CNA Basic Nursing Skills 3

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Many elderly residents lose their appetite due to

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As people age, loss of appetite can be normal. But when ability to enjoy food occurs, there can be several reasons. With fewer taste buds, flavors are harder to detect; more seasoning or appealing aromas may be helpful. People who are depressed or socially isolated often don't feel like eating. Choosing meals (that are beautifully prepared, colorful and nutritious) at senior centers or other places can make elderly people look forward to eating. Other causes are medication side effects or dental problems.

Headaches, nausea and pain would be called

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Symptoms are the client's experience about how they feel. Pain, nausea, and anxiety are things that only the client can perceive and report. They may contribute to the signs that others can see, such as a higher heart rate, change of skin color, or unusual behavior, but the symptoms begin with the client.

Which of the following is true regarding the use of side rails on a bed?

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Bed rails can be a safety risk for some clients who could be injured while trying to get out of bed. Clients can also become trapped or strangled in bed rails. Using bed rails without permission can be seen as an attempt to restrain the client. Always follow the care plan regarding use of bed rails.

Diabetes mellitus make a resident more prone to develop

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Diabetics have high blood sugar levels which can decrease the immune system which fights infections. Urinary tract and skin are the most common places for infections in diabetics. Because diabetics often have nerve damage, they can develop foot infections without knowing.

When lifting a heavy object, which muscle groups should be utilized

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When lifting a heavy object, the nurse aide should be positioned to support the client by using the legs. Keep your back straight and locked; do not turn or twist. Do not attempt to lift by bending forward. Bend hips and knees to squat down. Keep the load close to your body and straighten your legs as you lift. If you have any doubts, always ask for assistance from a co-worker.

A bedsore or decubitus ulcer is caused by

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One of the primary responsibilities of a nurse aide is to monitor the client's skin for any signs of breakdown that could develop into bedsores, also called decubitus ulcers or pressure sores. During baths, dressing, or position changes, inspect the skin for redness, pallor, warmth, or bruising. Reposition at least every two hours, protecting areas that rub together, as well as the bony prominences. Massages to the back and buttocks can promote circulation. Range-of-motion exercises are also helpful. Always report any signs of breakdown to the nurse.

One of the major reasons the elderly person is incontinent of urine is

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As part of the aging process, a client may experience urinary incontinence because of weakness of the muscle that keeps the urine in until the client can get to the toilet. Other reasons are that the bladder itself doesn't contract to expel all the urine. Bladder infections and prostate problems can contribute to incontinence. Diseases such as Alzheimer's or multiple sclerosis can also be causes.

Wasting or a decrease in the size of a muscle is called

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Muscle atrophy is a loss of muscle mass. The main cause for atrophy is lack of physical activity, from either injury or disease. After an injury, the muscles are often immobile or painful to move. Examples: A herniated disc or a broken leg. Diseases which lead to atrophy include multiple sclerosis, anorexia nervosa, and AIDS.

If the resident is smoking and the nurse aide needs to take an oral temperature, what should the nurse aide do

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Before taking an oral temperature, determine if the client has smoked, or had anything hot or cold to drink in the last 15 minutes. If so, wait a full 15 minutes before taking the temperature in order to obtain an accurate measurement.

The thinning of the fatty layer under the skin could cause the resident to

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The natural aging process causes many changes in the skin. The outer layer of skin becomes thin, and appears pale and clear. Blood vessels are fragile, leading to bruising and bleeding under the skin. The fat layer also thins, so there is less padding, which increases the risk of injury and pressure sores. Rubbing or pulling on the skin can produce skin tears.

The loss of the ability to express one’s self is

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When a client has suffered a stroke or other head injury, the speech center of the brain can be damaged, resulting in aphasia. Main signs of aphasia include difficulty finding appropriate words when speaking, trouble understanding speech, and difficulty with reading and writing.

A Foley catheter is used

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A Foley Catheter is a sterile tube that is placed into he bladder to drain urine. It is held in place by a balloon that is inflated after being inserted. When a client has an indwelling Foley catheter, the nurse aide should check that the tubing is open so that the urine can flow from the bladder. After each position change or when the client returns to the bed or chair after being up, ensure that the tubing is not kinked or closed. The bag should be lower than the bladder to prevent backflow.

The nurse aide notices on the flow sheet that a resident has not had a bowel movement for five days. The nurse aide should

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While each person has a unique pattern of bowel movements, the normal number is 3 to 14 times a week. If there is a sudden change in pattern, or if the client has symptoms of constipation such as bloating, pain, or nausea, the cause should be examined. Adding fiber and fluids to the diet can help prevent constipation.

The nurse aide is assigned to a stroke patient with a diagnosis of aphasia. The nurse aide knows

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When a client has suffered a stroke or other head injury, the speech center of the brain can be damaged, resulting in aphasia. Main signs of aphasia include difficulty finding appropriate words when speaking, trouble understanding speech, and difficulty with reading and writing.

Type 2 diabetes is

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Type 2 diabetes is the most common form of diabetes, usually occurring in adults who are obese and inactive. It is a chronic disease that requires ongoing medical management. While there is no cure, it can be controlled with lifestyle changes with diet and exercise. Medications can also be helpful in keeping blood sugar levels at optimal levels.

There are two kinds of restraints

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There are two categories of restraints that are meant to protect the client or others. Physical restraints are devices that are designed to restrict movement. Examples are vests, hand mitts, belts, lap trays, or bed rails. Chemical restraints are medications given to control behavior such as yelling or combative behavior. All restraints require a physician's order.

Elderly residents sometimes appear stooped over and like they have lost height. This is due to

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Osteoporosis in the spinal column can lead to a gradual loss of height and a stooped posture. The loss of calcium in the vertebral bones of the spine can cause fractures and back pain, although most of the fractures are tiny and painless. Both older men and women can get osteoporosis.

Constipation and indigestion can be result from

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About 75% of elderly people have slowed peristalsis (the way that food moves through the intestines) because there are fewer nerves to control the gut. As a result, food does not move in an even pattern. This can cause constipation and indigestion. Any pathogens in the digestive tract have a chance to multiply, so elderly people may be more likely to develop enteric infections.

Hospice specializes in the care of persons who are

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Hospice is specialized care for clients who are terminally ill. The care includes the family and caregivers. It does not attempt to cure the client. Hospice is intended to improve the quality of life for everyone involved, by taking care of their physical, emotional, and spiritual needs.

What is the purpose of using the chain-of-command in a long-term care facility

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Every staff member has a role in providing excellent client care. With good communication, each person can work within their scope of practice and allow others with different authority to handle appropriate tasks. In a long-term facility, the CNA reports to the RN or LVN, who reports to the Director of Nursing. The facility's Administrator and Medical Director may be the people with the most responsibility.

What can the nurse aide give the resident who has an order for NPO?

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NPO is a common medical term that means the client can not eat or drink anything, including water or ice chips. A doctor orders a patient to be NPO for situations such as before surgery or certain lab work. If a client is ill or has a gastrointestinal condition, the doctor may write an order to be NPO until the cause is known. The nurse aide can provide mouth care for a client who is NPO. Placing a "NPO" sign over the client's bed will remind all staff members not to give the client anything to eat or drink.

The nurse aide is going to take Mr. Heath’s vital signs. What should the nurse aide do to get Mr. Heath to cooperate and reduce his anxiety?

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Before providing any care, the nurse aide must follow all the standard steps in preparation. Gather everything needed, so that you don't have to leave the client's room once you begin. Handwashing is always done before and after each client interaction. After confirming the client's ID, explain the procedure to the client, even for routine tasks such as taking vital signs. Allow the client to ask questions before proceeding.

Strokes are seen in the elderly. Strokes are best described as

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A stroke happens when the blood supply to the brain is cut off, and oxygen cannot reach the brain cells. Strokes are caused by blood clots in the arteries of the brain or when a blood vessel in the brain bursts.

When dry, hard stool fills the rectum and will not pass, it is called

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A fecal impaction is a common occurrence in people who have chronic constipation. It is a mass of dry, hard stool in the colon or rectum. The client is unable to pass it without assistance. The stool may need to be removed manually by inserting a gloved finger into the rectum. Enemas and laxatives may also be tried.

To count a respiration, a respiration includes

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The normal respiratory rate for adults is 12-18 breaths per minute. To get an accurate respiratory rate, choose a time when the client is at rest. Observe the client for one minute while counting. Each rise and fall of the chest is one respiration. While counting, notice if the client has trouble breathing or taking full inhalations. If so, notify the nurse.

Who supervises the work of a nurse aide

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The work of a nurse aide is overseen by a registered nurse or a licensed practical or vocational nurse. The scope of practice for an RN or LPN/LVN includes responsibility of staff who provide the daily, hands-on care for clients. Open communication between the nurse aide and supervisor makes for excellent client care.

A resident is NPO for tests. The nurse aid should

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NPO is a common medical term that means the client can not eat or drink anything, including water or ice chips. A doctor orders a patient to be NPO for situations such as before surgery or certain lab work. If a client is ill or has a gastrointestinal condition, the doctor may write an order to be NPO until the cause is known. The nurse aide can provide mouth care for a client who is NPO. Placing a "NPO" sign over the client's bed will remind all staff members not to give the client anything to eat or drink.

When lifting, the nurse aide should have his feet separated in the standing position to

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When feet are placed apart, about shoulder width, a comfortable and wide base of support is established. With a wide base , you are less likely to lose your balance. Use your feet to turn, not your back. Do not twist your back or torso while lifting.

The nurse aide knows to wear which of the following to perform resident care?

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The nurse aide is considered to be a health care professional and should dress accordingly. Each facility has a dress code policy regarding the type of uniform to wear. Clothing must be clean and free from stains, tears, or wrinkles. Shoes must be closed-toe, with non-skid soles. Appropriate grooming is always necessary. Jewelry is usually limited to a watch and wedding ring, to avoid injuring a client while giving care. A name tag is part of the standard uniform.

Why should heat NOT be applied to a diabetic resident’s feet?

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Because diabetics often have neuropathy, or nerve damage, they are unable to detect if their feet are injured. Extreme care must be taken to protect the feet from both heat and cold, since the diabetic can't feel temperatures. Diabetics should always wear socks and shoes to prevent cuts or injuries to their feet.

Signs of poor circulation are

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Poor circulation is the result of another medical condition. Peripheral artery disease (PAD) causes circulation to be impaired due to narrowed blood vessels in the legs. Without a good blood supply, skin becomes pale and cool to the touch. Edema develops when extra fluid cannot be returned to the heart. Other symptoms include numbness, tingling, pain, and muscle cramps. Other causes of poor circulation are diabetes, obesity, and varicose veins.

The plan, which begins on the resident’s admission and assists when the resident goes home, is called

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A good discharge plan allows for continuity of the care that begins on admission. It anticipates possible issues or barriers which the client and their family may encounter, as well as services which will be needed after discharge. All team members can contribute to the plan, based on their interactions with the client.

A sitting or semi-sitting position with the head of the bed elevated is called

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Fowler's position is the standard way to position a client to improve oxygenation. There are several types of Fowler's position. In high Fowler's, the client sits upright in bed at a 90 degree angle to allow the chest to expand. Semi-Fowler's position raises the head of the bed at 45-60 degrees, and is used for drainage and comfort after surgeries.

The most important way for the nurse aide to gather information about the safety and well being of the resident is

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As the primary staff member who provides hands-on care for the resident, the nurse aide is able to observe the resident's current condition with accuracy. Flow sheets provide information about the resident over time, but the nurse aide is able to assess the situation in real-time.

Which of the following is a proper way to correct an error in charting

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There are strict guidelines regarding how to correct a charting error. Never erase or cover the error. Draw a single line through the error, so the entry can still be seen. Add the date and your initials. Continue with the correct entry. There can be serious consequences for you and your facility if proper protocols for error correction are not followed.

For most residents, normal respiration ranges between

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The normal breath rate for adults is 12-20 times a minute. When measuring a client's respiratory rate, start when the client is at rest. Each inhale and exhale makes up a single breath. Count breaths for 60 seconds when taking a respiratory rate.

The exchange of oxygen and carbon dioxide takes place

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The lungs are the main organs of the respiratory system. They take in oxygen during inhalation and release carbon dioxide during exhalation. The gases are exchanged in the tiny air sacs of the lungs, called alveoli.

Various factors will change pulse rate. Increased pulse rates can be caused by

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The heart rate is lowest when at rest or no physical activity is happening. It increases when there is a need for more oxygen. Exercise always triggers a faster pulse. Other factors that raise the heart rate include pain, anxiety, stress, or too much thyroid medication.

A Hepatitis B vaccination protects the person receiving it against a disease that affects

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Hepatitis B is a serious, contagious infection caused by a virus (HBV). Most commonly spread by exposure to body fluids, it can cause both acute and chronic disease. Many agencies and facilities require employees to receive the HBV vaccination series in order to protect themselves and others.

A diabetic resident asks the nurse aide to cut her toenails. The nurse aide should

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Because diabetics often have neuropathy, or nerve damage, they are unable to detect if their feet are injured. Even trimming toenails can cause an injury. Diabetics need expert care from a podiatrist or a qualified foot care professional. You could be held liable if the client developed an infection after you cut her toenails.

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