Assisting with Daily Living Flashcards

A CNA is assisting a resident with hemiplegia during dressing. The resident becomes frustrated and insists on attempting to button their shirt independently despite significant difficulty. Which action best balances resident autonomy with safe care?

Answer: Allow the resident to attempt buttoning independently, intervening only if they request help or show signs of distress

Resident autonomy and the right to attempt self-care are fundamental to person-centered care. The CNA should encourage independence and only intervene when requested or when safety is at risk. Completing the task for them undermines dignity and rehabilitation goals; suggesting adaptive clothing without consent bypasses autonomy; and the resident has not refused care — they're attempting it independently.

While assisting a resident with oral hygiene, the CNA notices the resident has several loose teeth and bleeding gums. The resident states this is normal for them. What is the most appropriate CNA response?

Answer: Proceed with oral hygiene using a soft-bristle brush and report the findings to the nurse after completing care

CNAs must complete necessary care while reporting abnormal findings to the nurse — loose teeth and bleeding gums are signs requiring clinical evaluation. Skipping oral care neglects the resident's hygiene needs; a firmer brush would worsen bleeding; and family confirmation is not the appropriate reporting chain — the nurse must be notified.

A cognitively intact resident with severe arthritis prefers a bath every other day rather than daily. The care plan specifies daily bathing. How should the CNA handle this conflict?

Answer: Document the resident's stated preference and report it to the charge nurse for a potential care plan revision

A cognitively intact resident has the right to express preferences about their care. However, CNAs cannot unilaterally change care plans — they must report the resident's preference to the nurse so the care plan can be formally revised through the interdisciplinary team. Ignoring the preference violates resident rights; changing the plan independently exceeds the CNA's scope; and making unauthorized modifications without reporting is improper.

During a meal, a resident with dysphagia on a pureed diet requests to try a piece of regular bread from another resident's tray, stating they are 'tired of the mushy food.' The CNA should:

Answer: Refuse the request, distract the resident with another topic, and report the incident to the nurse

Dysphagia diet restrictions exist to prevent aspiration, a potentially life-threatening complication. The CNA must not allow diet changes that violate physician or speech therapist orders, even at the resident's request. The nurse must be informed so the care team can address the resident's dissatisfaction appropriately — possibly through a dietary consult. Distraction is a compassionate interim measure. Family consultation delays critical safety communication to the appropriate clinician.

A resident who is typically independent in grooming has been spending increasingly long periods staring at their reflection in the mirror during morning care and has stopped styling their hair over the past week. The CNA should FIRST:

Answer: Document the observed behavioral change and report it to the nurse as a possible change in condition

A change in a resident's typical behavior — particularly withdrawal from self-care routines and social disengagement — can be an early sign of depression, cognitive decline, or other medical/psychological changes. CNAs are required to report changes in condition to the nurse promptly. Documentation and reporting take priority before interventions like activities referrals, which bypass the clinical chain of command.

A male resident tells his CNA that he wants to shave himself but has been started on warfarin (Coumadin) therapy. The resident has no documented cognitive impairment and his grip strength is intact. Which is the safest approach?

Answer: Provide an electric razor for the resident to use independently and notify the nurse of the resident's request

Residents on anticoagulant therapy such as warfarin are at elevated risk for uncontrolled bleeding from cuts. An electric razor significantly reduces laceration risk while preserving the resident's independence and right to self-care. The CNA should offer this safer alternative and notify the nurse so it can be documented in the care plan. Using a straight or safety razor is contraindicated with anticoagulants; doing it for the resident overrides their autonomy unnecessarily; and family consent is not required for a cognitively intact adult.