Long-Term Care Center Nursing Team Roles, Procedures, and Safety Measures, Exams of Nursing

Download Long-Term Care Center Nursing Team Roles, Procedures, and Safety Measures and more Exams Nursing in PDF only on Docsity! CNA Midterm Exam Questions And Answers. What is a nursing assistant? What do they do? - \A person who has passed a nursing training and compency evaluation; they perform delegated nursing tasks under the supervision of a licensed nurse The people are called residents. They are not sick enough to be in a hospital but cannot care for themselves. - \Describe the persons cared for in long-term care centers Identify the members of the nursing team - \The nursing team are those who provide nursing care. They include: NPs, RNs, LPNs/LVNs, CNAs Identify members of the health team - \The healthcare team are those whose skills and knowledge focus on the person's total care. A nursing assistant is part of both the nursing team and the health team What are the three things an agency must meet standards for? - \Licensure, certification, accreditation Describe the Omnibus Budget Reconciliation Act of 1987 and what does it require? - \OBRA is federal law. It requires that CNAs pass a training and competency evaluation What are the 11 resident rights? - \information; refusing treatment; privacy and confidentiality; personal choice; grievances; work; taking part in resident groups; personal items; freedom from abuse, mistreatment, and neglect; freedom from restraint; quality of life What is an ombudsman and what did they do? - \Someone who supports or promotes the needs and interests of another person. They act on behalf of persons receiving care What is the nurse practice act and what does it do? - \A law that defines a nurses scope of practice, describes their education and licensing requirements, and protects the public from people practicing without a license Explain what nursing assistants can do and their role limits - \A CNA can meet the person's personal needs, transfer persons and make observations, measure TPR and BP, help promote person's comfort A CNA cannot give drugs, insert things into body openings or remove them, take oral/phone orders from doctors, perform procedures that require sterile technique, tell the person or family diagnosis or treatment plans, diagnose and prescribe treatments or drugs, supervise others (even other CNAs) Five rights of delegation - \The Right Task, Circumstances, Person, Directions and Communication, Supervision. List tasks that cannot be delegated to you - \Perform assessments, develop care plans, evaluate response to care, provide education to person or family, supervise others, take oral or phone orders from doctors, drugs, perform procedures requiring sterile technique, insert intravenous catheters Integumentary system - \Skin that covers and protects the body Musculoskeletal system - \Provides framework for the body and allows it to move. Also protects organs Nervous system - \Controls, directs, and coordinates body functions Circulatory system - \The heart pumps blood & blood brings oxygen to the cells and carries food to them Lymphatic system - \Composed of a network of vessels, ducts, nodes, and organs. Provides defense against infection. Respiratory system - \Brings oxygen to the lungs and removes carbon dioxide Digestive system - \Removes solid waste from the body Urinary system - \Removes waste products from the blood and maintains water balance within the body Reproductive system - \produces offspring Endocrine system - \Hormones that regulate the activities of other organs and glands in the body Immune system - \Protects the body from disease and infection Three main parts of the brain - What is the function of medical asepsis? - \To reduce the number of microbes and to prevent microbes from spreading from one person or place to another Signs and symptoms of infection - \Fever, chills, increased pulse, increased respiratory rate, fatigue, loss of appetite, nausea, vomiting, rash, diarrhea, redness and swelling Droplet precautions - \Droplets are produced by coughing, sneezing, or talking. Precautions include donning a mask upon entering a room, limiting transport and movement outside of the room, have person wear a mask outside the room, staff transporting the person don't need a mask Standard precaution - \Used for all persons when care is given Transmission based precautions - \special precautions implemented on the basis of how the disease spreads Blood-borne pathogen standard - \Intended to protect the health team from viruses such as HIV and HBV What is an MSD and what are the risk factors? - \Work related musculoskeletal disorder (MSD) risk factors include activities that require force, repeating action, awkward postures, and heavy lifting Fowlers position - \a semi-sitting position; the head of the bed is raised between 45 and 60 degrees Semi Fowler's position - \Head of the bed is raise 30° (knee portion may be raised 15°) High Fowler's position - \Head of the bed is raised between 60° and 90° lateral position (side-lying position) - \the person lies on one side or the other; A pillow Is under the head and neck. The ankle, upper leg, and thigh are supported with pillows. A small pillow is against a person's back.A small pillow is under the upper hand and arm Sims position - \In left side lying position. the right leg is sharply flexed and the left arm is behind the person Prone position - \Person lies on the abdomen with head turned to one side. Small pillows are placed under the head, abdomen, and lower legs Friction - \The rubbing of one surface against another Shearing - \when skin sticks to a surface while muscles slide in the direction the body is moving What is logrolling and how is it done? - \logrolling: is turning the person as a unit, in alignment, with one motion. the spine is kept straight; 2 or 3 staff members are needed to logroll, 3 are used if the person is tall, sometimes a turning sheet is used, for spine, hip patients Comfort and safety measures for turning persons in bed - \Do not turn the person away from you with the far bed rail down. Raise the bed rail near you then go to the other side and turn the person toward you. Position the person in good alignment and use pillows as directed. Make sure their face is not obstructed by a pillow Rules for chair/wheelchair to bed transfers - \Position the chair/wheelchair so that the person's strong side is near the bed. The strong side moves first. Put on non-skid shoes and lock bed breaks and wheelchair brakes What do you need to do/know before using a mechanical lift? - \You must be trained to use it, check that the person's weight doesn't exceed the lift capacity, have enough help (at least two members are needed), know the person's functional status, what lift to use, if you need to apply an abdominal binder, what sling to use What are OBRA and CMS requirements for resident rooms? - \Rooms are designed for 1-4 persons; rooms are designed for full visual privacy; each person has closet space; room, bathrooms, and bedding areas have a call system; bed linens are correct for weather; room temperature levels are between 71° and 81° How are manual beds used? - \Manual beds are used with cranks at the foot of the bed. The cranks are pulled up for use Which manual bed crank raises the head of the bed? - \The left crank Which manual bed crank raises the knee portion of the bed? - \The right crank Which manual bed crank raises the bed horizontally? - \The middle crank What are the four types of beds? - \Closed bed, open bed, occupied bed, surgical bed When are linens changed in long-term care centers? - \On the person's shower day, which may be 1-2 times a week, unless soiled Early morning/AM care - \Routine care given before breakfast. Includes preparing persons for breakfast, assisting with hygiene and dressing, assisting with needed devices, making the bed and straightening the unit Morning care - \Care given after breakfast; hygiene measures are more thorough at this time. Measures include assisting with hair care, shaving, dressing, assisting with ROM Afternoon care - \Routine care that occurs between lunch and the evening meal in a facility. Care includes preparing the person for naps or activities, assisting with ROM, straightening the bed and unit Evening/PM care - \Care given in the evening at bedtime. Care includes preparing the person for sleep, changing certain linens and garments, assisting with hygiene, storing devices How do you perform oral care on an unconscious person? - \Use Sponge swaps to apply the cleaning agent. The head is turned to the side to prevent aspiration. A padded tongue blade is used to keep the mouth open What are important things to remember when performing perineal care? - \wipe from cleanest to dirtiest and use comfortably warm water Shampoo during the shower/tub bath - \Used for persons in shower chairs or taking tub baths with hand held nozzles Shampoo at sink - \Used for persons on a stretcher Shampoo in bed - \Used for those who need a complete bed bath and can't use a wheelchair, chair or a stretcher Rules for dressing and undressing - Safety measures for performing ROM exercises - \Cover person for warmth and privacy; exercise only the joints the nurse tells you to; expose only the body parts being exercised; use good body mechanics; support the part being exercise; move joint gently; don't force the joint beyond its range of motion; don't force joint to point of pain; ask if person has pain or discomfort Factors affecting pain - \Past experience, anxiety, rest and sleep, attention, personal and family duties, the value or meaning of pain, support from others, culture, illness, age Factors affecting sleep - \Age, illness, nutrition, exercise, environment, drug and other substances, lifestyle changes, emotional problems During the admission procedure, what can a nurse ask you to do? - \Collect some information for the admission form; measure the person's weight and height; measure the person's vital signs; obtain a urine specimen; complete a clothing and personal belonging list; orient the person to the room, the nursing unit, and the agency What measures do you follow when measuring height and weight? - \Person wears only a gown or PJs, no footwear; person voids before being weighed; a dry incontinence product is worn; weigh the person at the same time of day; use the same scale; balance scale before weighing the person What is the procedure for collecting a random urine specimen? - \Have the person void into the device, pour about 120 mL (4 oz) Into specimen container, place lid on the container. Put container in the plastic bag. Don't let the container touch the outside of the bag What is the procedure for collecting a mid stream specimen? - \Provide pericare; put on sterile gloves and open the sterile specimen container, don't touch the inside. Clean perineal area with towelettes. Have person void into the device. Pass the specimen container into the urine stream. Collect about 30 to 60 mL (1 or 2 ounces of urine). Put lid on container, don't touch the inside. Label the container in the person's presence. Place container in the bag. Don't let the container touch the outside What is the procedure for collecting a 24 hour specimen? - \Ask person to void. Measure and discard the urine, note the time. This starts the 24 hour period. Use a funnel to pour urine into the urine container Describe the procedure for collecting a stool specimen - \Have the person void in the specimen pan. Return when the person signals or every five minutes. Note color, amount, consistency, and odor. Collect a specimen. Take from the middle or from any unusual areas. Use tongue depressor to collect about 2 tablespoons and label the cup. Place the container in a plastic bag with the biohazard sign. Test specimen if needed Sedation - \A state of quiet, calmness, or sleep produced by a drug General anesthesia - \A treatment with certain drugs that produces a deep sleep and the absence of all sensation, especially pain Regional anesthesia - \the loss of sensation, produced by a drug, in a large area local anesthesia - \Loss of sensation, produced by a drug, in a small area Describe your role in transporting patients to the operating room - \The person is covered with a bath blanket, the safety straps are secured and side rails are raised, a pillow may be placed under the person's head. If you are their nurse then stand at their head What is rehabilitation and what are its goals? - \The process of restoring the person to his or her highest level of physical, psychological, social and economic function. The goal of rehab is to prevent or reduce the degree of disability, improve abilities, and to help the person adjust to the disability Aphasia - \Loss of the ability to use or understand language Apraxia - \Person knows what to say but can't use speech muscles for understandable speech. The brain can't coordinate muscles to make words Dysarthria - \Difficult or poor speech due to nervous system damage. Slurred speech, speaking slowly and softly, hoarseness and drooling can occur Age-related macular degeneration (AMD) - \a condition in which the macula degenerates, gradually causing central vision loss Glaucoma - \Fluid buildup causes pressure on the optic nerve. Peripheral vision is lost and blindness eventually occurs Cataract - \clouding of the lens of the eye Chemotherapy - \Involves drugs that kill cancer cells Radiation therapy - \Involves x-ray beam is aimed at the tumor. Sometimes radioactive material is implanted in or near the tumor What occurs in autoimmune disorders and what are some common disorders? - \Autoimmune disorders occur when the immune system attacks the body's own healthy cells, tissues, and organs. Common disorders include celiac's disease, graves disease, Hashimoto's disease, lupus, MS, rheumatoid arthritis, type one diabetes What happens when a stroke occurs? What are risk factors for a stroke? - \A stroke occurs when a blood vessel in the brain burst and bleeds into the brain or a blood clot blocks a blood vessel in the brain and blood flow stops. Risk factors include high blood pressure, smoking, heart disease, diabetes, high cholesterol, TIAs, age 55 or older, being overweight, lack of physical activity, family history What happens in ALS? - \ALS attacks nerve cells that control voluntary muscles. Over time, the person loses function of the muscles What are risk factors for arthritis and what is the treatment? - \Aging, being overweight, gender, joint injury, and family history Treatment includes pain control, heat and cold, exercise, rest and joint care, assistive devices, weight control, healthy lifestyle, safety, joint replacement surgery What are the measures to take when taking care of someone in traction? - \Keep the person in good alignment, don't remove traction, keep weight off the floor, don't add or remove weights, check for frayed ropes, perform ROM exercises for uninvolved joints, position person as directed, provide fracture pan for elimination, give skincare, put bottom linens on the bed from the top down, check for redness, drainage and odors What is CAD and what are the major complications? - \Complications of coronary artery disease (CAD) include angina, myocardial infarction, irregular heartbeats, and sudden-death What is an MI and what happens in the heart? - \A myocardial infarction (MI) is a heart attack. In an MI, part of the heart muscle dies from sudden blockage of blood flow in a coronary artery. A blood clot blocks blood flow Describe COPD -