CNA Feeding and Hydration 2 — Questions and Answers
Question 1: A resident with severe rheumatoid arthritis has difficulty holding standard utensils. Which piece of adaptive equipment would be most beneficial for promoting independent eating?
- A plate guard
- A nosey cup
- A universal cuff with a utensil holder (Correct answer)
- A standard long-handled spoon
Correct answer: A universal cuff with a utensil holder
A universal cuff is a strap that fits over the hand and has a slot to hold a utensil. This is ideal for residents with a very weak or painful grip, such as those with severe arthritis, as it does not require them to actively grasp the handle.
Question 2: You are caring for a resident with a new G-tube for enteral feeding. Which of the following is an essential, yet indirect, aspect of your care related to their nutrition and hydration status?
- Administering the feeding formula at the prescribed rate.
- Providing frequent and thorough oral hygiene. (Correct answer)
- Ensuring the head of the bed is elevated to at least 30 degrees.
- Checking for gastric residual volume before each feeding.
Correct answer: Providing frequent and thorough oral hygiene.
Residents who are NPO (nothing by mouth) and receiving enteral nutrition are at high risk for dry mouth, which can lead to discomfort, oral infections, and even affect their overall health. Providing meticulous oral care is a critical comfort and safety measure for these residents.
Question 3: A resident on a fluid restriction of 1500 mL/day is being monitored closely. At the end of your shift, you calculate their intake as: 240 mL coffee, 120 mL gelatin, 1/2 of a 240 mL bowl of soup, and 4 oz of ice chips. What is the resident's total intake?
- 480 mL
- 600 mL
- 540 mL (Correct answer)
- 420 mL
Correct answer: 540 mL
To calculate the total, you must convert all items to mL and remember that ice chips melt to half their volume. The calculation is: 240mL (coffee) + 120mL (gelatin) + 120mL (half of the soup) + 60mL (4oz of ice chips = 120mL, which melts to 60mL). The total is 240 + 120 + 120 + 60 = 540 mL.
Question 4: During a meal, you observe a resident who had a stroke 'pocketing' food in their left cheek. What is the MOST appropriate immediate action for the CNA to take?
- Offer a drink of water to wash the food down.
- Gently touch the outside of their left cheek and remind them to swallow. (Correct answer)
- Remove the food from their mouth with a gloved finger.
- Immediately stop the meal and report it to the nurse.
Correct answer: Gently touch the outside of their left cheek and remind them to swallow.
Pocketing food is common after a stroke due to decreased sensation or muscle weakness. Providing a gentle tactile cue (touching the cheek) and a verbal reminder can prompt the resident to use their tongue to clear the food and swallow, which is the least invasive and most therapeutic initial step.
Question 5: A resident with advanced dementia has become increasingly confused, irritable, and drowsy over the past 24 hours. They have also had a decreased urinary output. Which condition should the CNA suspect and report to the nurse immediately?
- A urinary tract infection.
- Progression of their dementia.
- A reaction to a new medication.
- Dehydration. (Correct answer)
Correct answer: Dehydration.
While the other options are possible, the acute onset of increased confusion, lethargy, and decreased urination are classic signs of dehydration in the elderly. These symptoms can often be mistaken for dementia progression, but their sudden appearance warrants immediate investigation for dehydration.
Question 6: A resident with dysphagia is prescribed nectar-thick liquids. The CNA notices the resident coughing and having a gurgly, 'wet' sounding voice after drinking. This is a potential sign of:
- Allergic reaction.
- Dehydration.
- Aspiration. (Correct answer)
- Esophageal reflux.
Correct answer: Aspiration.
Coughing, choking, and a wet or gurgling voice during or after drinking are key signs of aspiration, which is when fluid or food enters the airway instead of the esophagus. Even with thickened liquids, aspiration can occur, and these signs must be reported to the nurse immediately.
CNA Feeding and Hydration 2
A resident with severe rheumatoid arthritis has difficulty holding standard utensils.
Which piece of adaptive equipment would be most beneficial for promoting independent eating?