Cna Class Test 4

Front 1

Aspiration

Back 1

breathing fluid or an object in to the lung

Front 2

Decubitus Ulcer

Back 2

a pressure sore or bed sore

Front 3

AM, PM, and HS Care

Back 3

care performed before or after breakfast, and before or after the evening meal. Or at the time placing residents to bed (HS = Hour of Sleep) for the night

Front 4

Perineal Care

Back 4

(Peri-care) cleaning and anal areas of the body

Front 5

Daily Care of the resident: before breakfast

Back 5

AM care
brush teeth (give po care)
comb hair, shave residents, male ans female
bath/shower
BRp

Front 6

DAILY CARE OF THE RES: After Breakfast

Back 6

assist the res to the bathroom
clean incontinent residents, and assist with ADL's
bath/shower
finish with all ADL's which were not completed
Clean unit/room

Front 7

DAILY CARE OF THE RES: Afternoon Care

Back 7

BRP or assist to the bathroom
clean incontinent res. and assist w/ADL's
Assist res to lie down and up after nap
clean up the unit
give report to oncoming NAC

Front 8

DAILY CARE OF THE RES: Evening Care

Back 8

Assist res. to bathroom, BRP
Clean incontinent res. and provide ADL's
help res to bed after pm care
Dinner/supper

Front 9

Oral Care

Back 9

Brushing teeth 3x/day (TID)
Oral care for unconscious res. is done every 2 hours
Denture Care TID
Partial Denture Care TID

Front 10

Bathing: General Rules

Back 10

-Assure that the bath area is clean
-check water temperature (105-110F)
-Find out type of bath and skin products needed for the res.
-Collect necessary equipment (towels, wash cloths, soap)
-protect privacy and cover for warmth
protect from falling, never leave res. unattended
-wash from clean to dirty
-encourage the resident to help as much as is safe and possible
-rinse skin thoroughly and pat the skin dry
-use good body mechanics at all times

Front 11

Purpose for Bathing

Back 11

hygiene
comfort/relaxation
circulation
observe the skin

Front 12

Types of baths

Back 12

completes bed bath (water temp. 110-115)
Partial bed bath (water temp. 110-115)
tub bath (water temp. 105)
the shower
Whirlpool
Sitz Bath
Bordet

Front 13

The Back Massage

Back 13

1. the back massage relaxes muscles and stimulates circulation
2. use the firm hand motion from the sacrum up, and soft circular motion down
3. warm lotion by rubbing some between your hands
4. do not massage a res. w/a cardiac condition

Front 14

Perineal Care

Back 14

1. Use Gloves
2. Wash front to back
3. Wipe, look ,turn and apply (A and D ointment, follow facility policy)
4. Clean all skin fold areas
5. Remove gloves before touching res. linen for covering

Front 15

Hair Care

Back 15

1. Brushing and combing (place a towel around the back of the neck)
2. Shampooing x2
3. Shaving; place a towel around the front of the neck

Front 16

Care of Nails and Feet

Back 16

Cut during shower time as the nails are soft, or soak the nails
cut with the contour of the finger or toes, and clean with orange stick
never cut nails of diabetic res.
place a towel under the hands/feet

Front 17

Dressing/Undressing Res

Back 17

1. Undress unaffected side first
2. Dress affected side first

Front 18

Decubitus Ulcers: General Rules

Back 18

The elderly, paralyzed, obese, or very thin and malnourished res. are at high risk.
The first sign is pale or white skin or a reddened area.
Res may c/o pain, burning, or tingling in the area
Some may not feel and abnormal sensation

Front 19

Sites of Decubitus Ulcers

Back 19

-Back and Side of head
-Ear
-Shoulders
-Elbows
-Hip and greater trochanter
-Sacrum
-Heels, Malleolus, Toes
-Knees
-Palms of hand
-Nose

Front 20

Prevention of Decubitus Ulcers

Back 20

-reposition res. in good health at least q2h
-Provide good skin care and apply lotion
-do not massage pale or reddened pressure points
-keep linen clean, dry, and free of wrinkles and crumbs
-NO SKIN TO SKIN CONTACT - SAR
- Use a drew sheet or incontinent pad in bed to reposition the res.

Front 21

Treatment of Decubitus Ulcers

Back 21

Sheepskin
Bed Cradle
Foot Board
Heel and Elbow Protectors
Alternating Pressure mattresses/Flotation mattresses/pads
Egg crate mattresses and w/c pads
special beds
spanco mattress

Front 22

Who is at risk for Decubitus Ulcers

Back 22

poor circulation
diabetes
obese or thin
poor nutrition or hydration
incontinent
paralysis
diminished pain awareness
weakened immune system
corticosteroid therapy
mental impairment
decreased level of consciousness
sedation
confusion
use of restraints
previos ulcers
chronic ulcers that require bed rest

Front 23

Stages of decubs.

Back 23

Stage 1: Skin appears red and fails to turn to a normal color even after 30 min. w/o pressure; capillaries refill slower then normal; revers the reddened condition by removing pressure
Stage II: Blistering w/ reddened. Epidermis may not be intact. Skin erosion involves Epidermis and part of dermis; Ulcer area is pink and moist, res c/o pain and numbness; can become infected and it takes 2 pr more weeks to heal
Stage III: Full thickness wound resembles a shallow crater and may have extending tunnels; becomes easily infected, healing may take up to 3 mo.
Stage IV: Extend through all layers of the skin, fat, muscle and to the bone; Possible tunneling and infection occurs; healing is several months or even a year. this is due to a compromised elderly person

Front 24

Catheter

Back 24

a tube used to drain or inject fluid through a body opening

Front 25

Foley Catheter

Back 25

A catheter that is left in the urinary bladder for drainage

Front 26

Continent

Back 26

Having control of bladder or bowel function

Front 27

Voiding

Back 27

urination

Front 28

Incontinent

Back 28

involuntary bladder or bowel release

Front 29

The regular Bedpan and Fracture Bed Pan

Back 29

to void in

Front 30

Normal Urination

Back 30

1000-1500 ml/cc per day (formula 1 oz. = 30 ml.cc)
People usually urinate before going to bed abd after getting up
Some ppl. void every 2-3 hours, others 8-12
Certain substances increase urination - coffee, tea, alcohol, and some drugs are diuretics
Usually "straw" color or light amber

Front 31

Maintaining Normal Urination: General Rules

Back 31

Help the res. to the bathroom and assume position
Cover for warmth and privacy
Give signal light and toilet paper with in reach
run water if res has difficulty voiding
remain neaerby
wash res. hands post BRP

Front 32

Urination: What to Report to Nurse

Back 32

1. Color, clarity, odor
2. amount and particles
3. c/o urgency
4. burning upon urination
5. Dysuria, or problem starting to urinate
6. frequent small amounts
7. spotting/bleeding
8. back pain

Front 33

s/s of full bladder

Back 33

distended abdomen
c/o pain in low abd pr peri area
fullness
no urine in foley cath

Front 34

Catheters: types

Back 34

indwelling foley cath
condom cath
suprapubic

Front 35

Catheters: General Rules

Back 35

1. make sure the urine flows freely
2. keep the drainage beg below the bladder and in a covering bag
3. coil tubing on the bed and fasten to bedding
4. use catheter straps (leg straps) to prevent pulling
5. provide cath care
6. empty drainage bag at the end of each shift
7. report any c/o and follow standard precautions

Front 36

Catheters: Bladder Training

Back 36

to gain voluntary control
res. may be asked to void q 1 1/2 - 2 hours

Front 37

Collection and Testing Urine Specimens

Back 37

The random Urine Specimen: is collected for PRN UA
The Midstream Specimen
24- hour specimen
The Double-Voided Specimen: urine collected w/in 30 min apart

Front 38

Testing Urine

Back 38

Testing for pH, glucose and ketones, testing for blood, reagent strips

Front 39

The Res. w/a Ureterostomy

Back 39

a surgical removal of the urinary bladder

Front 40

Dialysis

Back 40

Hemodialysis: Waste products and fluids are removed by filtering blood
Peritoneal Dialysis: The lining of abd cavity to remove waste and fluid from blood

Front 41

Colostomy

Back 41

an artificial opening between the colon and abd

Front 42

Constipation

Back 42

the passage of hard dry stool (difficulty of passing in stool)

Front 43

Enema

Back 43

introduction of liquid into the rectum and lower colon

Front 44

Impaction

Back 44

inability to pass the hard stool

Front 45

flatus

Back 45

(GI gas) or air in the stomach or intestines

Front 46

Ileostomy

Back 46

an artificial opening between the ileu (small intestins) and the abdomen

Front 47

Stoma

Back 47

an opening

Front 48

Peristalsis

Back 48

alternating contraction and relaxation of the intestinal muscles

Front 49

Suppository

Back 49

a cone-shaped solid medication that is inserted into the rectum

Front 50

Normal Bowel Movements

Back 50

1. Frequency is highly individual qd or 2-3 days
2. Brown in color
3. odor present due to bacterial action in intestine
4. normally soft, formed and shaped like rectum, S shaped

Front 51

BM: What to report to the nurse

Back 51

shape, size and frequency
color if not brown
consistency (coffee grounds)
odor: C-diff

Front 52

S/S of Impaction

Back 52

seepage/oozing
no BM
stops eating/feeling of fullness
urgent use for BRP
pain

Front 53

Factors Affecting Bowel Elimination

Back 53

Privacy, Disability
aging
diet and fluids
activity
medication

Front 54

Bowel Training (B & B)

Back 54

Gaining control of BM
Develop regularity in pattern of elimination

Front 55

Enemas: General Rules

Back 55

Soln. temp 105F
the sims position
enema bag raised only 16" from rectum or 18" from bed and given slowly
Tip lubricated/ask res. to breath
Retain solution as long as possible
bathroom should be empty or commode ready
report the results to the nurse or ask the nurse to see it
use standard precations and blood borne pathogens procedure
instill 500-700 cc for adults

Front 56

Types of Enemas

Back 56

Commercial Enemas: Fleets, SSE, TWE
Rectal Tubes
Suppository
TWE (tap water enema) and or SSE (soap, sude enema)

Front 57

The Resident with an ostomy

Back 57

colostomy - stool is soft
Ileostomy - stool is liquidy
consistency of stool

Front 58

Collecting Stool Specimens

Back 58

Use standard precautions
Use Clean container
Label name, date and time