CNA Exam#1 (miracosta) – Flashcards
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Acute illness
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A sudden illness from which the person is expected to recover
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Chronic illness
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An ongoing illness that is slow or gradual in onset. There is no known cure. Hospitalized or placed in a SNF.
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Types of agencies
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Hospitals Rehabilitation/subacute agencies Long term care facilities/SNF's Assisted living residences (ALR) Hospice Home care agencies Mental health centers
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Health team
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RN, LVN, CNA, HHA
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Registered nurse
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Has a completed 2,3,or 4yr nursing program
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Licensed practical nurse Licensed vocational nurse
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Has completed a 1yr nursing program and has passed a licensing test
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Certified Nursing assistant
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Requires 150hrs training
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Home health aide
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40hrs more training
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Nursing care patterns
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Functional nursing Team nursing Primary nursing Case management Patient focused care
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Paying for health care
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Private insurance Group insurance Medicaid(state) Medicare (65yrs or older partA & part B)
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OBRA
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Omnibus budget reconciliation act Federal law applies to all states passed in1987
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OBRA requirements
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Established standards of care statewide surveys for SNF's Violations include fines, termination of licenses and loss of training facilities
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Federal and state laws
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Nurse practice act-regulates nursing practice in that state Most states CNA's are certified after passing state's education/competency evaluation OBRA ( 75 hours minimum) state laws
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CNA program
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Approved by the Dept. of Public Health (DPH California) Requires a minimum of: 50 hours- Theory 100 hours-Long term care Complies with Title 22/OBRA Criminal screening before training Competency exam includes: written portion (multiple choice) skills portion 3 opportunities to pass exam must be taken within 2 years
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Title 22
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California State Law Licensing/certification of health facilities Requires minimum standards of care SNF must be licensed Ensures resident rights/safety Violations lead to fines/citations
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Delegation
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RN's/ LVN's-delegate tasks to nursing assistants Tasks can only be in the nursing assistants: "scope of practice" job description
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Legal aspects
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-Torts- civil law meaning right or wrong -Unintentional tort-did not mean to cause harm:malpractice, negligence -Intentional tort- meant to cause harm: defamation, libel-through drawings/writing, slander, assault,battery, false imprisonment, invasion of privacy, fraud
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Reporting abuse
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Report to instructor Report to DON, Administrator or DSD that day Follow up with written report
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Abuse of elder and children
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Abuse is the intentional mistreatment or harm to another person CNA's are mandated reporters: federal/state laws require report of elder and child abuse Elder abuse: financial, verbal, sexual, physical, psychological/mental, involuntary seclusion/isolation, abandonment
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Signs of elder abuse
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Unsafe, unclean living conditions Poor personal hygiene. Weight loss/bruises/frequent injuries Quiet, withdrawn attitude Anxious to please Not allowed private conversations Frequent visits to the ER
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HIPPA
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Health Insurance Portability and Accountability Act of 1996. -Protects health information for the patient -Maintains confidentiality of patient records.
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Libel
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Drawing pictures/ writing negative info re.individual
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Slander
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Verbally saying negative info re.individual
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Defamation
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Verbally saying to a 3rd person negative info regarding individual ex: defaming their character
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Resident rights
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Rights as citizens of the US High quality care Clean and safe environment Dignity and respect Privacy Information Freedom from abuse Right to vote Right to refuse treatment
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Ombudsman
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Advocate someone who supports or promotes the needs and interests of another person. Supports residents and families Recommends changes Identifies problems and issues
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Holistic approach
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physical social psychological spiritual
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Maslow's hierarchy of needs
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Physiological Safety Love Esteem Self actualization
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Discomfort and pain
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Can be physical or emotional Affects rest and sleep Decrease function and quality of life
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Pain
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Pain or discomfort means to ache, hurt, or be sore. Comfort and discomfort are subjective. Pain is personal. If a person complains of pain or discomfort, the person has pain or discomfort. You must rely on what the person says. Pain is a warning from the body. Is called the fifth vital sign. It signals tissue damage It causes the person to seek health care.
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Acute pain
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Is felt suddenly from injury,disease,trauma or surgery
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Chronic pain
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Lasts longer than 6 months
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Radiating pain
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Is felt at at the site of tissue damage and in nearby areas
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Phantom pain
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Is felt in a body part that is no longer there
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Factors that can affect pain
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Past experience Anxiety Rest and sleep Attention Personal and family duties The value or meaning of pain Support from others Culture Illness Age
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Disability
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A physical and or mental condition that interferes with meeting human basic needs
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Restorative/rehab care
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Helps disabled individuals returns to their highest level of physical psychological functioning
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Immobility
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Deconditioning Atrophy Contracture
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Deconditioning
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Loss of muscle strength when active
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Atrophy
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decrease in size; wasting of muscle
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Contracture
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abnormal shortening of muscle
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Types of rehabilitation patients
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Patients suffering chronic neuro-muscular disorders Trauma patients
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Paraplegic
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Injury to the spinal column that causes loss of some use of lower extremities
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Quadriplegic
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Injury occurs at a higher level and involves upper and lower extremities.
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Cerebral Vascular Accident
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Called a "stroke" by the public. An injury to the brain caused by an embolic occlusion (plugged) or Hemorrhagic (broken bleeding) blood vessel.
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Cerebral vascular accident (CVA)
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Weakness or paralysis on one side- -Hemi paresis Facial drooping Aphasia It's important to contact 911 to get emergency care.
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Basic positions
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Supine Prone Lateral position Sims position Chair position
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Supine position
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dorsal recumbent position (on back laying position
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Prone position
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Lies on abdomen with head turned to one side and with feet hanging over edge of mattress
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Lateral position
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On side 4 pillows; under neck and head, under upper hand and arm, under front lower leg and against back
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Sims position
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Is a left side-laying position
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Chair position
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Person is positioned in chair with feet flat on the floor back straight and against the back of the chair
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Fowlers position
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Is a semi-sitting position. Head of bed is raised between 45 and 60 degrees
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Semi-fowlers position
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HOB 30-45 degrees and knee portion is raised 15 degrees
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Trendelenburg
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HOB is lowered and the foot is raised
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Reverse Trendelenburg
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HOB is raised and the foot is lowered
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Hospital beds entrapment zones
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Zone 1: Within the bed rail Zone 2: Between the top of the compressed mattress and the bottom of the bed rail and between the rail supports Zone 3: Between the bed rail and the mattress Zone 4: Between the top of the compressed mattress and the bottom of the bed rail and at the end of the bed rail Zone 5: Between the split bed rails Zone 6: Between the end of the bed rail and the side edge of the headboard or footboard Zone 7: Between the headboard or footboard and the end of the mattress
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Range of motion (ROM)
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The movement of joints through their normal range of movement to the point of resistance or discomfort
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Purpose of ROM
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Maintain muscle strength; stimulate circulation; maintain body alignment; prevent complications
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Types of ROM
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Active Passive Active-assistance ROM- The CNA helps the resident or the resident uses a resistive device
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Hypo-
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Low slow below
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Hyper-
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High fast above
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Brady-
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Slow
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Tachy-
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Fast
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Dys-
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Difficultly
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A, an
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Without
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Types of Measurements
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Temperature, pulse, respiration, blood pressure
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Febrile
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Fever
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Afebrile
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No fever
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Pulse measure
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BPM (beats per minute)
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Pnea
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Related to lungs or breathing
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Tachypnea
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Rapid breathing, above 24 respiration a per minute
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Bradypnea
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Slow breathing below 10 respiration so per minute
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Dyspnea
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Difficulty breathing
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Hyperventilation
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Heavy or excessive breathing
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Normal oral range temp
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97.6-99.6 f
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Normal axillary range temp
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96.6-98.6 f
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Normal rectal range temp
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98.6-100.6 f
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Average normal oral temp
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98.6 f
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Average normal axillary temp
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97.6 f
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Average normal rectal temp
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98.6 f
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Heart rate normal range
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60-100 BPM
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Vital signs
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Measurements of 3 body functions
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Body functions
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Heat regulations Ability to breath Heart function
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Measurements of temperature
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Fahrenheit (F) and Centigrade (C)
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Temperatures sites
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Oral -tympanic, axillary, rectal
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Hypothalamus
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Area of brain that regulates temperature
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Reasons for not taking oral temp
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Unconscious, mouth breather, has NG tube, oral or facial surgery, confused/restless,has hemiplegia
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Normal pulse range
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60-100 BPM
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Brachycardia
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Slow heartbeat, slower than 60 BPM
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Tachycardia
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Fast heartbeat, greater than 100 BPM
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Pulse point locations
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Temporal. Cartoid Brachial Apical Radial. Fermoral Popliteal. Dorsalis pedis Posterior tibial
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Number of beats per minute
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Rate
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Regularity of pulse Irregular strong or weak
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Rhythm
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Thready-weak pulse Bounding- strong pulse
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Strength
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Factors of increased pulse
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Exercise, strong emotions, fever,shock,drugs,hemorrhage
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Factors of decreased pulse
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Sleep,rest,depression,hemorrhage
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Inhalation
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Breathing air into lungs
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Exhalation
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Breathing out of the lungs
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Normal respiration range
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16-20 respiration per min
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During Systole
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Contracting of heart and pumping blood
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During diastole
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Heart is at rest
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Systolic
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Pressure of the amount of force needed to pump blood out of the heart into the arterial circulation
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Diastolic
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Pressure in the arteries when the heart is at rest
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Measurement of blood pressure
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Millimeters(mm) of mercury (Hg)
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Record of blood pressure
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Systolic over diastolic
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Equipment used to measure bp
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Stethoscope and sphymomanmeter
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Artery blood pressure is measured at
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Brachial artery
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Average blood pressure
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120/80
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Normal range of systolic
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90-140mm hg
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Normal range of diastolic
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60-90mm hg
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Hypertension
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Systolic is abobe 140 mm hg & Diastolic above 90 mm hg
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Hypotension
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Systolic is below 90 mm hg Diastolic below 60mm hg
