CNA Personal Care Skills 2

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TED hose (anti-embolism) are applied

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Elastic stockings, or anti-embolism stockings, are used for patients who have had surgery or are unable to ambulate. Make sure the size is correct for the patient before starting. Assist the patient to lie down in a supine position. The patient's feet and legs should be dry. Roll the stocking inside out all the way to the heel. Fit it on the foot and heel, then roll it up onto the patient's leg. Smooth any wrinkles and make sure the stockings are straight. Talcum powder can be helpful to prevent friction and rubbing on the skin.

Making sure that the client participates in normal activities of daily living such as getting dressed, brushing hair, and eating is

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Every client should be encouraged to be as independent and active as possible. Participating in their own ADL is important. Even clients who must remain in bed can often still participate in their care. They can move and turn in bed during the linen change. They can assist with their bed bath and perform their own oral care. The nurse aide should encourage the client to do as much as possible.

The patient who has suffered from a stroke usually _________.

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Following a stroke, paralysis occurs on the side of the body opposite the side of the brain where the stroke happened. 9 out of 10 stroke patients have some type of paralysis, which can require months or years of rehabilitation.

Which should you use to clean dentures?

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Keeping dentures clean is an important part of patient care. Always handle dentures carefully, because they are expensive. Before cleaning, place a paper towel or washcloth in the sink to provide a cushion in case the dentures fall. Hold the dentures over the sink and brush them with toothpaste or a denture cleaner, using a soft toothbrush. Rinse under running water.

Which is an appropriate task for a CNA?

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It is important for every health care professional to only perform tasks that are within the scope of practice. As a CNA, you are a valuable team member to contribute to a care plan conference. The other tasks are for the nurse.

A nurse aide can do any of these to help reduce a patient's pain level EXCEPT

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The CNA is not allowed to give any medications, but can use other ways to help a patient with pain relief. Non-medication methods have been shown to be effective ways to deal with pain. Distraction by listening to music or watching television can be effective. Breathing and relaxation techniques can be similar to meditation. Guided imagery is useful for visualizing pleasant and positive scenarios.

Which statement about sitz baths is true?

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A sitz bath cleans and soothes the perineum, promotes healing, and reduces pain. It is often recommended after rectal surgery or vaginal births. The water is about 100 degrees, at a level of about the navel. The sitz bath lasts about 15-20 minutes.

You are making an occupied bed. To remove the bottom linens, you should

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Always start by telling the resident what you are going to do. Raise the bed to a comfortable height. After removing the top blanket and sheet, cover the resident for warmth and privacy. Roll them to their side, with the opposite side rail up. Roll the dirty bottom linens tightly toward the patient, tucking them under the resident's shoulders, back, and feet. If the mattress is soiled, clean and dry. Place the clean linens on the bed, rolling to meet the dirty linens. Tell the resident they will be going over a bump and help them roll to the clean side, with the side rail up. Move to the other side of the bed to remove the dirty linens, clean and dry any soiled areas. and pull the clean linens into place, making sure they are smooth. tuck in all corners and place the clean top sheet and blanket.

Mr. Jones needs to be transferred from his bed to his wheelchair. What action must the nurse aid take?

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When transferring a patient to a wheelchair, the wheelchair must be locked before starting. The foot plates should be out of the way, and the floor should be free from obstacles. Position the wheelchair directly next to the bed (or toilet, chair, bench, etc.). An angle of 30-45 degrees is helpful. The patient should have non-slip footwear for the transfer.

When helping a client to eat, the first thing a CNA should do is

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Washing hands before eating is important for everyone. The CNA should wash their own hands, as well as the client's. A client's hands can be soiled from touching objects, as well as their noses and mouths between meals. Even if the client is being fed, they may touch the food or their mouths during the meal, increasing the risk of spreading germs. Be sure to wash under fingernails, which can carry the most germs.

Some clients have to be fed at meal times. Which is the correct procedure concerning feeding clients?

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Meals should be pleasant and unhurried for all clients. Food should be served at proper temperatures, so leave the tray in the food cart until you are ready to serve it. Since feeding a client can go slowly, allow sufficient time for the client to eat.

When helping a disabled person with ADLs, the nursing assistant should

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Every person should be encouraged to be as independent and active as possible. Participating in their own ADL is important, and often tasks can be adapted to accommodate disabilities. Even people who must remain in bed can often still participate in their care. They can move and turn in bed during the linen change.

When helping a client use the commode, it is essential that

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After helping a client to the commode, 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 their care givers. Restraints may never be applied without an order from the client's doctor.

Your patient is on bed rest. You can help prevent development of contractures by

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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. 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. Supportive devices, such as splints, wedges, and bedrolls can maintain alignment and position. Proper body alignment is also important.

Before giving a back rub, the bottle of lotion can be placed in a basin of hot water for several minutes so that

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Lotion should be warmed before applying it to a patient's back. You can rub it between your hands or place it in hot water to get it warm.

Aids to position a patient include all the following except

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To help position a patient, a variety of items and devices can be used. To prop the patient on their sides or to keep knees and ankles from rubbing together, use blankets and pillows. A washcloth can be rolled to place in the hand of a stroke patient to maintain a natural position. Roll a blanket to make a trochanter roll to support the paralyzed side of a patient's body. A footboard is used to prevent footdrop; the patient's foot is placed against it to maintain flexion, as if the patient were standing.

If a resident refuses a bath, the nurse aide should

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If a resident is competent, they can refuse care or treatment. A resident who has dementia may simply need a different approach to bathing that day. In either case, try to reschedule the shower or offer a bed bath. If the resident continues to refuse, document what was offered. If the resident gave a reason, include their statement. The nurse aide should show that care was offered and refused, not that the care was skipped.

What is important to know about making an occupied bed?

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Always start by telling the resident what you are going to do. Raise the bed to a comfortable height. After removing the top blanket and sheet, cover the resident for warmth and privacy. Roll them to their side, with the opposite side rail up. Roll the dirty bottom linens tightly toward the patient, tucking them under the resident's shoulders, back, and feet. If the mattress is soiled, clean and dry. Place the clean linens on the bed, rolling to meet the dirty linens. Tell the resident they will be going over a bump and help them roll to the clean side, with the side rail up. Move to the other side of the bed to remove the dirty linens, clean and dry any soiled areas. and pull the clean linens into place, making sure they are smooth. tuck in all corners and place the clean top sheet and blanket.

Which device does NOT make toileting easier?

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Residents should be encouraged to be as independent as possible, including when they use the toilet. There are many aids which make transferring, sitting, and standing easier. An elevated seat is more comfortable and requires less leg strength. Grab bars let the resident pull themself up and maintain balance. Bedside commodes are useful for residents who are unable to walk to the bathroom.

Proper oral hygiene _______________.

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Oral hygiene is important for several reasons. The primary purpose is to keep teeth, gums, and mouth healthy, free from decay or infection. Research shows that it also can help prevent heart disease, memory loss, and autoimmune disease.

When a patient is receiving nasogastric (NG) tube feeding, what should the nursing assistant do?

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A nasogastric (NG) tube is a tube that is passed through the nose into the stomach. One of the uses of an NG tube is feeding on a short-term basis. When a patient is receiving nourishment via the NG tube, the head of the bed is raised to reduce the chance of choking or aspiration. The patient must be observed for signs of choking, nausea, vomiting, and regurgitation of the liquid food. Excellent oral care is necessary for the patient during the time that the tube is in place.

A contracture is caused by

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A contracture is a deformity that develops when muscles, joints, and connective tissue become stiff from lack of active exercise. It prevents the normal movement of the joints. The muscles get shorter, so arms or legs are unable to straighten. Some causes are paralysis, from stroke or injury, cerebral palsy, or muscular dystrophy. Range of motion exercises are essential to prevent contractures.

To clean a resident's eyeglasses, what should you do?

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The best way to clean eyeglasses is with warm water and a drop of liquid dish soap on each lens. Don't use soap that contains lotion. Gently rub both sides of each lens, as well as the nose piece and frame. Rinse with warm water. Dry carefully with a microfiber towel or a soft, clean cloth.

Mr. Mac begins to fall as you are ambulating him. The first thing you do is

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If a patient begins to fall while walking or standing, do not try to catch them or prevent the fall. Control the fall by easing them to the floor. This prevents injury to both the patient and the CNA. It also allows you to protect the patient's head from hitting the floor or an object. Stay with the patient until help arrives.

To give your residents complete privacy, you should

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Privacy is a basic right for all residents. Privacy can be physical, as when closing the curtain each time when giving care. It can also protect resident information and medical history.

When giving a bed bath, the last area to be cleaned is the

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When giving a bed bath, the perineum is the last area to be washed. After bathing the patient's body, empty the basin and refill with warm water. Place a towel under the patient's hips and buttocks. For females, wash front to back, from labia to perineum. For males, wash the penis and scrotum. For both genders, turn the patient on their side to wash the buttocks and anal area. Dry the area well.

When giving a back rub, the nurse aide should __________.

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Back rubs can promote relaxation, while giving you a chance to observe the resident's skin. Although you will warm the lotion in your hands, the resident may feel chilled during the back rub. Cover the resident with a bath blanket for warmth and privacy. Expose the area being massaged, then return the blanket when finished.

Why do residents with Parkinson's disease require assistance when walking?

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Parkinson's disease is a chronic movement disorder that gets worse over time. Patients develop tremors in the hands, arms, legs, and face. They walk slowly with a shuffling gait. About 70% of patients fall because of balance problems, so assisting them when walking may be necessary.

Which of the following is true about caring for a resident who wears a hearing aid?

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Hearing aids are expensive devices and care must be taken to avoid getting them wet. If a hearing aid does accidentally get wet, turn it off and remove the battery. Dispose of the battery. Open the battery door and allow the battery to completely dry out, which can take a day or two. Insert a new battery before using it again.

When applying anti-embolism hose (TED), it is important to remember that the _______.

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Compression stockings or anti-embolism hose help prevent blood clots and swelling. Make sure the size is correct for the patient before starting. Assist the patient to lie down in a supine position. The patient's feet and legs should be dry. Roll the stocking inside out all the way to the heel. Fit it on the foot and heel, then roll it up onto the patient's leg. Smooth any wrinkles and make sure the stockings are straight. Talcum powder can be helpful to prevent friction and rubbing on the skin. Hint: wearing gloves can help you grip the hose better and smooth out the wrinkles. Wrinkles can cause pain and pressure that can damage skin.

Mr. Hawkins tells you that his hearing aid isn't working properly. The first thing that you should do is _________.

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When a device, such as a hearing aid, does not seem to be working, begin by checking to see if it is turned on, if the volume is correct, and if the battery is inserted properly. Often the solution is something simple that the patient has overlooked. If it still doesn't work, try a new battery. Finally, tell the nurse.

A stroke patient with a paralyzed left arm may be able to feed himself if he uses

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After a stroke, patients can learn to feed themselves by trying different products. Special silverware with larger handles are easier to grip. Added-weight flatware can stabilize tremors. Angled and open-handled flatwear are two more options. Plates with suction cups and higher edges or guards keep dinnerware in place as the patient pushes food against the side of the plate. Physical and occupational therapists can work with patients to find what is best.

When feeding a resident, frequent coughing can be a sign the resident is _______.

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If a resident is coughing frequently when eating, report it to the nurse. It could be a sign of a swallowing disorder (dysphagia). Other signs are extra time or effort needed to chew or swallow; food leaking from the mouth or getting stuck in the mouth; and a "gurgly" voice after eating or drinking. Some residents may lose weight because they can't eat enough.

When providing foot care to a diabetic resident it is important for the nurse aide to _________.

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Check the feet of diabetics daily and report any signs of skin breakdown or injury. 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. Feet must be clean and dry, especially between the toes. Diabetics need expert care from a podiatrist or a qualified foot care professional.

Mr. Francis is blind. When ambulating him, you should walk ________.

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When assisting a client who is blind or has low vision, allow them to hold your arm so you can guide them. Touch the back of your hand to the back of theirs, so they can move their hand and locate your upper arm. They should hold on above your elbow, and walk half a step behind you. Walk at a pace that is comfortable for both of you.

To protect a patient’s skin when moving them up in bed, you should _______.

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Use a draw or lift sheet to move a patient up in bed. Two people are required to move the patient. Explain to the patient what you are going to do. Lower the head of the bed to a flat position. Roll the patient to one side and place a rolled draw sheet as far as possible under the patient. Roll the patient to the other side to pull out the draw sheet. If possible, ask the patient to bend their legs. On a count of three, lift the patient up in bed. Roll the patient to remove the draw sheet and elevate the head of the bed.

Urinary incontinence is a predisposing factor to

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Exposure to feces and urine is one of the most common causes for skin irritation and breakdown. Thorough cleaning after a client has had an incontinent episode is important for several reasons. If perineal skin stays wet, it becomes waterlogged and fragile. Urine contains ammonia, a harsh chemical that damages skin. Many clients have dry skin which can develop tiny cracks, allowing bacteria to enter the body. Clean the client, dry the area, and apply a barrier ointment to minimize any future contact by feces and urine.

Your client has a fractured hip. The best way to turn is to _________.

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Always check with the nurse before turning or moving a patient with a fractured hip. Following hip surgery, the client should be positioned to maintain natural alignment of the leg. A pillow or wedge is placed between the legs keeps the legs in the correct position. Ankles and legs cannot be crossed, and toes should point toward the ceiling. The hip should not be rotated inwards or outwards. The client can never lie on the non-operative side.

Why should you wash a resident’s hands before a meal, even when you are feeding her?

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Washing hands before eating is important for everyone. A resident's hands can be soiled from touching objects, as well as their noses and mouths between meals. Even if the resident is being fed, they may touch the food or their mouths during the meal, increasing the risk of spreading germs. Be sure to wash under fingernails, which carry the most germs.

When cleaning a male's genital area during perineal care, the nurse aide should

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Male perineal care begins by washing the inner thighs and inguinal area. The penis is washed first, starting at the tip. If the man is uncircumcised, retract the foreskin to clean the tip of the penis. Return the foreskin after washing; if it is not returned, it can tighten around the shaft, causing pain. Wash the shaft of the penis, then the scrotum. Roll the man to his side to wash the outer buttocks, then the inner buttocks and rectal area.

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