” and are at increased risk of foot injury.
For more information on Lower Extremities – we have some great resources.
Free Assessing Lower Extremity Handout
Free Webinar: 3 Steps to DeFeet Amputations
Register for our Level 2 – Lower Extremity Assessment Course- Earn 1.5 CEs
We hope you appreciate this week’s rationale! Thank you so much for taking the time to answer our Question of the Week and participate in this fun learning activity!
Older Individuals are at Higher Risk of Foot Injury
Join us live on May 13th for our
Older Adults & Diabetes
This course is included in: Level 2 – Standards of Care. Purchase this course individually for $29 or enroll in the entire bundle and save 45% (discount already applied).
We are living longer & more people are getting diabetes. The American Diabetes Association has updated the Older Adults Standards, with special attention to considering the reduction of medication & insulin therapy intensity. The older population has unique issues & special needs that require consideration as we provide diabetes self-management education. This online course highlights key areas of assessment, intervention, and advocacy for older clients living with diabetes.
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