Nurse Aide Training and Long-Term Care: Essential Skills and Procedures, Exams of Nursing

Download Nurse Aide Training and Long-Term Care: Essential Skills and Procedures and more Exams Nursing in PDF only on Docsity! Prometric CNA Exam Study Guide A fracture pan is - ✔ a bedpan that is flatter than the regular bedpan. It is used for residents who cannot assist with raising their hips onto a regular bedpan Daily fluid intake - ✔ A healthy person should take in 64 to 96 ounces of fluid each day to maintain health Items used to take a blood pressure - ✔ A stethoscope and a blood pressure cuff--also called a sphygmomanometer Nurse Aide Training Competency Evaluation Program - ✔ Makes the rules about training and testing nursing assistants. The state programs make sure that federal rules are followed in nursing facilities that receive payment from Medicare or Medicaid. Setting up and running the nursing assistant registry is also a part of this program. If a nursing assistant is accused of abusing a resident the facility will investigate according to its policies and procedure. If they determine abuse has occurred a report must be made to them and they will decide whether or not to mark it on their registry. A policy is - ✔ a course of action that should be taken every time a certain situation occurs A procedure is - ✔ a method or way of doing something Assisting stroke residents to eat - ✔ Place food in the resident's field of vision Use assistive devices Watch for signs of choking Place food in the unaffected/nonparalyzed side of the mouth Hand hygiene - ✔ Washing hands with either plain or antiseptic soap and water or using alcohol--based hand rubs the most important thing NA can do to prevent the spread of disease Wet hands and wrists, apply soap, lather for at least 20 seconds, clean nails Conversions - ✔ 30 mL = 30 cc = 1 oz = 1/8 cup Cyanotic - ✔ Skin that is blue or gray Military time - ✔ Midnight = 0000 1 am = 0100 1pm = 1300 OBRA: hours of training and continuing education hours for CNAs - ✔ NAs must complete at least 75 hours of training that covers topics like communication, preventing infections, safety and emergency procedures, and how to promote residents' independence and legal rights They must attend regular in-service education (a minimum of 12 hours per year) to keep their skills updated Importance of wrinkle free linen - ✔ Sheets that do not lie flat under the resident's body increase the risk of pressure ulcers because they cut off circulation Communication with visually-impaired resident - ✔ When you enter a new room with them, orient them to where things are. Describe things around you without using words like "see, look, watch" Use the face of an imaginary clock as a guide to explain the positions of objects that are in front of the person Walk slightly ahead of them if they need guidance in getting around Protein - ✔ part of every body cell, needed for tissue growth and repair, supply energy, excess is stored as body fat. Sources: meat, eggs, milk, beans, nuts, soy Fats - ✔ helps the body store energy, add flavor to food, important for the absorption of certain vitamins. Sources: butter, margarine, oils. Monounsaturated and polyunsaturated vegetable fats are healthier. Saturated fats should be limited in most diets Vitamins - ✔ needed by the body to function. The body cannot produce most of them--they can only be obtained by eating certain foods. A, D, E, and K are fat-soluble (carried and stored in body fat). B and C are water-soluble (broken down by water in the body, and used by the body but cannot be stored) Minerals - ✔ maintain body functions. Provide energy and regulate body processes. Zinc, iron, calcium, magnesium, etc Good listening skills - ✔ Allow the resident to express their ideas completely. Concentrate on what they're saying. Don't interrupt. Restate what they said in your own words to be sure you've understood. Don't change the subject, don't ignore their requests, stand close to them and lean forward Types of Abuse - ✔ Abuse - ✔ purposeful mistreatment that causes physical, mental, or emotional pain or injury to someone Neglect - ✔ the failure to provide needed care that results in physical, mental, or emotional harm to a person Physical abuse - ✔ any treatment that causes harm to a person's body Psychological abuse - ✔ emotional harm caused by threatening, scaring, humiliating, intimidating, isolating, or insulting a person or treating them like a child. Includes verbal abuse--words that mistreat a person Sexual abuse - ✔ forcing a person to perform or participate in sexual acts outside of their will, including unwanted touching and exposure, porn Financial Abuse - ✔ improper or illegal use of someone's money or property Assault - ✔ threat to harm a person Battery - ✔ intentional touching of a person without their consent Domestic violence - ✔ abuse by spouses, intimate partners, or family members Workplace violence - ✔ abuse of staff by others at work (other staff, residents, or visitors False imprisonment - ✔ unlawful restraint that affects a person's freedom of movement (includes threatening restraint and keeping residents from leaving Involuntary seclusion - ✔ separation of someone from others against their will Sexual harassment - ✔ any unwelcome sexual advance or behavior Substance abuse - ✔ use of substances in a way that harms oneself or others Active neglect - ✔ purposeful failure to provide needed care, resulting in harm to a person Passive neglect - ✔ unintentional failure to provide needed care, resulting in harm to a person Negligence - ✔ the failure to act or provide the proper care for a resident, resulting in unintended injury Malpractice - ✔ when a person is injured due to professional misconduct through negligence, carelessness, or lack of skill Policies in LTC facilities - ✔ All resident information must remain confidential Plan of care must always be followed NAs should not do tasks not listed in the job description NAs must report important changes in residents to a nurse Personal problems are not discussed with residents NAs shouldn't accept gifts from residents Be on time for work Procedure - ✔ a method or way of doing things Fowlers - ✔ semi-sitting Sims' - ✔ left side-lying position lower arm behind back, upper knee flexed Sexual contact - ✔ intercourse, contact of the mouth with both areas, contact of the hands with front area STIs - ✔ chlamydia - ✔ can cause PID which can lead to sterility. yellow or white discharge CNA documentation - ✔ Because NAs spend more time with residents than other members of the care team they may observe things about residents that others haven't noticed. This is valuable information that will help in care planning. Documenting accurately is the key to care planning. A thorough written record shows an NA's observations to others. A medical chart is a legal document that is considered in court to be what actually happened. If it was not documented, it was not done. It is the only way to guarantee clear and complete communication with all members of the care team. Document AFTER care is given. Standard precautions - ✔ treating blood, body fluids (not including sweat), non-intact skin (like abrasions, pimples, or open sores), and mucous membranes as if they were infected. Should be used with all residents Only safe way to do your job HIV testing - ✔ results are confidential and cannot be shared with a person's family, friends, or employer without his consent. They can't be fired from a job because of the disease. But a healthcare worker with HIV/AIDS may be reassigned to job duties with a lower risk of transmitting the disease Feeding residents - ✔ Check the diet card and verify their identity, sit at their eye level, bed at 90 degree angle, clean their hands, put a protective barrier, identify the foods and ask what they want first, offer drink, give them full attention, talk, wipe their hand and hands, remove clothing protector and food tray, document, call bell Pressure ulcer signs - ✔ Stage 1: redness that is not relieved after 15-30 minutes Stage 2: partial skin loss--looks like a blister or shallow crater Stage 3: full skin loss--deep crater, possibly to the muscle Stage 4: full skill loss with major damage to muscle, bone, etc. Beginning signs and symptoms of HIV - ✔ symptoms similar to the flu--fever, muscle aches, cough, fatigue. As it worsens the immune system overreacts and attacks everything Hearing-impaired communication - ✔ speak clearly, slowly, and good lighting. Face them, get their attention, ask if they can hear you, don't shout, keep your voice pitch low, use short sentences and simple words, repeat using different words when needed TB and sputum collection - ✔ TB--highly contagious lung disease that includes coughing, fever, shortness of breath, fatigue and bloody sputum Sputum--thick mucus coughed up from the lungs. Sputum specimen--may help diagnose respiratory problems/illness or evaluate the effects of medication. collect in the early morning Spit it directly into the specimen container Stand behind the resident during the collection process You must wear PPE--gloves and mask--when collecting Contrature - ✔ the muscle shortens, becomes inflexible, and "freezes" in position. Causes permanent disability of the limb Ostomy guidelines - ✔ regular skin care Empty and clean the bag whenever stool is eliminated Always wear gloves and wash hands carefully Skin barriers to protect from irritation Follow diet instructions Include plenty of fluids Provide privacy Report odors to nurse Report emotional or physical adjustment problems to nurse Perseveration - ✔ repeating words, phrases, questions, or actions. Happens often with people with Alzheimer's disease and can be soothing for them. Put on and take off PPE - ✔ ON: Gown, mask, gloves OFF: gloves, mask, gown Take off gloves, untie gown, roll it away Transfer resident with weak side - ✔ Use gait belt, stand on their weaker side, lead with the strong side, place wheelchair on strong side Hypertension - Emphysema--results from chronic bronchitis and smoking. Trouble breathing, rapid heartbeat. NO cure. Clean - ✔ has not been contaminated with pathogens Draw sheets - ✔ an extra sheet placed on top of the bottom sheet when the bed is made to allow caregivers to reposition the resident without causing shearing Bladder retraining - ✔ Follow the schedule carefully, keep a record of their bladder habits, offer bathroom trips regularly, answer call lights promptly, privacy, running water, positive words for all attempts Barriers to communication - ✔ Resident doesn't hear NA Resident is difficult to understand Meaning of words is not understood Slang, profanity, cliches, why?, advice, yes/no questions only, foreign language, nonverbal communication Verbal communication - ✔ involves the use of words, spoken or written Nonverbal communication - ✔ communicating without using words, like shrugging or the tone of how someone says something Deep breathing - ✔ help expand the lungs, clearing them of mucus and preventing infections. Incentive spirometers are used (requires special training) Incident reporting - ✔ confidential and not written on the medical record. Done to improve the quality of the facility and protect everyone involved. Covers falls, breaking things, mistakes in care, sexual advances, threats, injury on job, exposure to blood or body fluids. State the facts and include suggestions for change. Angina pectoris - ✔ chest pain, pressure, or discomfort Ethical behavior - ✔ honesty, protecting residents privacy and property, keep information confidential at and away from the workplace, reporting abuse, follow the care plan, report and document accurately, don't accept gifts, don't get personally involved with residents or their family members Physical restraints - ✔ a way to restrict voluntary movement. Vests, jackets, belts, mitts, rails, tray tables. Must be ordered by a doctor Rehabilitation - ✔ care that is managed by professionals to help restore a person to his highest possible level of functioning. Restorative care - ✔ usually follows rehabilitation. The goal is to keep the resident at the level achieved by rehabilitative services.