CNA Basic Nursing Skills 6
A restraint should always be tied to the
In an October 2015 warning, the FDA stated: "Secure restraints designed for use in bed to the bed springs or frame, NEVER to the mattress or the bed rails. If the bed is adjustable, secure restraints to parts of the bed that would move with the patient (not constrict the patient)" The knots used for the restraints must be quick-release.
Some common causes of constipation include all of the following EXCEPT
Activity and exercise can help prevent constipation by moving food through the large intestine more quickly. When food passes through the digestive system faster, less water is absorbed, so the stool is also softer.
Your client has been placed on I & O. This means that you should
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.
When muscles atrophy, they become
Muscle atrophy is a decrease in the size of the muscles. It is caused by not using the muscles or lack of activity. People who are injured or have a disease that restricts movement are at risk for muscle atrophy. It can often be reversed with active exercise and proper nutrition.
The medical abbreviation for “before meals” is
The Latin term for before meals is "ac" which means "ante cibum." Many medical abbreviations come from Latin or Greek. The abbreviation for after meals is "pc" which means "post cibum."
One of the differences between an RN and a CNA is that only the RN can ________.
Registered nurses are trained in pharmacology, measurement, and the side effects of medications. They can also take orders from physicians for medications.
When preparing a new patient's room, the CNA should collect
Admitting new patients usually involves a standard procedure. By gathering everything needed, you can avoid leaving the new patient to get an item. You also make a good impression because you are organized and efficient.
What body system provides framework for the body and allows the body to move?
The musculoskeletal system is made up of the muscles, bones, cartilage, tendons, ligaments, and joints. Together, they provide the framework for the body, muscles to move the bones, and connective tissue that links all the moving parts.
A warning sign of cancer is
Always see a doctor for any of the seven signs of cancer from the American Cancer Society: 1. Change in bladder or bowel habits 2. A sore that does not heal 3. Unusual bleeding or discharge 4. Thickening or a lump in the breast or elsewhere 5. Indigestion or difficulty swallowing 6. Obvious change in a wart or mole 7. Nagging cough or hoarseness.
The proper way to identify a patient is to
A patient's ID wristband is the only proper way to identify a patient. The wristband is waterproof and has the patient's name, birthdate, and hospital/patient number. Many facilities also have a bar code on the wristband. Every facility has strict protocols for using the ID wristband to identify a patient before treatments, procedures, medications, tests, and special diets.
Continual oozing or diarrhea may be a symptom of
Fecal incontinence, also called bowel incontinence or accidental bowel leakage, happens when people are unable to control their bowel movements. Stool can leak or ooze from the rectum, sometimes without the person being aware that it's happening. About 45% of nursing home residents have this condition. It's more common in women than men, because of childbirth.
The CNA can do all of these to assist a patient for discharge EXCEPT
The RN is trained to provide patient education and answer questions regarding orders and treatment. It is beyond the scope of CNA practice to give discharge instructions to a patient.
If a nurse aide needs to wear a gown to care for a patient in isolation, the nurse aide should
All items used for a patient in isolation must remain in the room. This includes personal protective equipment (PPE) such as gowns, gloves, and masks. Every facility has strict isolation protocols to prevent spread of infection and disease.
A resident has a slow heart rate; less than 60 beats per minute. The nurse tells you she is having
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.
Which of the following foods is allowed in a clear liquid diet?
A clear liquid diet means the patient can have liquids that you can see through and foods that turn to liquid at room temperature. Examples: grape juice, apple juice and cranberry juice are okay, but orange juice is not. Broth, Jell-O, and popsicles are also acceptable. Tea and coffee without cream are fine, too.
The medical abbreviation for “three times a day” is
The term "TID" means three times a day. It is an abbreviation for Latin "ter in die." It is used in medicine and pharmacy, and can also be written as t.i.d. or tid.
As death nears, the last sense to leave the body is
Research with brain waves, using EEGs, shows that hearing may be the last sense to shut down during the death process. Never assume that the patient can't hear, even if are unconscious or not responsive. Continue to speak to the patient, as if they can hear. Tell them who else is present and encourage others to tell the patient why they are there and to say good-bye.
A fracture-type bedpan is used for residents who
A fracture pan is a smaller version of a bedpan, with one side flat, which makes it easier to slide under a patient who cannot raise their hips or who must maintain alignment. The other end has a handle for easy removal. Many nurses like to powder the fracture pan to make it easier to slide and to avoid skin irritation.
When nursing assistants find equipment in need of repair, they should
Every staff member is responsible for keeping clients safe at all times. This includes monitoring all equipment and reporting when anything needs repair. Never use broken equipment or try to create a temporary solution if equipment is not working properly. Tag the broken item and move it so that another client can't use it.
Which function is NOT done by the circulatory system?
The circulatory system is the heart and blood vessels. Arteries are the vessels that leave the heart with oxygen and nutrients for all cells. Veins are the vessels that remove waste products and carbon dioxide.
When the valves in the legs weaken it can result in
Varicose veins are large, swollen veins in the legs that result from weakened valves. Veins have one-way valves to prevent blood from backflowing as it returns to the heart. If they are damaged, the blood pools in the veins, causing swelling, pain, and possibly blood clots. Varicose veins can be treated with compression stockings, or if they are serious, surgery.
Which is the best way to prevent joint and muscle damage?
Range of motion (ROM) exercises provide a way to maintain joint flexibility. In passive ROM, someone moves the joints with no assistance from the client. In active ROM, the client does the exercises alone or with the help of devices, such as a strap. ROM is important to prevent contractures. A contracture is a shortening of muscles, tissues, tendons, and skin at the joints, due to lack of movement and exercise. When joints remain bent over time, they can no longer be straightened.
The branch of medicine concerned with the problems and diseases of the elderly is called _______.
Geriatrics, or geriatric medicine, is the branch of medicine specializing in elderly people. The focus is on preventing illness and treating conditions that are common in older people. Medical care can become complex as people age, and a geriatrician can help manage multiple health issues.
The nurse aide enters a client’s room, and the client states that he has pain. What should the nurse aide do?
As a CNA, you may be the first person that learns of a client's pain. Report what the client tells you to the nurse. You can try to make the client more comfortable with a position change, arranging pillows, or other supportive measures.
Pulses can be taken
A radial pulse is found at the client's wrist. To locate it, place your index and middle fingers on the hollow area below the thumb. Apply light pressure to feel the pulse. Count each beat for 30 seconds and multiply by 2 to get the pulse rate. If the client has an irregular heartbeat, count for 60 seconds. Record the pulse rate in the client's chart.
The RN, LPN, and CNA are members of the
The nursing team is made of the staff members with specific training in direct patient care. The team coordinates to provide care according to each person's scope of practice.
When heat is applied to the skin, the blood vessels _______.
Heat makes blood vessels dilate, or open up. This delivers more blood to the area, helping muscles and joints relax. Heat also brings more oxygen and nutrients to the site, which promotes healing. Heat is helpful for chronic pain, such as arthritis.
While providing denture care for a client, the nurse aide observes that the upper plate is cracked. The nurse aide should
If you notice that a client's denture is cracked or damaged, report it to the nurse. Do not put the denture in the client's mouth, because it can irritate or injure the gums.
The proper temperature for a soapsuds enema is
The proper temperature for a soapsuds enema is 105°F. This is slightly warmer than body temperature, or lukewarm.
The physician ordered Mrs. Jones “to receive physical therapy QOD”. That means that she will go ________.
QOD means every other day. "Q" stands for every and "D" stands for day. "QD" is every day. Remember that "O" is other, or alternate.
When making a bed, ________.
To avoid back injury, raise the bed to about waist height. You should be able to stand with your back straight.
A sodium-restricted diet for heart disease does NOT include
Lowering or eliminating salt from the diet is important for people with heart disease. Salt causes fluid retention, which can strain the heart as it works harder to pump the extra fluid. Foods that are prepared or preserved with salt are not allowed: pickles, olives, soy sauce, broth mixes, sauerkraut, bacon bits, and barbeque sauce are examples of "hidden" sodium.
The surgical creation of an artificial opening of the large intestine is called _______.
A colostomy is a surgical procedure that takes a section of the colon and creates an artificial opening through the abdomen. The opening is called a stoma. Contents of the colon, or large intestine, are collected in a pouch outside the body.
Which of the following is recorded as the systolic blood pressure?
When taking a blood pressure, inflate the cuff of the sphygmomanometer until it is snug, about 180 mmHg. Slowly release the valve of the cuff. When the blood is allowed to circulate, there will be a sound. That is the systolic pressure measurement, or the top number of the blood pressure reading. Hint: To remember which is the top number, think of the "S" in systolic, superior, and sky. All of them are "above" or "high."
When giving an enema to a person you ask the person to lie on _______.
The left Sim's position is used for rectal examinations and administering enemas. The client lies on the left side, with the right knee and hip bent. It is also called the lateral recumbent or semi prone side position.
The period of heart muscle contraction is called
Systole (pronounced "SIS-toe-lee") is the time when the heart muscles contract, sending oxygenated blood to the body. It produces the first sound heard when taking a blood pressure, called the systolic pressure.
A major risk factor for a stroke is
Hypertension is the main risk factor for strokes. Other risk factors are diabetes, heart disease, smoking, and a history of strokes or TIAs.
The patient just voided 400cc of cloudy yellow urine that has a strong smell. The patient also complains of pain while urinating. What should you report to the nurse?
When you notice anything unusual, and when a patient complains of pain, always tell the nurse. Urine should be clear and yellow. There should not be pain when urinating. Record your observations in the chart as well as reporting to the nurse.
The nutrient used to build and repair tissue is
Protein is necessary to build and repair bones, muscles, cartilage, skin, and blood. It is also used to make hormones and enzymes.
All of the following are signs of approaching death EXCEPT
As death nears, the heart rate drops, causing many signs: the circulation slows, blood pressure drops, and the extremities become cold. Blood begins to pool on the patient's back and back of the legs. Skin can grow pale. As the lungs work to bring in more oxygen, breathing becomes labored and irregular.
Mrs. Jones is an insulin-dependent diabetic. What task should not be done for Mrs. Jones?
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.
A normal adult blood pressure is
The American Heart Association guidelines state that a normal blood pressure for an adult is a systolic pressure of less than 120 and diastolic less than 80. Prehypertension levels are a systolic pressure of 120-139 and diastolic of 80-89. Hypertension begins at a systolic pressure of 140 or higher and diastolic of 90 or higher.
The admission process includes all EXCEPT
The CNA can obtain objective information such as vital signs, height and weight, or observing a patient's skin, but cannot do an assessment. The RN is able to do a physical assessment as part of the nursing diagnosis and report findings to the MD.
Edema (pronounced "Eh-DEE-mah") is swelling caused by excess fluid that gets trapped in the body's tissues. It usually occurs in the feet, ankles, and legs of a person with heart failure. It often develops gradually. The area looks puffy and the skin appears shiny. If you press on the area, it leaves a depression that lasts after you remove your finger.
An apical pulse is counted for _______.
An apical pulse is taken on the patient's chest near the heart. You will need a stethoscope and a stopwatch to count for one full minute. An apical pulse is useful for slow pulse rates (under 60 bpm) or irregular pulse rates.
Rheumatoid arthritis may
Rheumatoid Arthritis (RA) is an autoimmune disease. The patient's immune system attacks the lining of the membranes that surround the joints, causing severe pain, swelling, redness, and muscle spasms. Over time, the joints become deformed. There can be periods of remission, but there is no cure for RA.
The case manager for a client requiring home health care is usually done by
Home health agencies employ registered nurses to manage client care. While a physician gives orders and is always available for consultation, the RN oversees the daily care by the home health staff. Home health agencies follow strict guidelines to maintain their accreditation.
When making an occupied bed, the nurse aide should always
Making an occupied bed involves changing the bed linens while keeping the patient comfortable. Use a privacy sheet to cover the patient during the process. Always raise the side rail on the opposite side of where you are working to prevent the patient from rolling out or falling.. If the patient is able, they can hold onto the side rail. Adjust the bed height to avoid injuring your back. Return the bed to its lowest level when you are finished.
The first sign of a decubitis ulcer is
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 breakdown to the nurse.
Which statement best describes ADL's
Activities of Daily Living (ADLs) are the basic personal tasks that can be done without help. There are six tasks: eating, bathing, dressing, personal hygiene, mobility, and using the toilet. As long as the client can perform these tasks, even with special tools or devices, they are considered independent. A way to remember the ADLs is "DEATH" which stands for D=Dress, E=Eat, A=Ambulate, T=Transfer/Toilet, H=Hygiene.
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