A restraint may be either physical or chemical. Its purpose is to protect the client from harming himself or others. Only a physician may order a restraint, and guidelines are strict. A pain medication may help calm a client or relieve behavior associated with severe pain, but it is not in the restraint category.
When a resident must stay in bed, it is very important to prevent skin breakdown. Any pressure can lead to the development of a decubitus ulcer (also called a pressure ulcer, pressure sore, or bed sore). Even a wrinkle or ridge in the bed linen can harm a resident's fragile skin. Keep linens smooth, clean, and dry.
It is important to maintain proper spinal position with lifting. The risk of injury to the low back increases when using the back muscles, bending at the waist, twisting, or trying to lift when the load is too heavy. Common injuries associated with lifting are strains, sprains and herniated discs. For heavy loads, always find another person to help.
A quad-cane has four tips to provide a broad base to support the client while walking. The client holds the cane in the strong or unaffected side. To walk, place the cane about an arm's length away, with all four tips touching the ground at the same time. Step forward with the weak leg, using the cane for stability.
When encountering any type of emergency situation, such as an unconscious client, always call for help first. Others can clear the area, phone for an ambulance, assist with CPR, help move or transfer the client, or document the events.
When prioritizing, start with the resident who has the most urgent need. Helping the resident who has finished toileting is most important. The patient will be comfortable, and you can then do the other tasks.
Contact isolation precautions are used when infection or disease can be spread by touching the patient or items in the patient's room that could possibly be contaminated. Scabies, MRSA, severe diarrhea, and RSV are examples of conditions requiring gowns and gloves to care for the patient.
A person who is choking will automatically grab their throat. This is a signal for help. Abdominal thrusts (the Heimlich maneuver) is the best response to choking. Calling for assistance as you prepare to do abdominal thrusts will alert others of the emergency. A quick back slap can be tried, but if the food does not immediately dislodge, the nurse aide must quickly move to start abdominal thrusts. Performing abdominal thrusts involves standing behind the client and using hands to exert upward pressure on the bottom of the diaphragm.
Abdominal thrusts (the Heimlich maneuver) is the best response to choking. Calling for assistance as you prepare to do abdominal thrusts will alert others of the emergency. A quick back slap can be tried, but if the food does not immediately dislodge, the nurse aide must quickly move to start abdominal thrusts. Performing abdominal thrusts involves standing behind the client and using hands to exert upward pressure on the bottom of the diaphragm.
Physical restraints are devices or equipment that prevent normal movement. Examples are arm or leg restraints, hand mitts, or vests. It is against the law to use restraints unless necessary to treat a client's medical symptoms, or if there is a risk of harming self or others. Restraints are not used for punishment, convenience, or a method of control. Either a physician's order or the client's consent is required before a restraint can be applied.
9 oz. = 270 cc. When converting ounces (oz.) to cubic centimeters (cc) remember that 1 oz. = 30 cc. Although an ounce is slightly more, the amounts are considered to be equal by doctors and pharmacists. Also, 1 cc = 1 ml.
After giving care, or when leaving the client's room, always ensure that the client's call signal is within reach. Clients must always have access to caregivers. For safety, bed should be in the lowest position, with bed rails up. Restraints may never be applied without an order from the client's doctor.
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.
Atrophy occurs with underuse or disease of a part of the body, causing a loss of cells. When muscles are not used, they can waste away, resulting in poor strength or movement. In Alzheimer's disease, the brain atrophies, shrinking until all functions are lost.
Obtaining the client's weight is an important part of assessment. Weight should be done at the same time every day; morning is the best time. Ideally, to get the most accurate, or dry, weight, use the same scale and weigh the client after the first void and before breakfast.
Hypoglycemia, or low blood sugar, causes a diabetic to become shaky. Other signs and symptoms are sweating, chills, nausea, and a rapid heartbeat. The resident may act confused, irritable, or anxious. As a CNA, you should know which residents are diabetic and what to watch for. Notify the nurse immediately.
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