CNA Exam #1 Review
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Define abuse
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- An act or failure to act that intentionally or recklessly causes harm to a resident (W13) - Purposely causing physical, mental, or emotional pain or injury to someone (H13)
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Examples of proper phone etiquette (W23)
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1. Identify your name + facility's name 2. Be friendly + professional 3. Ask if they are willing to be put on hold before being transferred 4. Write down message & repeat back 5. Ask for proper spellings 6. Do not give out additional information
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each level in Maslow's hierarchy of needs (W57)
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1. Physical needs: oxygen, water, food, elimination, rest 2. Safety & security: clothing, stability, protection 3. Need for love: acceptance, belonging 4. Need for self-esteem: achievement, belief in one's own value, respect 5. Need for self-actualization: need to learn, create, realize potential
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Disinfectant v. sterilization
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- Disinfectant = killing of just pathogens - Sterilization = killing of all microbes, including pathogens + nonpathogens
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When should you look for changes in a resident's condition?
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All the time
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What should you do if you notice anything abnormal with a resident?
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- Inform a nurse - Record a written objective observation in the patient chart - Continue to observe the patient for further symptoms
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What is HIPAA? Why was it passed? (H16)
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HIPAA = Health Insurance Portability and Accountability Act - Requires that all health information remain private and secure for confidentiality - Only those who need to process records can have access - Including phone number, SS, e-mail, med records
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What happens when a CNA is suspected of abuse?
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They can get their license suspended
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Why are activities important? (H61)
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- lessens risk of heart disease, colon cancer, diabetes, obesity, UTI, blood clots - relieve symptoms of depression - improves concentration, body functions, sleep quality, and ability to cope w/stress - increases energy, appetite, and promotes better eating habits - can increase self-esteem, independence, memory - lowers risk of falls
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What should you do if you are unable to complete a resident care task?
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Ask another NA if they can take over/help.
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how do we make residents feel important?
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- Allowing them to make as many personal decisions as possible - Respect their choices - Encourage their activities and community involvement
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how does customer service pertain to care giving?
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- answering phone calls politely - professional manner present to resident + family - tend to the wish's of the resident
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examples of illnesses that require contact isolation?
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- MRSA - VRE - Scabies - Lice - Bacterial conjunctivitis (pink eye) - C. diff
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How to maintain dignity and self esteem in residents?
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- Allow them to make many personal decisions - Allow them to engage in activities - Respect their choices
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Roles and responsibilities of a CNA? (H4)
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- charting improvements/deteriorations - help w/toileting needs - assist mobility - keeping living areas clean - caring for supplies & equipment - making beds - giving backrubs - help w/dressing - assist w/personal care (ie bathing and mouth care) + grooming (ie shaving, hair care) NOT ALLOWED: administer meds, inserting/removing tubes, changing sterile dressings, give tube feedings
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Principles of Standard Precautions? (H44)
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- means treating all blood, body fluids (which includes everything except sweat), non-intact skin, and mucous membranes as if they were infected - way to stop the spread of infection via interrupting mode of transmission 1. wash hands 2. wear gloves in appropriate situations (ie mouth care, cuts, shaving, cleaning, toilet assistance, disposing wastes) 3. wearing PPE (personal protective equipment) 4. disposing gloves & PPE immediately afterwards 5. NEVER cap a used needle/syringe 6. avoid cuts 7. clearly label body fluids; bag all contaminated wastes + dispose properly
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What can culture and values affect?
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- Communication - Behavior - Attitudes
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Procedure for handwashing?
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1. rinse in lukewarm water 2. lather with soap 20+ sec 3. use friction & get under nails 4. dry hands with paper towel thoroughly 5. use paper towel to turn off facet
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Standard ending steps for any task?
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- making sure residents have what they need - place call light closer - wash hands
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Standard beginning steps for any task?
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- wash hands - identify patient - idenfity yourself - explain what you are going to do
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What should you do if you see a call light on?
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Attend to it immediately. Turn off the call light when you arrive at the resident
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Procedure for handling soiled linen? (H51)
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- do not shake linen - place wet linen in leak-proof bags - transport soiled linens away from uniform, skin, and mucous membrane - sort soiled linen away from resident care areas
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Why proper bedmaking is important? (H191-192)
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- important for comfort, cleanliness, and health - linens should be changed after personal care (ie bed baths) or soilage - damp linen can harbor microbes - non-wrinkled sheets decreases bedsores
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How you would address a new resident?
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1. Get their visual attention 2. Introduce yourself 3. \"Hello, Mrs. S
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What safety measures can we use to prevent falls that is ordered by a physician?
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- clear pathway of clutter, cords, and rugs - use rugs w/non-slip backing - residents should avoid hanging clothes that drag - tie shoelaces with non-slip shoes - answer call lights immediately - clean up spills immediately - report loose hand rails - mark uneven floors - improve lighting - return bed to lowest position when finished w/care - get help moving residents - leave furniture in the same place - lock bed wheels and wheelchairs when helping in/out
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Correctly describe a long term care facility (H31)
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24 hour supervised nursing care which is focused on recovery and independence
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Define disinfection
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process that kills pathogens, but not all microbes
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Why a person requires long term care placemement (H1)
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- chronic debilitating disease or ongoing condition - disability that impedes every day life - terminal disease
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What actions are considered illegal or unethical
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1. Any type of abuse on a resident 2. Violating HIPPA and giving out private information 3. Administrating medications 4. Insert/remove rubes 5. Changing sterile dressings 6. Give tube feedings 7. Accepting orders from the resident's physician (that's the nurse's job) 8. Physical or financial exploitation
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what is considered infectious waste
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- used disposable razors - used gloves - used needles/syringes - Any waste containing body fluids
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how would we make a resident's room more homelike
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Arrange furniture and things the way they like it
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what does NPO mean
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nothing by mouth
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chain of infection and each link
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1. Causative agent: pathogen 2. Reservoir: where the pathogen lives and grows 3. Portal of Exit: any body opening that allows pathogens to leave 4. Mode of Transmission: how to pathogen travels btwn ppl 5. Portal of Entry: any body opening that allows pathogen to enter 6. Susceptible Host: an uninfected person who could get sick
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resident's rights - what does it mean?
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Protects rights of: 1. quality of life - dignity, choice, etc 2. service & activities to maintain wellness 2. be fully informed regarding their rights & services 4. participate in their own care & refuse 5. independent choices 6. security of possessions 7. rights to complain 8. rights for others to visit
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how to communicate with co-workers?
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- With clarity - chart everything - stay on topic - use objective, NOT subjective, communication
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what should you do if a resident is masturbating
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1. cover them up 2. don't freak out 3. get them to a private place then leave 4. distract them with something else if have dementia
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what should you do if you don't understand how to complete a task
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Ask
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what is CVA
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cerebrovascular accident = stroke
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the difference between CNA, CMA, LPN, RN and what they do
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- CNA = certified nurse aide = takes vital signs, provides routine peronal care - CMA = certified medical assistant = can take BP and draw blood; also complete clerical/administrative work - RN = registered nurse = coordinates, manages, and provides skilled nursing care; gives special treatments, meds, assign tasks, supervises CNA; can do IV - LPN = licensed practical nurse = gives medications and treatments; supervise
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why do we use an interdisciplinary approach in resident care
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So we can fully maximize care
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what does I&O mean
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intake and output
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examples of communication
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- written - non-verbal via facial expressions - tone - oral - drawings - pictures - symbols/signs - behavior
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principles of communication
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the process of exchanging information with others
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how to communicate with our residents
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- don't just ask yes/no questions; encourage details - greet them by preferred name - identify yourself - face the resident when speaking - talk while giving care - listen and respond - smile & be courteous - tell resident when you are leaving the room
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define sterilization
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to destroy all microbes; not just pathogens
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the care of a visually impaired resident
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- makes sure glasses are clean - knock on door and identify yourself; don't touch first - always tell them what you are doing - give specific directions \"right in front of you\" - talk directly to the resident; do not talk to others - proper lighting - when you enter a new room, orient them to the area - don't use words such as \"see,\" \"look,\" \"watch\" - tell the resident where the call light is - use the face of an imaginary clock as a guide to explain object positions - don't more furniture w/out permission; put back where it was found - use larger print font - clocks that chime
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care of a resident with memory loss
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- don't talk to them as if they were children - simple statements - be aware of body language - avoid arguments - maintain eye contact - maintain appropriate distance
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know what pathogens and non-pathogens are
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pathogens = disease causing microorganism non-pathogen = microorganism which does not cause a disease
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different routes of transmission
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1. airborne 2. direct contact 3. indirect contact 4. droplets 5. vehicle
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CDC
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Center of Disease Control
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what we do to facilitate visits btwn resident's and their family
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- ask if the family needs anything - give them space - help them make care decisions - communicate
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what you should do if a resident refuses
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1. accept their refusal 2. give them space 3. come back later and ask again
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the care of a resident who is upset
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- lower tone of voice - be flexible and patient - don't respond negatively - don't use frightening/startling gestures - consider what provoked them - report behavior - give space
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true statements regarding the elderly
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- aging doesn't start at 65; it depends on the individual - some memory change is associated w/aging, but older adults will not face severe memory loss - creativity and intelligence doesn't change; learning shows only slight decline - financial status is varied
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time management
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??
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what should you do if you find 2 residents in bed together and 1 is confused
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kindly and professionally separate the two before someone gets hurt
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autonomy
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right of self-government
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what you should do for equipment failure
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- label this equipment as failed - report it - push it to the side
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the care of a resident who is crying
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- try to distract them - assure them
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the care of a resident who is mad and yelling
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- lower tone of voice - be flexible and patient - don't respond negatively - don't use frightening/startling gestures - consider what provoked them - report behavior - give space
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the care of a resident who is frightened
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- try to calm them - assure them - get their visual attention - give space
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know the difference btwn microorganisms, organisms, pathogens, and non-pathogens
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- microorganism = organism which cannot be seen with the naked eye - organism = living being - pathogen = disease causing microbe - non-pathogen = microbes which don't cause diseases
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what types of information you can share with a residents family
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mood, diet, etc CANNOT share tx though
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chain of command
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1. Administrator 2. head of medical services (MD) 3. DON 4. ADON 5. staff development coordinator 6. nursing supervisor 7. charge nurse 8. staff nurses (RN, LPN) 9. nursing assistants (CNA, CMA)
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what we can do to control the spread of infection
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- wear gloves and appropriate PPE - wash hands, esp if visually soiled - dispose disposable objects after use - dis-infect - properly throw away wastes and label - care for all residents as if they are infected --> gown, mask, goggles, gloves --> gloves, goggles, gown, mask
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the care of a resident coping with loss
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- encourage independence - compassion - support - encourage activities
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what types of patients would benefit from passive range of motion exercises
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those who cannot move on their own
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the care of a resident in isolation
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Isolation = transmission based precautions - confidentiality - wear proper PPE - don't wear the PPE outside the resident's room - perform hand hygiene before exiting/enter room - don't share equipment btwn residents - follow standard precautions w/waste removal - reassure the residents that it is the disease, not the person that is being isolated
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when should you wash your hands
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- b/a patient care - b/a shift - after bathroom - b/a handling food - b/a handle dirty things - b/a cleaning - b/a handle body fluids - after smoking - after removing gloves or other PPE
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the care of a patient with a hearing impairement
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- ensure their hearing aids are okay - get their visual attention - speak slowly and clearly - use visual gestures - remove noise such as TVs, radios, etc - close door if needed - DON'T SHOUT nor exaggerate mouth - know which is the better ear - use short sentences and simple words - avoid sudden topic changes - repeat
