Rationale of the Week | How to use a Monofilament to Check Feet
For last week’s practice question, we quizzed test takers on the best use of monofilament to check feet. 60% of respondents chose the best answer. We want to 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: Answer Question
Question: ADA Standards of Care recommend using a 5.07 monofilament to evaluate for loss of protective sensation in lower extremities in people with diabetes. Which of the following statements is most accurate regarding using a monofilament to assess lower extremities?
Answer Choices:
- When using the monofilament, test above or below thickened or callused skin.
- Be careful not to bend the monofilament when testing for sensation.
- Alternate between hot and cold testing with monofilament testing to enhance accuracy.
- Rotate monofilament testing between the medial malleolus and distal phalanges for best results.
As shown above, the most common choice was option 1, the second most common answer was option 4, then option 2, and finally 3.
Getting to the Best Answer
Answer 1 is correct. 60.00% chose this answer, “When using the monofilament, test above or below thickened or callused skin.” YES, GREAT JOB. Many people with diabetes have calluses and thickened skin that will block the sensation of 10gms of linear pressure delivered by the monofilament. For this reason, avoid areas with thickened insensate skin and test for sensation above or below the callused location.
Answer 2 is incorrect. 11.27% of you chose this answer, “Be careful not to bend the monofilament when testing for sensation.” Actually, to deliver 10gms of linear pressure using a monofilament, the examiner needs to slightly bend the 5.07 filament into a “C” position. This will deliver the correct amount of pressure to evaluate if the person is experiencing loss of sensation.
Answer 3 is incorrect. 4.13% of respondents chose this answer, “Alternate between hot and cold testing with monofilament testing to enhance accuracy.” Hot and cold testing is a strategy to determine if the person has decreased temperature sensation. However alternating between these two assessment techniques won’t enhance the testing accuracy of the monofilament.
Finally, Answer 4 is incorrect. 24.60% chose this answer, “Rotate monofilament testing between the medial malleolus and distal phalanges for best results.” This is a juicy answer with some cool foot terms. The medial malleolus is actually the bump that protrudes on the inner ankle and the distal phalanges are the tips of the toes. The inner ankle is not one of the points of assessment using a monofilament. The large toe, the foot pad and heel are locations included in a foot assessment using a 5.07 monofilament.
Want to learn more about this question?
Join us for our new FREE Webinar
3 Steps to Save Feet; Assess, Screen, and Report
Airs live July 19th at 11:30 am PST (45 to 60 minutes)
All health care professionals are invited to join us to learn strategies to protect lower extremities during this FREE Webinar.
Coach Beverly will walk participants through the 3 Step Process to Save Feet; Assess, Screen and Report. She will provide simple and clear instructions on how to assess and inspect feet, along with risk assessment and action steps. We will share free teaching tools, strategies, and documentation forms adapted from the Lower Extremity Prevention Program (LEAP) that you can immediately implement in your practice setting.
CEs: 1.0 CEs for $19 or No CEs for FREE
Topics include:
- Effective foot assessment made easy
- How to use a monofilament to assess sensation
- Using screening form to report findings
Can’t join us live?
Don’t worry, we will send you a link to the recorded version.
FREE Handouts and Resources
Read More: FREE Handouts and Resources 3 Steps to Save Feet – Assess, Screen, Report Handout. This handout walks health care professionals through the steps involved in a 10-minute foot assessment and monofilament screening. Also includes a Screening Form to document and report findings. Foot Care Teaching Sheet – Steps to Healthy Feet. This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language. Foot Care Teaching Sheet in Spanish– Pasos Para Tener Pies Sanos. This handout covers the important elements of foot care for people living with diabetes with simple and straightforward language. Coach Beverly Thomassian, RN, MPH, BC-ADM, CDCES Author, Nurse, Educator, Clinician and Innovator, Beverly has specialized in diabetes management for over twenty years. As president and founder of Diabetes Educational Services, Beverly is dedicated to optimizing diabetes care and improving the lives of those with diabetes. People with diabetes are at increased risk of foot complications. By using a 5.07 monofilament (delivers 10gms of linear pressure) to assess for loss of sensation, diabetes health care professionals can immediately identify high-risk feet and take steps to protect lower extremities. Basic foot care education and intervention can reduce the risk of amputation by over 50 percent. We are excited to provide these single-use 5.07 monofilaments in packs of 20. We have included instructions on how to assess and inspect feet, along with risk assessment and action steps. We enhanced the teaching tools and forms from the Lower Extremity Prevention Program (LEAP) and are excited to share them with our community of diabetes advocates. Whether you are new to diabetes or a seasoned expert, you’ll benefit from this virtual conference with the latest research plus critical content that you can immediately apply to your clinical practice. Download Course Flyer | Download Schedule If you are seeking a state-of-the-art review of current diabetes care, this course is for you. Our team has been fine-tuning this course for over fifteen years, and we know what you need. This program can also be a great addition to your CDCES or BC-ADM exam study plan. Team of expert faculty includes: Don’t worry if you can’t make it live. Your registration guarantees access to the recorded version in the Online University. All hours earned count toward your CDCES Accreditation Information Sign up for Diabetes Blog Bytes – we post one daily Blog Byte from Monday to Friday. And of course, Tuesday is our Question of the Week. It’s Informative and FREE! Sign up below! The use of DES products does not guarantee the successful passage of the CDCES exam. CBDCE does not endorse any preparatory or review materials for the CDCES exam, except for those published by CBDCE.
NEW! Order Monofilament (5.07) for Diabetes Foot Screening 20-Pack
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