CNA Supporting Rehabilitation Activities 2 — Questions and Answers
Question 1: A patient is working with physical therapy to regain the ability to walk after a hip replacement. How should the CNA support this goal during daily care?
- Do everything for the patient to let them rest and heal faster
- Encourage and allow the patient to perform as much activity as they are able, per the care plan (Correct answer)
- Limit all mobility until the physical therapist is present
- Substitute the CNA's judgment for the physical therapist's plan
Correct answer: Encourage and allow the patient to perform as much activity as they are able, per the care plan
Rehabilitation is most effective when encouraged throughout the day, not only during formal therapy sessions. The CNA reinforces the therapy plan during ADLs.
Restorative care principles recognize that the CNA sees the patient far more than the therapist does. By encouraging the patient to do as much as they safely can during daily activities — self-feeding, dressing, grooming — the CNA reinforces neuromotor relearning and builds functional strength. The care plan specifies the level of assistance required.
Question 2: What is restorative care?
- Care that restores the facility to its original condition after patient discharge
- Nursing care focused on returning patients to acute hospital status
- A care approach that maintains or improves a patient's functional abilities and independence (Correct answer)
- Care provided only by licensed physical therapists
Correct answer: A care approach that maintains or improves a patient's functional abilities and independence
Restorative care focuses on helping patients maintain or improve their ability to perform daily functions independently, delaying decline.
Restorative care is a philosophy and set of techniques aimed at preventing avoidable functional decline. CNAs providing restorative care use a 'do with, not for' approach — guiding and assisting patients to perform tasks at the highest level they are capable of, rather than performing all tasks for them. This maintains muscle strength, self-efficacy, and quality of life.
Question 3: A patient recovering from a stroke has been instructed to use their affected arm during self-care. They ask the CNA to do everything for them because it is frustrating. What should the CNA do?
- Perform all tasks for the patient to reduce frustration
- Acknowledge the frustration, encourage the effort, and follow the therapy team's instructions to involve the affected arm (Correct answer)
- Contact the physician to change the care plan
- Allow the patient to choose not to participate in rehabilitation
Correct answer: Acknowledge the frustration, encourage the effort, and follow the therapy team's instructions to involve the affected arm
Empathizing with frustration while following the established rehabilitation plan supports recovery. CNAs play a key role in motivating patients through difficult therapy activities.
Stroke rehabilitation often requires repetitive, effortful use of the affected side to promote neural plasticity. Avoiding the affected side leads to 'learned non-use,' a significant barrier to recovery. The CNA should validate the patient's feelings, offer encouragement, and maintain the therapy team's approach. Concerns about the patient's distress should be communicated to the nurse.
Question 4: Which of the following is a sign that a patient may be overdoing activity during rehabilitation?
- The patient completes the activity without assistance
- The patient reports mild fatigue after the activity
- The patient becomes pale, short of breath, or reports chest pain during activity (Correct answer)
- The patient requests to rest for five minutes mid-activity
Correct answer: The patient becomes pale, short of breath, or reports chest pain during activity
Pallor, shortness of breath, and chest pain during activity are warning signs of cardiovascular or respiratory distress requiring immediate cessation of activity and nursing notification.
Mild fatigue and the need for brief rest are normal during rehabilitation. However, pallor, diaphoresis (sweating), significant shortness of breath, chest pain, or sudden dizziness indicate the patient has exceeded safe activity tolerance. The CNA must stop the activity, ensure the patient is safe, and immediately notify the nurse.
Question 5: What is the role of the CNA in a patient's interdisciplinary rehabilitation team?
- The CNA has no formal role in the interdisciplinary team
- To lead the team meetings and coordinate therapy schedules
- To implement the care plan, provide daily restorative assistance, and report observations to the team (Correct answer)
- To modify therapy goals based on patient feedback
Correct answer: To implement the care plan, provide daily restorative assistance, and report observations to the team
The CNA's role on the interdisciplinary team is to implement care plans, carry out restorative activities, and communicate patient observations to inform team decisions.
Interdisciplinary teams include nurses, physicians, physical/occupational/speech therapists, social workers, and CNAs. The CNA provides invaluable observational data about daily function, patient motivation, and progress between therapy sessions. This information helps the team refine goals and interventions. CNAs typically attend care conferences and contribute their observations.
Question 6: How should a CNA document a patient's participation in rehabilitation activities?
- Only note if the patient refused to participate
- Record the level of assistance provided, patient's effort and tolerance, and any concerns observed (Correct answer)
- Document only after the physical therapist countersigns
- No documentation is needed for routine ADL assistance
Correct answer: Record the level of assistance provided, patient's effort and tolerance, and any concerns observed
Accurate documentation of assistance level, effort, and patient response creates a record that tracks rehabilitation progress and informs care planning.
Rehabilitation documentation by the CNA typically uses a standardized assistance level scale (independent, supervision, minimal assist, moderate assist, maximum assist, dependent). Recording patient effort (cooperative, resistant, fatigued) and any concerns (reported pain, unusual shortness of breath) provides the clinical team with data for progress evaluation and care plan modification.
CNA Supporting Rehabilitation Activities 2
A patient is working with physical therapy to regain the ability to walk after a hip replacement.
How should the CNA support this goal during daily care?