CNA Basic Nursing Skills 4

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A restraint attached to a patient's body and to a stationary object is ________.

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A restraint is a way of limiting a patient's movement or freedom. It protects the patient's safety or the safety of others. An active restraint is attached to the patient's body and to a secure object. Example: a vest that ties to a wheelchair.

A health care agency or program for patients who are dying is

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Hospice is a special type of care that works with patients who have life-limiting conditions, their families, and their caregivers. The goal is to maintain the patient's dignity and quality of life, while supporting each person. Hospice care does not prolong life or hasten death.

Mrs. Harvey complains of abdominal discomfort. Watery stool has been leaking from her rectum. This could be a sign of

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Fecal impaction can be serious. When constipation is not resolved, stool becomes hardened and unable to pass. Liquid stool may pass around the impaction. Patients may complain of feeling bloated; having the urge to push; nausea or vomiting; not wanting to eat. There are several treatments to expel the impaction, but it may need to be manually removed.

Mrs. Allen has a gastrostomy and the nurse just put Ensure through the feeding tube. The CNA needs to put her in which position for the next 1-2 hours?

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Fowler's position is a sitting position that is used for several reasons. It prevents aspiration during and after a tube feeding. It can also help patients with respiratory problems breathe more easily. Standard Fowler's position is 45-60 degrees.

Mr. Brown has an ankle brace. When you remove the brace, you notice a reddened area on the ankle bone. You should

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A reddened area is the first sign of skin breakdown. It means that there is pressure and a lack of blood circulation to the area. The nurse aide should immediately remove the source of pressure or reposition the client to eliminate pressure. Never massage a reddened area, as this will increase the damage. Report your observation to the nurse.

What is the normal range of systolic blood pressure for adults?

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Systolic pressure is the top number of a blood pressure reading. It measures the pressure in the arteries after the heart takes a beat, as the blood moves. The normal pressure is less than 120. A pressure of 120-140 is considered pre-hypertensive.

A nursing aide has four patients to assist. Who should she address first?

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When prioritizing, start with the patient that has the most urgent need. Assist the patient to the bathroom, to prevent incontinence and clean up. The patient will be comfortable, and you can then attend to the other patients.

The RN assigns you a task that is in your job description. Which statement is FALSE?

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While the RN can assign or delegate tasks that are in your job description, they must ensure that you know how to do the task and that it's beneficial to the patient. Some non-RN tasks may be outside the scope of your CNA practice. If so, inform the RN.

Settings where a CNA can work include

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As a healthcare professional, the CNA can choose from a variety of work settings, depending on interest and experience. Hospitals, hospices, and home care are three examples, as well as clinics and long-term care facilities.

The earliest identifying sign for a developing pressure sore is a local _______.

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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. 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 redness or breakdown to the nurse.

A patient with a persistent blood pressure measurement above 140/90 has

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Hypertension is diagnosed when a person has consistent blood pressure measurements of 140/90 or greater. Hypertension has no symptoms as it develops; it can be present for years without a person knowing it.

What is the definition of Aphasia?

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Aphasia occurs after a stroke or injury to the part of the brain that controls language, usually the left side of the brain. Aphasia can affect the ability to speak, understand words, as well as reading and writing. Intelligence is not affected, which can lead to frustration for the person.

Mr. Green’s water pitcher holds 1000 cc, It is full when you came on shift. You refill it once during your shift. At the end of the shift it is half full. How much water has Mr. Green had to drink?

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1000 cc equals one liter. If the patient drinks one liter plus another half, they have had 1500 cc. In medical and pharmacy terms, 1 cc = 1 ml. Mr. Green drank 1500 cc or 1500 ml.

If your patient has bradycardia, what does that mean?

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The normal range of heartbeats is 60-100 per minute. A pulse rate below 60 is called bradycardia, and should be reported to the nurse. "Brady" means slow. Bradypnea is a slow respiratory rate.

The type of bed used for a patient arriving by stretcher or wheelchair is called _________.

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An open bed is the term used for a bed that is ready for a patient to enter. The sheets are folded back, so that it's easy for the patient to get in. Open beds are for new patients, as well as preparing the bed when patients get up for a short time.

Paralysis on one side of the body is called

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A client with hemiplegia has paralysis on one side of the body. The paralysis can be partial or total. It occurs on the opposite side of the CVA (stroke) or brain disorder. The paralysis occurs on the opposite site of the brain where the brain injury happens. If the injury is on the right side of the brain, the left side of the body is affected.

How would a nursing aide identify a problem with a diabetic patient?

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Every CNA should know the basic signs of problems of diabetes. Cold, clammy skin is abnormal and should be reported immediately to the nurse. The patient likely has a low blood sugar (hypoglycemia) and needs glucose quickly: orange juice, hard candy, or glucagon. Other warning signs of hypoglycemia are shakiness, anxiety, irritability, rapid heart beat, and dizziness.

A client who requires a high fiber diet should eat

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Dietary fiber is found in plants: fruits, vegetables and grains. There is very little fiber in meat and dairy products. Fruit juices have most of their natural fiber removed.

The preferred way to remove a bed pan from a client who is unable to lift their buttocks is to

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If a client is unable to lift their hips or buttocks, turn them on their side, press the bedpan against their buttocks, and roll them back. Sometimes a smaller "fracture bedpan" can slide under the client's buttocks. To remove the pan, turn the client while keeping the bedpan level.

Besides hearing, what other function does the ear have?

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The inner ear is responsible for helping maintain balance. Three tiny fluid-filled tubes, called the vestibular, send impulses to the brain. The brain uses the impulses to adjust the body's position.

Breathing liquids or solids into the airway or lungs is called

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Aspiration results when food, liquids, saliva, or vomit enter the lungs instead of being swallowed. This is a dangerous situation, because pneumonia can develop.

Which of the following is NOT a sleep aid?

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Alcohol is not a sleep aid. It actually disrupts sleep. It interrupts the normal REM sleep cycle. For people with breathing problems or sleep apnea, alcohol worsens symptoms.

Which vegetable is not allowed on a low sodium diet?

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Any food that is fermented, such as sauerkraut, has a high sodium level. A cup of sauerkraut has over 1,500 milligrams of sodium. This is more than many people are allowed on a low sodium diet.

Which is INCORRECT when recording on a patient's chart?

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All documentation must be done in permanent ink. If you make a mistake, follow your facility's policy for correction. Usually it is a single line through the error, with the date, time, and your initials.

You notice that a patient has passed a black tarry stool. This is called

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Bleeding in the upper gastrointestinal (GI) system causes a stool that is black, tarry, and foul smelling. The bleeding comes from the esophagus, stomach, or small intestine. Immediately report any unusual stools to the nurse.

If your patient is in traction you should NOT

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Patients who are in traction require full care. Including vital signs, positioning, and bathing. Traction weights are ordered by physicians, so the CNA may not change any weights. If the CNA observes a weight out of place or on the floor, notify the nurse immediately.

What does afebrile mean?

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A medical term that begins with "A" means the absence of. Afebrile means no fever. Other examples: Asystole (no heart beat), apnea (no breathing) and anuria (no urine).

What is rigor mortis?

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Rigor mortis is the stiffening and locking of the joints following death, due to muscles contracting. It occurs from head to toe. It can begin any time from a few minutes to a few hours after death.

The last sensation that is lost when dying is

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Studies have shown that hearing is likely the last sense that remains before death. Always speak directly to the patient, explaining what you are doing. Do not discuss the patient as if they were not there.

Mrs. Andrews has an indwelling urinary catheter. Which is INCORRECT?

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An indwelling urinary catheter is used to drain the bladder into a bag outside the body. In females, it is a long tube with a balloon that is inflated after being inserted through the urethra. The tube that drains the urine must not be tugged or become kinked. In males, it is attached to the client's inner thigh by tape or a special fastening device. Never attach the tube to anything except the client's inner thigh. The drainage bag should remain lower than the client's bladder to prevent backflow of urine.

A type of service that long term care facilities can provide include

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Home care may be an option for patients who require long term care services. Depending on the patient's condition, some families may prefer to provide care at home for as long as possible.

Hypothermia is a __________.

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The prefix "hypo" always indicates that something is below normal. Hypothermia means a subnormal temperature. Hypotension is low blood pressure.

A client who is on a low cholesterol diet should not eat

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Dietary cholesterol comes from animals. Plant-based foods are recommended, as well as "good" fats such as nuts and olive oil.

Which is the most accurate way to measure a resident’s temperature?

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Rectal temperature is the most accurate, although other ways can be calculated to give an approximate measurement. The ear is also accurate, but adults often have wax in their ears, so it may not provide an ideal measurement.

You are instructed to strain Mr. Powers' urine. You know that straining the urine is done to find ______.

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Kidney stones can be passed with urine. To assist the physician, urine is strained to detect and save the stones. The RN will tell you what to do with any stones that are filtered. Passing kidney stones can be painful, so let the RN know if the patient complains of discomfort when urinating.

The definition of scope of practice is?

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"Scope of practice" means the actions and procedures that any health care professional is allowed to do, according to their license. For example, a CNA cannot start an IV, and a LPN cannot perform surgery. Those actions are beyond the scope of practice for each of them.

Intake and Output deals with

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Intake and output measure the fluid balance in the body. To calculate input, add all liquids, plus foods that are liquid at room temperature, such as ice cream, ice pops and jello.

Which does NOT prevent or reduce odors?

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The best way to prevent unpleasant odors is to treat them promptly. Keeping a patient clean, emptying the bedpan, and using an ongoing deodorizer are all good methods. Flowers cannot disguise or cover an odor that is already in place.

Mr. Burns just smoked a cigarette. How long should you wait to take his oral temperature?

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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 -20 minutes before taking the temperature in order to obtain an accurate measurement.

The back-lying position is the

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The supine (pronounced "soo-pine") position is when the patient is on their back. Hint: both "supine" and "sky" start with an S. "When supine, I look at the sky.").

Who is in charge of delegating the work assignment?

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The CNA works under the supervision of a licensed nurse. The RN or LVN/LPN can make assignments that will provide the best and most efficient care for the patients.

When taking a blood pressure, you should do all of the following EXCEPT

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Blood pressure should never be taken in an arm with an IV. The compression of the cuff could cause the IV site to be damaged. Also, never take a blood pressure on an arm with a fistula for hemodialysis or a special line that has been inserted to deliver antibiotics.

Three liquid ounces equals how many milliliters?

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When converting milliliters (ml) to ounces (oz.) remember that 30 ml = 1 ounce. Although an ounce is slightly more, the amounts are considered to be equal by doctors and pharmacists.

You observe that a patient is bleeding from an IV site. You should

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As a CNA, you may observe that an IV site is not normal. Bleeding, redness, or swelling should immediately be reported to the nurse. The IV will need to be removed and a sterile dressing applied. These procedures are beyond the cope of practice for a CNA.

When documenting in a patient's record, which statement is FALSE?

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Never chart a procedure or care before doing it. If you forget to do it, or is something happens to the patient, you have made a false entry. Besides compromising the patient's care, you could be disciplined or lose your job.

The goal of the health care team is to

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Health care teams are based on the idea that no one has all the knowledge to do everything for a patient. By having each specialty contribute, the patient gets the best possible care.

If a resident drinks four ounces of water with a meal, how many milliliters (ml) has he consumed?

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When converting milliliters (ml) to ounces (oz.) remember that 30 ml = 1 ounce. Although an ounce is slightly more, the amounts are considered to be equal by doctors and pharmacists.

What basic need is most essential?

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In Maslow's hierarchy of needs, humans must first feel safe and secure before they can do anything else. First are the most basic needs: food, water, warmth, and sleep. Then safety and security come next.

The medical term for hair loss is called

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Alopecia is the loss of hair where it normally grows. Cancer patients can experience alopecia as a result of chemotherapy. Hint: any medical term that starts with an "a" means without. Example: Asystole means "without a heartbeat."

Who is responsible for the entire nursing staff and the activities involved in providing safe care.

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The Director of Nursing (DON) is a registered nurse who oversees all patient care at a facility. The DON supervises all nursing staff, manages budgets, and handles patient and family issues that staff RNs can't resolve.

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