CNA Legal & Ethical Behaviours 2

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If your home health client refuses to take their medication, you should

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Home health clients have the same rights as patients in any other setting: nursing home, hospital, or clinic. They may refuse treatment without fear of punishment. You should try to find out why they don't want their medications. Perhaps the reason can be resolved or there is another issue that they can tell you about. Report their refusal to your supervisor. Do not try to trick or threaten them. Always remove any medication that is not taken.

When caring for a resident whose religion is different from your own, you should

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Cultural diversity includes acceptance and respect of other religions and their practices. Religions may be different regarding which day of the week is set aside for worship. Jewish, Muslim, and Seventh-Day Adventists worship on Fridays and Saturdays. There may also be dietary restrictions and days of fasting. Within a religion, individuals may participate in some, but not all, aspects. Allow residents to observe their religion without interference or discrimination.

An example of neglect is when a nurse aide

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Neglect is considered mistreatment that results from lack of attention or carelessness. Neglect can be physical, emotional, or financial. Leaving a resident unattended in a dangerous situation is an example of physical neglect, because basic safety was disregarded.

Which of the following would affect a nurse aide’s status on the State Registry and possibly cause the nurse aide to be ineligible to work in a nursing home?

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If the CNA has a neglect charge, their license will be revoked for at least a year. Each state licensing board has regulations regarding reinstatement after claims of abuse or neglect. If the state allows reinstatement, they will provide information about the process. An attorney may be useful in reviewing the case and helping dispute or reinstate the license.

Before touching a resident who is crying to offer comfort, the nurse aide should consider ______.

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While Western culture uses therapeutic touch as a way to offer support or comfort, other religions or cultures see it as a violation of privacy. For example, Asians or Muslims do not welcome touch by strangers or by the opposite gender. When in doubt, ask for permission or be conservative in your approach.

When you are caring for an elderly resident who has dentures, but seldom wears them, what should you do?

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A resident has the right to choose, including whether or not to wear their dentures. Although dentures can make eating easier and improve nutrition, there may be a reason the resident doesn't wear them. Jaw bones can change over time, causing dentures to not fit well or to be uncomfortable. Ask the resident why they aren't wearing their dentures. Tell the nurse if a dental appointment is necessary.

If abuse is suspected within a facility

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All abuse or suspected abuse must be reported. Every health care facility has a procedure for handling concerns about client care. If an incident involves a co-worker, notify the charge nurse. If a nurse aide observes the charge nurse in a situation that could be dangerous or neglectful for a resident, the nurse aide can go directly to the Nursing or Administrative Supervisor.

On Monday, Mrs. Green and her family requested and received a “Do Not Resuscitate" order from her doctor. While bathing her on Thursday, she stops breathing and dies. Her son is not home. You should

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When a client (or the client's Power of Attorney for Healthcare) obtains a "Do Not Resuscitate" (DNR) order, they do not want any measures taken if their breathing or heart stops. When a DNR order is in place, do not do CPR or call Emergency Services. Notify your supervisor and provide post-mortem care.

The nurse aide is administering a bed bath when all of a sudden they hear a scream coming from the next room. What should the nurse aide do?

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If you are providing care for a patient and hear a disturbing noise nearby, make sure your patient is safe before checking on what has happened. Calling for help is wise, in case there is a medical emergency. Return to your patient as soon as possible.

When caring for a home health client, all team members need to

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Home health care requires ongoing communication among all team members. Each person may provide specialized care, but with accurate charting and coordination with the case manager and each other, the client receives excellent care. For example, if the CNA knows that the speech therapist is coming at 10 am, the CNA makes sure the client is ready for the session, not taking a shower.

After you have visited a home health client, learned some new information about them, and want to talk about it, you should

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HIPAA privacy laws strictly protect a client's medical information. Only those who need the information to give care can have access. Discussing the client with your supervisor is acceptable. HIPAA also gives patients the right to restrict who can have access to their health information, even with family members. It is illegal to discuss clients with anyone not involved in client care.

Patients can suddenly become combative and hit a nurse aide. If this happens, you should _____.

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Patients can become aggressive or combative for several reasons. They may be angry at their situation or someone else. They may be confused or scared. Do not let them hurt you. Step out of the way and speak In a soft, reassuring way. Listen to their words and emotions, and try to find the cause of their behavior.

What are your legal and ethical responsibilities if you have access to medical records?

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HIPAA (Health Insurance Portability and Privacy Act) is the Federal law that protects a resident's privacy. This includes documentation, records, and communications. Information can only be shared with those who need it to provide treatment. There are severe penalties for sharing information, even if it is unintentional.

A patient's chart is a legal document. If something is mistakenly written on the chart, the correct action is to

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If you make a mistake, follow your facility’s policy for correction. Many times a single line through the mistake, with date, time, and your initials is acceptable. Never erase, black out, or use correction fluid.

It is okay to call a resident by a nickname if

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"Register" is the formality of speech, depending on the circumstances. It always applies to how you address someone. For example, you may first address a new client as "Mr. Smith" until he asks you to call him "Bob." Do not assume that because his family calls him "Bubba" that you can, too. All languages have register, and usually we know exactly how to switch from formal to informal.

A 22-year old with terminal brain cancer tells you that she has an Advanced Directive for her end-of-life care. You know this can mean any of the following EXCEPT

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Advanced directives describe the kind of medical treatment you want for yourself if you are in serious health condition or unable to speak for yourself. Anyone over age 18 can have an Advanced directive. Once in place, it is a legal document that cannot be revoked. A person can choose to have a Living Will, which lists the person's wishes regarding end-of-life care. The person can also designate someone who can make medical decisions if the person is unable to; this is called the Medical Power of Attorney. A person can also indicate they wish to be a DNR, or Do Not Resuscitate, patient if their heart stops beating or they stop breathing.

The intentional attempt or threat to touch a person's body without the person's consent is

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Assault is an intentional attempt or threat to touch someone without their consent. There does not need to be actual touching. If the person feels afraid of being harmed, assault can be charged, even if there was no possibility of being touched. A simple assault is when no harm is done. It is a misdemeanor. Aggravated assault happens when a child, elderly person, patient, or someone in a protected class is threatened. It is a serious felony charge.

A famous athlete has been admitted into your facility. He is in a different unit. If you want to find out why he is there, what should you do?

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All health care professionals must be trained in HIPAA regulations before beginning client care. Facilities are responsible for protecting client privacy at every level. It can be tempting to want to learn more about a certain client, and possible to do because you are an employee. But even basic information or a conversation violate HIPAA. You could lose your job for seeking information.

Using the phones in the nursing station for personal calls, except in an emergency is

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Personal phone calls during work hours takes you away from your job. It is also distracting to others. Each facility has a policy regarding using phones during work, including personal cell phones.

While you are at lunch with other nurse aides, they start to discuss how rude a resident was behaving. What should you do?

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HIPAA (Health Insurance Portability and Privacy Act) is the Federal law that protects a resident's privacy. This includes documentation, records, and communications. Information can only be shared with those who need it to provide treatment. There are severe penalties for sharing information, even if it is unintentional.

A standard of care is a way of ensuring that patients always are cared for by professionals who are everything EXCEPT

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A standard of care is what a reasonable and competent professional, with the same level of training, would do in the same situation. It means that you should be properly trained for the tasks your job. If you are not, then you can refuse to do a task until you are trained. This ensures that patients always received the highest quality of care. Being fast does not always equal being competent.

While bathing and doing a.m. cares on Mr. Jones you observe a large bruised area on his back, you should

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As a CNA, your responsibility is to notify the nurse of any new or unusual findings. When reporting or charting your observation, use only objective language, such as "a reddened area on the upper back, about two inches square." Do not say, "A big bruise on the back probably done by the lazy night shift."

A nurse aide forgets to raise the side-rails on a bed and the resident is injured from a fall. This is termed as

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Neglect occurs when a resident does not receive the proper level of care they need. It can be intentional or unintentional, but the effect is the same: the resident can be harmed both physically and psychologically. Putting residents in unsafe situations is neglect. Other examples of neglect include poor hygiene or nutrition, and leaving residents to try to take care of themselves. Both the employee and the facility are liable for neglect.

You observe a co-worker tying a resident to their wheelchair. What type of abuse is this?

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Physical abuse involves restricting movement of a resident. Physical restraints can only be applied with a physician's order. All abuse or suspected abuse must be reported. Every health care facility has a procedure for handling concerns about client care. If an incident involves a co-worker, notify the charge nurse. If a nurse aide observes the charge nurse in a situation that could be dangerous or neglectful for a resident, the nurse aide can go directly to the Nursing or Administrative Supervisor.

After caring for a resident for four hours, you are exhausted from hearing her ask to use the bathroom every 15 minutes. You should

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If a resident's situation is causing frustration, you may not stop giving care. .Tell the nurse or supervisor. The resident may have a medical problem, such as a urinary tract infection. Neglect occurs when a resident does not receive the proper level of care they need. Putting residents in unsafe situations is neglect. If she doesn't get proper assistance, she might try to go to the bathroom alone, risking a fall. Both the employee and the facility could be liable for neglect.

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