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13 Cards in this Set

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Hand washing Procedure;
1 Wet hands and apply soap?
2 lather --front and back -
hands, wrists, between
fingers, cuticles & under nails?
3 friction for min of 15 seconds?
4 Remove soap, rinsing holding
fingers lower than wrists?
5 Dry hands with Several paper
towels & limit contact of
towel to cleansed skin
surfaces?
6 Turn off water with paper
towel and dispose -towel?
7 Complete task without
contaminating hands, such
as against sink?
Assist resident to use a bedpan:
PART 1
1. Greet resident-Use their
name Self Intro
2 Explain Procedure {throughout}
2a. Utilize Standard Precautions
3. Use protective pad over
bottom sheet & under
buttocks before bedpan
4 Position bedpan under
5 Raise head of bed after
positioning on bedpan.
6 Toilet paper within reach
before removing bedpan?
7 Lower head of bed before
removing bedpan? [SEE PART 2]
Bedpan: PART 2
8 Goves before bedpan Removal
& during emptying &
cleaning bedpan?
9 Empty contents into toilet?
10 Rinse, dry & Remove gloves
before or use a barrier when
storing bedpan?
11. Store bedpan Bottom Shelf
Bedside Cabinet
12 Offer resident a damp
washcloth/towelette to
cleanse hands
13. Utilize Standard precautions
& infection control

14 Promote resident comfort &
resident rights
16 Promote resident safety
Ambulate the resident using a gait belt:
1. Greet resident, intro-self?
2 Explain procedure?
3 Apply gait belt -@waist
Securley [not 2 tight] B4-
resident stands.
4 shores or non-slip socks?
5. Properly hold Gait belt while
resident to stands
6 Ask about dizziness?
7 Walk slightly behind & 1side
Hold gait belt in back
8 Match resident's pace
9 Walk resident a min- 20 steps
10 Ask re: tolerance, comfort,
dizziness or fatigue?
11 Assist to turn and position to
sit back in chair.
12 Control gentle lowering of
resident into chair?
13 Remove gait belt- No harm or
shake resident.
14 Use Standard Precautions
15 Promote Comfort, safety &
resident rights throughout
procedure?
Change an occupied bed
1. Greet resident, intro-self?
2 Explain procedure?
3 Lower head of bed before
changing sheet?
4 Move resident safely 2 non
working side of bed?
5 Loosen dirty bottom sheet
@working side, push dirty
sheet& tuck against resident?
6 Place clean bottom sheet@
workside, & secure @ corners
7 Extend clean sheet across
bed and tuck under resident?
8 Assist resident 2 roll onto
working side of bed?
9 Complete placement of
bottom sheet, secure
sheet (all four corners)?
10 bottom sheet NOT wrinkled
11 Place clean top sheet?
12 Avoid resid. exposure.
13 Secure top sheet@ bottom of
bed create foot pocket.
14 Top sheet untucked on
sides (USE hospital corners)
15 Replace pillowcase {NO
Pillows on bed/under Chin}
16 Soiled linen in hamper?
17 Resident on top & under
bottom sheet& pillow @ head?
18 Use Standard Precautions
19 Promote Comfort, safety &
resident rights throughout
procedure?
Feed the resident who is in bed
Does the candidate:
1. Greet resident, intro-self?
2 Explain procedure?
3 Raise bed 2 sitting position
(minimum 60 degrees)
4 Offer/assist R' to wash hands
5 Eye level contact with R'
6 Apply clothing protector
7 Offer drink before feeding?
8 Use spoon to feed?
9 Offer drink throughout feeding
(every3-4 bites of food)?
10 Check 2 see R' swallowed B4
next bite?
11 Encourage R' 4 food intake?
12 Converse with R
13 R' mouth clean and dry?
14 Remove linen/trash
15 Accurately record food intake
Use Standard Precautions
16 Promote Comfort, safety &
resident rights throughout
procedure?
Measure and record the contents of urinary drainage bag
1. Greet resident, intro-self?
2 Explain procedure?
3 Gloves B4 handling urinary
drainage bag?
4 Empty bag into graduated
container without touching
tubing against container?
5 Wipe drain with alcohol swab
after emptying urine.
6 Close/protect drain(clamp/tuck)
7 Leave bag secured to bed
[No touch Floor]
8 Container on flat surface
[use barrier]
9 Read urine @ eye level?
10 Empty urine in2 toilet
rinse and dry container?
11 Remove gloves & wash hands
B4 recording output?
12 Record output within +/-
50cc’s of nurse’s reading?
13 Record output as urine and
indicate the correct time
on the I&O Form?
14) Use Standard Precautions
Promote Comfort, safety &
resident rights throughout
procedure?
Measure and record the resident’s blood pressure
1. Greet resident, intro-self?
2 Explain procedure?
3 Expose R's antecubital?
4 Position R's arm-palm up,
elbow level of heart?
5 Wrap cuff evenly- bottom of
cuff positioned inch above
antecubital?
6 Locate the brachial artery
B4 stethoscope?
7 Position diaphragm of
stethoscope over brachial
artery, and place stethoscope
earpieces B4 inflating cuff?
8 Inflate cuff safely (e.g., inflate
not more than 30mm past
point pulse last felt or heard)?
9 Control deflation of cuff?
10 Record systolic blood pressure within +/-4mm of
nurse’s readings?
11 Record diastolic blood pressure within +/-4mm of
nurse’s readings?
12 Clean earpieces and diaphragm of stethoscope and
store equipment at completion of procedure and
leave work area tidy?
13 Utilize Standard Precautions and infection control
measures throughout procedure?
14 Promote resident comfort throughout procedure?
Measure and record the resident’s
pulse and respirations
1. Greet resident, intro-self?
2 Explain procedure?
3 Support R's forearm - taking
pulse?
4 Place fingers over radial pulse?
5 Count pulse for at least one
full minute?
6 Record pulse rate?
7 Report pulse within +/- 4
beats per minute of
nurse’s measurement?
8 Refrain from telling resident
respirations are being
counted?
9 Count respirations for at least
one full minute?
10 Record respirations within +/- 2 breaths per min of nurse’s
measurement?
11 Utilize Standard Precautions
and infection control
measures throughout
procedure?
12 Promote resident comfort
throughout procedure?
Perform passive range of motion exercises to
resident’s upper extremity
(shoulder, elbow, wrist and fingers)
1. Greet resident, intro-self?
2 Explain procedure?
3 Perform range of motion on
the correct side?
4 Support extremity above and
below joints throughout ROM
exercises?
5 Take shoulder through ROM,
raising and lowering
straightened arm along
side, towards head of bed
(HOB) and back to mattress?
6 Take resident’s shoulder
through abduction/
adduction ROM exercises?
7 Take resident’s shoulder
through rotation ROM
exercises?
8 Flex and extend elbow through
ROM exercises?
9 Provide ROM exercises to wrist
(e.g., gently rotate,
or flex/extend and move side
to side)?
10 Flex and extend finger and
thumb joints through
ROM exercises?
11 Provide three repetitions of
each ROM exercise?
12 Ascertain resident’s comfort with movement either
verbally or by observing resident’s face throughout
ROM exercises?
13 Control extremity throughout ROM exercises
providing smooth, slow, nonforceful movement?
Provide catheter care to the resident who has an
indwelling urinary catheter
1. Greet resident, intro-self?
2 Explain procedure?
3 Apply gloves before using soapy washcloth to clean
around catheter insertion site?
4. Place incontinent pad under buttocks before
beginning procedure?
5 Obtain bath basin with water of safe and
comfortable temperature?
6 Apply small amount of soap directly to wet
washcloth before cleansing?
7 Change spot on soapy washcloth for each washing
stroke, wiping inside labia from front to back?
8 Cleanse catheter, washing away from body and
down the catheter about 3-4 inches?
9 Use clean wet washcloth to rinse washed areas?
10 Change spot on washcloth for each rinsing stroke,
wiping inside labia from front to back?
11 Replace water in basin during procedure if becomes
too cool or soapy?
12 Dry perineal area, from front to back after
completing cleaning and rinsing?
13 Adjust linen to avoid unnecessary exposure of
resident throughout procedure?
14 Avoid tugging or pulling on catheter?
15 Leave tubing free of kinks or obstructions and not
t
Provide foot care to the resident
1. Greet resident, intro-self?
2 Explain procedure?
3 Obtain water in bath basin, checking to ensure
water is safe and comfortable temperature?
4 Offer resident opportunity to check water
temperature before submerging foot in water?
5 Place water filled basin on protective barrier on
floor?
6 Place resident’s barefoot in water to soak?
7 Refrain from adding soap directly to basin of water?
8 Wash foot using washcloth with small amount of
soap applied directly to wash cloth?
9 Wash top and bottom of foot and between toes?
10 Submerge foot in water in basin to remove soap
residue?
11 Remove foot from water and dry entire top and
bottom of foot including between toes?
12 Warm lotion in hand before applying to foot?
13 Apply lotion to top and bottom of foot, excluding
between toes?
14 Remove unabsorbed excess lotion?
15 Apply sock to foot ensuring sock is smooth and
replace shoe?
Provide foot care to the resident

PART 2
16 Provide support to lower extremity throughout
procedure as needed to avoid strain?
17 Avoid placing resident’s barefeet directly on floor
before, during or after foot care?
18 Clean and dry basin, store equipment, and dispose
of soiled linen when procedure completed?
19. Utilize Standard Precautions
and infection control
measures throughout
procedure?
20. Promote resident comfort
throughout procedure?