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24 Cards in this Set

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washes hands
Address client by name and introduces self to client
by name
2 Turns on water at sink
3 Wets hands and wrists thoroughly
4 Applies soap to hands
5 BOLD Lathers all surfaces of wrists, hands, and fingers,
producing friction for at least 15 (fifteen) seconds
6 Cleans fingernails by rubbing fingertips against palms
of the opposite hand
7 After lathering for at least 15 seconds, rinses all
surfaces of wrists, hands, and fingers keeping hands
lower than the elbows and the fingertips down
8 Uses clean, dry paper towel to dry all surfaces of
hands, wrists, and fingers then disposes of paper towel
into waste container
9 Uses clean, dry paper towel to turn off faucet then
disposes of paper towel into waste container or uses
knee/foot control to turn off faucet
10 Does not touch inside of sink at any time
5 CRITICAL STEP: BOLD Lathers all surfaces of wrists, hands, and fingers,
producing friction for at least 15 (fifteen) seconds
TED hose elastic stocking
1 Explains procedure, speaking clearly, slowly,
and directly, maintaining face-to-face contact
whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Client is in supine position (lying down in bed) while
stocking is applied
4 Turns stocking inside-out
5 Places foot of stocking over toes, foot, and heel
6 Pulls top of stocking over foot, heel, and leg
7 Moves foot and leg gently and naturally, avoiding
force and over-extension of limb and joints
Skill continues
8 BOLD Finishes procedure with no twists or wrinkles
and heel of stocking (if present) is over heel and
opening in toe area (if present) is either over
or under toe area (Evaluator: If stocking toe is
completely open, or if client has large foot, it is
okay if toes go through opening)
9 Signaling device is within reach and bed is in low
position
10 Washes hand
8 BOLD Finishes procedure with no twists or wrinkles
and heel of stocking (if present) is over heel and
opening in toe area (if present) is either over
or under toe area (Evaluator: If stocking toe is
completely open, or if client has large foot, it is
okay if toes go through opening)
ASSISTS TO AMBULATE USING TRANSFER BELT
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 BOLD Before assisting to stand, candidate ensures client is
wearing shoes
3 Before assisting to stand, bed is at a safe level
4 Before assisting to stand, checks and/or locks bed
wheels
5 Before assisting to stand, client is assisted to sitting
position with feet flat on the floor
6 Before assisting to stand, applies transfer belt securely
over clothing/gown
7 Before assisting to stand, provides instructions
to enable client to assist in standing including
prearranged signal to alert client to begin standing
8 Stands facing client positioning self to ensure safety of
candidate and client during transfer. Counts to three
(or says other prearranged signal) to alert client to
begin standing
9 On signal, gradually assists client to stand by grasping
transfer belt on both sides with an upward grasp
(candidate’s hands are in upward position), and
maintaining stability of client’s legs
10 Walks slightly behind and to one side of client for a
distance of ten (10) feet, while holding onto the belt
11 After ambulation, assists client to bed and removes
transfer belt
12 Signaling device is within reach and bed is in low
position
13 Washes hands
BOLD Before assisting to stand, candidate ensures client is
wearing shoes
ASSISTS WITH USE OF BEDPAN
1 Explains procedure speaking clearly, slowly, and directly,
maintaining face-to-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Before placing bedpan, lowers head of bed
4 Puts on clean gloves before handling bedpan
5 BOLD Places bedpan correctly under client’s buttocks
6 Removes and disposes of gloves (without contaminating
self) into waste container and washes hands
7 After positioning client on bedpan and removing
gloves, raises head of bed
8 Toilet tissue is within reach
9 Hand wipe is within reach and client is instructed to
clean hands with hand wipe when finished
10 Signaling device within reach and client is asked to
signal when finished
11 Puts on clean gloves before removing bedpan
12 Head of bed is flat before bedpan is removed
13 Avoids overexposure of client
14 Removes, empties, and rinses bedpan and pours rinse
into toilet
15 After rinsing bedpan, places bedpan in designated
dirty supply area
16 After placing bedpan in designated dirty supply area,
removes and disposes of gloves (without contaminating
self) into waste container and washes hands
17 Signaling device is within reach and bed is in low
position
5 BOLD Places bedpan correctly under client’s buttocks
RADIAL PULSE
COUNTS AND RECORDS RADIAL PULSE*
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Places fingertips on thumb side of client’s wrist to
locate radial pulse
3 Count beats for one full minute
4 Signaling device is within reach
5 Washes hands
6 After obtaining pulse by palpating in radial artery
position, records pulse rate within plus or minus 4
beats of evaluator’s reading
* Count for one full minute
BOLD After obtaining pulse by palpating in radial artery
position, records pulse rate within plus or minus 4 beats of evaluator’s reading

* Count for one full minute.
COUNTS AND RECORDS RESPIRATIONS
COUNTS AND RECORDS RESPIRATIONS*
1 Explains procedure (for testing purposes), speaking
clearly, slowly, and directly, maintaining face-to-face
contact whenever possible
2 Counts respirations for one full minute
3 Signaling device is within reach
4 Washes hands
5 Records respiration rate within plus or minus 2
breaths of evaluator’s reading
* Count for one full minute. For testing purposes you
may explain to the client that you will be counting the
respirations. For testing purposes you
may explain to the client that you will be counting the
respirations
Records respiration rate within plus or minus 2
breaths of evaluator’s reading
* Count for one full minute.
DRESSES CLIENT WITH AFFECTED (WEAK)
RIGHT ARM
DRESSES CLIENT WITH AFFECTED (WEAK)
RIGHT ARM
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Asks which top he/she would like to wear and dresses
him/her in top of choice
4 While avoiding overexposure of client, removes gown
from the unaffected side first, then removes gown
from the affected side
5 Assists to put the right (affected/weak) arm through
the right sleeve of the top before placing garment
on left (unaffected) arm
6 While putting on items, moves body gently and
naturally, avoiding force and over-extension of limbs
and joints
7 Finishes with clothing in place
8 Disposes of gown into soiled linen container
9 Signaling device is within reach and bed is in low
position
10 Washes hands
BOLD Assists to put the right (affected/weak) arm through
the right sleeve of the top before placing garment
on left (unaffected) ar
FEEDS CLIENT WHO CANNOT FEED SELF
FEEDS CLIENT WHO CANNOT FEED SELF
1 Explains procedure to client, speaking clearly,
slowly, and directly, maintaining face-to-face contact
whenever possible
2 Before feeding, candidate picks up name card from
tray and asks client to state name
3 Before feeding client, client is in an upright sitting
position (45-90 degrees)
4 Places tray where it can be easily seen by client
5 Client’s hands are cleaned with hand wipe before
beginning feeding
6 Candidate sits facing client during feeding
7 Tells client what foods are on tray and asks what client
would like to eat first
8 Using spoon, offers client one bite of each type of food
on tray, telling client the content of each spoonful
9 Offers beverage at least once during meal
10 Makes sure client’s mouth is empty before offering
next bite of food or sip of beverage
11 At end of meal, client’s mouth is wiped and hands are
cleaned with hand wipe
12 Removes food tray and places tray in designated dirty
supply area
13 Signaling device is within client’s reach
14 Washes hands
BOLD Before feeding client, client is in an upright sitting
position (45-90 degrees)
BLOOD PRESSURE B/P
MEASURES AND RECORDS BLOOD PRESSURE*
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Before using stethoscope, wipes bell/diaphragm and
earpieces of stethoscope with alcohol
3 Client’s arm is positioned with palm up and upper
arm is exposed
4 Feels for brachial artery on inner aspect of arm, at
bend of elbow
5 Places blood pressure cuff snugly on client’s upper
arm, with sensor/arrow over brachial artery site
6 Earpieces of stethoscope are in ears and bell/
diaphragm is over brachial artery site
7 Candidate does one of the following: a. Inflates cuff
between 160 mm Hg to 180 mm Hg. (If beat heard
immediately upon cuff deflation, completely deflate
cuff.) Re-inflate cuff to no more than 200 mm Hg.
OR b. Inflates cuff 30 mm Hg beyond where radial
or brachial pulse was last heard or felt
8 Deflates cuff slowly and notes the first sound
(systolic reading), and last sound (diastolic reading)
(If rounding needed, measurements are rounded UP
to the nearest 2 mm of mercury)
9 Removes cuff
10 Signaling device is within reach
11 Washes hands
12 After obtaining reading using BP cuff and
stethoscope, records both systolic and diastolic
pressures each within plus or minus 8 mm of
evaluator’s reading
* This is a one-step blood pressure procedure. However, if
a candidate correctly performs a two-step blood pressure
procedure that includes step 7b, the candidate will not be
penalized and will be given credit for step 7.
BOLD After obtaining reading using BP cuff and
stethoscope, records both systolic and diastolic
pressures each within plus or minus 8 mm of
evaluator’s reading
MEASURES AND RECORDS URINARY OUTPUT
1 Puts on clean gloves before handling bedpan
2 Pours the contents of the bedpan into measuring
container without spilling or splashing urine outside
of container
3 Measures the amount of urine at eye level with
container on flat surface
4 After measuring urine, empties contents of measuring
container
5 Rinses measuring container and pours rinse into toilet
6 Rinses bedpan and pours rinse into toilet
7 After rinsing equipment, and before recording
output, removes and disposes of gloves (without
contaminating self ) into waste container and washes
hands
8 Records contents of container within plus or minus
25 ml/cc of evaluator’s reading
BOLD Records contents of container within plus or minus
25 ml/cc of evaluator’s reading
PERFORMS PASSIVE RANGE OF MOTION
( PROM ) FOR ONE KNEE AND ONE ANKLE
(PROM) FOR ONE KNEE AND ONE ANKLE
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Instructs client to inform nurse aide if pain is
experienced during exercise
4 Supports leg at knee and ankle while performing range
of motion for knee
5 Bends the knee and then returns leg to client’s normal
position (extension/flexion) (AT LEAST 3 TIMES
unless pain is verbalized)
6 Supports foot and ankle close to the bed while
performing range of motion for ankle
7 Pushes/pulls foot toward head (dorsiflexion), and
pushes/pulls foot down, toes point down (plantar
flexion) (AT LEAST 3 TIMES unless pain is
verbalized)
8 While supporting the limb, moves joints gently,
slowly, and smoothly through the range of motion,
discontinuing exercise if client verbalizes pain
9 Signaling device is within reach and bed is in low
position
10 Washes hands
BOLD While supporting the limb, moves joints gently,
slowly, and smoothly through the range of motion,
discontinuing exercise if patient verbalizes pain
MEASURES AND RECORDS
WEIGHT OF AMBULATORY CLIENT
WEIGHT OF AMBULATORY CLIENT
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Candidate ensures client has shoes on before walking
to scale
3 Sets scale to zero before weighing client
4 While client steps onto scale, candidate stands next to
scale and assists client, if needed, onto center of scale,
then determines client’s weight
5 While client steps off scale, candidate stands next
to scale and assists client, if needed, off scale before
recording weight
6 Records weight based on indicator on scale. Weight
is within plus or minus 2 lbs of evaluator’s reading
(If weight recorded in kg weight is within plus or
minus 0.9 kg of evaluator’s reading)
7 Washes hands
While client steps off scale, candidate stands next
to scale and assists patient, if needed, off scale before
recording weight
BOLD:
Records weight based on indicator on scale. Weight
is within plus or minus 2 lbs of evaluator’s reading
(If weight recorded in kg weight is within plus or
minus 0.9 kg of evaluator’s reading
PROVIDES MOUTH CARE
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Before providing mouth care, client is in upright
sitting position (45-90 degrees)
4 Puts on clean gloves before cleaning mouth
5 Places clothing protector across chest before providing
mouth care
6 Moistens toothbrush
7 Applies toothpaste to toothbrush
8 Cleans mouth (including tongue and surfaces of
teeth) using gentle motions
9 Maintains clean technique with placement of
toothbrush
10 Holds emesis basin to chin while client rinses mouth
11 Wipes mouth and removes clothing protector
12 Empties, rinses, and dries basin
13 Places used toothbrush in basin
14 After rinsing basin, places basin in designated dirty
supply area
15 Disposes of clothing protector appropriately
16 After placing basin in designated dirty supply area,
and disposing of used linen, removes and disposes
of gloves (without contaminating self ) into waste
container and washes hands
17 Signaling device is within reach and bed is in low
position
Cleans mouth (including tongue and surfaces of
teeth) using gentle motions
FEMALE PERI CARE
PROVIDES PERINEAL CARE (PERI-CARE)
FOR FEMALE
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Before washing checks water temperature for safety
and comfort and asks client to verify comfort of water
4 Puts on clean gloves before washing perineal area
5 Places pad/linen protector under perineal area before
washing
6 Exposes perineal area while avoiding overexposure of
client
7 Applies soap to wet washcloth
8 Washes genital area, moving from front to back,
while using a clean area of the washcloth for each
stroke
9 Using clean washcloth, rinses soap from genital
area, moving from front to back, while using a
clean area of the washcloth for each stroke
10 Dries genital area moving from front to back with
towel
11 After washing genital area, turns to side, then washes
and rinses rectal area moving from front to back using
a clean area of washcloth for each stroke. Dries with
towel
12 Repositions client
13 Empties, rinses, and dries basin
14 After rinsing basin, places basin in designated dirty
supply area
15 Disposes of used linen into soiled linen container and
disposes of linen protector appropriately
16 Avoids contact between candidate clothing and used
linen
17 After disposing of used linen, and placing used
equipment in designated dirty supply area, removes
and disposes of gloves (without contaminating self )
into waste container and washes hands
18 Signaling device is within reach and bed is in low
position
8 BOLD Washes genital area, moving from front to back,
while using a clean area of the washcloth for each
stroke
9 BOLD Using clean washcloth, rinses soap from genital
area, moving from front to back, while using a
clean area of the washcloth for each stroke
10 Dries genital area moving from front to back with
towel
11 After washing genital area, turns to side, then washes
and rinses rectal area moving from front to back using
a clean area of washcloth for each stroke. Dries with
towel
TRANSFERS FROM BED TO WHEELCHAIR
USING TRANSFER BELT
TRANSFERS FROM BED TO WHEELCHAIR
USING TRANSFER BELT
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Before assisting to stand, wheelchair is positioned
along side of bed, at head of bed, and facing the foot
of the bed
4 Before assisting to stand, footrests are folded up or
removed
5 Before assisting to stand, bed is at a safe level
6 Before assisting to stand, locks wheels on
wheelchair
7 Before assisting to stand, checks and/or locks bed
wheels
8 Before assisting to stand, client is assisted to a sitting
position with feet flat on the floor
9 Before assisting to stand, candidate ensures client is
wearing shoes
10 Before assisting to stand, applies transfer belt securely
over clothing/gown
11 Before assisting to stand, provides instructions to
enable client to assist in transfer including prearranged
signal to alert when to begin standing
12 Stands facing client positioning self to ensure safety of
candidate and client during transfer. Counts to three
(or says other prearranged signal) to alert client to
begin standing
13 On signal, gradually assists client to stand by grasping
transfer belt on both sides with an upward grasp
(candidates hands are in upward position) and
maintaining stability of client’s legs
14 Assists client to turn to stand in front of wheelchair
with back of client’s legs against wheelchair
15 Lowers client into wheelchair
16 Positions client with hips touching back of wheelchair
and transfer belt is removed
17 Positions feet on footrests
18 Signaling device is within reach
19 Washes hands
6 BOLD Before assisting to stand, locks wheels on
wheelchair
DONNING AND REMOVING PPE
(GOWN AND GLOVES)
1 Picks up gown and unfolds
2 Facing the back opening of the gown places arms
through each sleeve
3 Fastens the neck opening
4 Secures gown at waist making sure that back of
clothing is covered by gown (as much as possible)
5 Puts on gloves
6 Cuffs of gloves overlap cuffs of gown
7 With one gloved hand, grasps the other glove at the
palm, pulls glove off
8 Slips fingers from ungloved hand underneath cuff of
remaining glove at wrist, and removes glove turning it
inside out as it is removed
9 Disposes of gloves into designated waste container
without contaminating self
10 After removing gloves, unfastens gown at neck and
waist
11 Removes gown without touching outside of gown
12 While removing gown, holds gown away from body,
turns gown inward and keeps it inside out
13 Disposes of gown in designated container without
contaminating self
14 Washes hands
GIVES MODIFIED BED BATH
(FACE AND ONE ARM, HAND AND
UNDERARM)
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Removes gown while keeping client covered
4 Before washing, checks water temperature for safety
and comfort and asks client to verify comfort of water
5 Puts on clean gloves before washing client
6 Beginning with eyes, washes eyes with wet washcloth
(no soap), using a different area of the washcloth for
each eye, washing inner aspect to outer aspect then
proceeds to wash face
7 Dries face with towel
8 Exposes one arm and places towel underneath arm
9 Applies soap to wet washcloth
10 Washes arm, hand, and underarm, keeping rest of
body covered
11 Rinses and dries arm, hand, and underarm
12 Moves body gently and naturally, avoiding force and
over-extension of limbs and joints
13 Puts clean gown on client
14 Empties, rinses, and dries basin
15 After rinsing basin, places basin in designated dirty
supply area
16 Disposes of used gown and linen into soiled linen
container
17 Avoids contact between candidate clothing and used
linens
18 After placing basin in designated dirty supply area, and
disposing of used linen, removes and disposes of gloves
(without contaminating self ) into waste container and
washes hands
19 Signaling device is within reach and bed is in low
position
MAKES AN OCCUPIED BED
(CLIENT DOES NOT NEED ASSISTANCE TO
TURN)
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Lowers head of bed before moving client
4 Client is covered while linens are changed
5 Loosens top linen from the end of the bed
6 Raises side rail on side to which client will move and
client moves toward raised side rail
7 Loosens bottom used linen on working side and moves
bottom used linen toward center of bed
8 Places and tucks in clean bottom linen or fitted
bottom sheet on working side and tucks under client
9 Before going to other side, client moves back onto
clean bottom linen
10 Raises side rail then goes to other side of bed
11 Removes used bottom linen
12 Pulls and tucks in clean bottom linen, finishing with
bottom sheet free of wrinkles
13 Client is covered with clean top sheet and bath
blanket/used top sheet has been removed
14 Changes pillowcase
15 Linen is centered and tucked at foot of bed
16 Avoids contact between candidate’s clothing and used
linen
17 Disposes of used linen into soiled linen container and
avoids putting linen on floor
18 Signaling device is within reach and bed is in low
position
19 Washes hands
PERFORMS PASSIVE RANGE OF MOTION
(PROM) FOR ONE SHOULDER
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Instructs client to inform nurse aide if pain is
experienced during exercise
4 Supports client’s arm at elbow and wrist while
performing range of motion for shoulder
5 Raises client’s straightened arm from side position
upward toward head to ear level and returns arm down
to side of body (extension/flexion) (AT LEAST 3
TIMES unless pain is verbalized)
6 Moves client’s straightened arm away from the side
of body to shoulder level and returns to side of body
(abduction/adduction) (AT LEAST 3 TIMES unless
pain is verbalized)
7 While supporting the limb, moves joint gently,
slowly, and smoothly through the range of motion,
discontinuing exercise if client verbalizes pain
8 Signaling device is within reach and bed is in low
position
9 Washes hands
BOLD While supporting the limb, moves joint gently,
slowly, and smoothly through the range of motion,
discontinuing exercise if client verbalizes pain
CLEANS UPPER OR LOWER DENTURE
1 Puts on clean gloves before handling dentures
2 Sink is lined and/or sink is partially filled with water
before denture is held over sink
3 Rinses denture in tepid/moderate temperature
running water before brushing them
4 Applies toothpaste to toothbrush
5 Brushes surfaces of denture
6 Rinses surfaces of denture under tepid/moderate
temperature running water
7 Before placing denture into cup, rinses denture cup
and lid
8 Places denture in denture cup with tepid/moderate
temperature water and places lid on cup
9 Rinses toothbrush and places in designated toothbrush
basin/container
10 Maintains clean technique with placement of
toothbrush and denture
11 Sink liner is removed and disposed of appropriately
and/or sink is drained
12 After rinsing equipment and disposing of sink
liner, removes and disposes of gloves (without
contaminating self ) into waste container and washes
Hands
COUNTS AND RECORDS RADIAL PULSE
1. Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Places fingertips on thumb side of client’s wrist to
locate radial pulse
3 Count beats for one full minute
4 Signaling device is within reach
5 Washes Hands
6 After washing hands and obtaining pulse by palpating in radial artery
position, records pulse rate within plus or minus 4
beats of evaluator’s reading
* Count for one full minute.
COUNTS AND RECORDS RESPIRATIONS
1 Explains procedure (for testing purposes), speaking
clearly, slowly, and directly, maintaining face-to-face
contact whenever possible
2 Counts respirations for one full minute
3 Signaling device is within reach
4 Washes hands
5 After washing hands records respiration rate within plus or minus 2
breaths of evaluator’s reading
* Count for one full minute. For testing purposes you
may explain to the client that you will be counting the
respirations.
DONNING AND REMOVING PPE
(GOWN AND GLOVES)
1 Picks up gown and unfolds
2 Facing the back opening of the gown places arms
through each sleeve
3 Fastens the neck opening
4 Secures gown at waist making sure that back of
clothing is covered by gown (as much as possible)
5 Puts on gloves
6 Cuffs of gloves overlap cuffs of gown
7 With one gloved hand, grasps the other glove at the
palm, pulls glove off
8 Slips fingers from ungloved hand underneath cuff of
remaining glove at wrist, and removes glove turning it
inside out as it is removed
9 Disposes of gloves into designated waste container
without contaminating self
10 After removing gloves, unfastens gown at neck and
waist
11 Removes gown without touching outside of gown
12 While removing gown, holds gown away from body,
turns gown inward and keeps it inside out
13 Disposes of gown in designated container without
contaminating self
14 Washes hands
PROVIDES FOOT CARE ON ONE FOOT
1 Explains procedure, speaking clearly, slowly, and
directly, maintaining face-to-face contact whenever
possible
2 Privacy is provided with a curtain, screen, or door
3 Before washing, checks water temperature for safety
and comfort and asks client to verify comfort of water
4 Basin is in a comfortable position for client and on
protective barrier
5 Puts on clean gloves before washing foot
6 Client’s bare foot is placed into the water
7 Applies soap to wet washcloth
8 Lifts foot from water and washes foot, including
between the toes
9 Foot is rinsed, including between the toes
10 Dries foot, including between the toes
11 Applies lotion to top and bottom of foot, removing
excess (if any) with a towel
12 Supports foot and ankle during procedure
13 Empties, rinses, and dries basin
14 After rinsing basin, places basin in designated dirty
supply area
15 Disposes of used linen into soiled linen container
16 After cleaning foot and equipment, and disposing of
used linen, removes and disposes of gloves (without
contaminating self ) into waste container and washes
hands
17 Signaling device is within reach