CNA - Ch.4 & 5

metabolism

physical/chemical processes that convert food into energy. allows the body to stay in homeostasis.

Anterior (ventral)

front of the body

Posterior (dorsal)

back of body

superior

toward the head

inferior

away from the head

Medial

Toward the midline of the body

Lateral

to the side, away from the midline of the body

proximal

closer to the torso

distal

farther away from the torso

blood vessels dilate when...

the outside temperature is too high

blood vessels constrict when...

the outside temperature is too cold

How NAs can help with aging skin

Using lotions as ordered. Bed linens should be kept wrinkle free

atrophy

muscle wastes away, decreases in size, and becomes weak

contracture

muscle or tendon shortens, becomes inflexible, and 'freezes' in position

autoimmune illness

causes the body's immune system to attack normal tissue in the body

menopause

the end of menstruation(occurs when women has not had a menstrual period for 12 months)

dress the ______ side first

weaker

Partial weight bearing (PWB)

the ability to support some weight on one or both legs.

Non-weight bearing (NWB)

unable to support any weight on one or both legs

two ways to prevent blood clots

- sequential compression device(SCD) is an air filled device on the leg that inflates and deflates

- antiembolic stockings aid circulation

two main parts of the nervous system

-CNS: brain and spinal cord

-PNS: nerves

hemiplagia paralysis

paralysis of one side of the body

hemiparesis

weakness on one side of the body

expressive aphasia

trouble communicating thoughts through speech or writing

receptive aphasia

difficulty understanding spoken or written words

emotional lability

Inappropriate or unprovoked emotional responses, including laughing, crying, and anger

dysphagia

difficulty swallowing

Parkinson's disease

A progressive disease that causes a section of the brain to degenerate. causes stooped posture, shuffling gait, pill rolling, tremors, and a mask like facial expression.

parkinson's guidelines

- high risk for falls

- observe for swallowing problems

multiple sclerosis(MS)

- destruction of the myelin sheath on neurons in the CNS and its replacement by plaques of sclerotic (hard) tissue.

- symptoms include blurred vision, fatigue, tremors, poor balance, and trouble walking.

how often should a resident in bed change positions?

every 2 hrs

how often should a resident in a wheelchair change positions?

every hour

hypertension (HTN)

high blood pressure(130/80 or higher)

major causes of hypertension

atherosclerosis(hardening and narrowing of blood vessels), kidney disease, tumors of the adrenal gland, pregnancy, and some medications.

Diuretics

medications to treat hypertension that reduce fluid volume in the body(more frequent urination)

congenital heart failure(CHF)

when one or both sides of the heart stop pumping blood properly

when the right side of the heart is affected,

blood backs up into the legs, feet, or abdomen

when the left side of the heart is affected

blood backs up into the lungs

CHF (congestive heart failure) guidelines

- help resident with getting to the toilet. diuretics will increase the need to urinate.

what are some signs of urinary incontinence

- confusion

-changes in urine

Why are UTIs more common in women?

shorter urethra and proximity to anus.

guidelines for preventing UTIs

- give careful perineal care when changing incontinence briefs

- offer a bedpan or trip to the toilet at least every two hours.

guidelines for diabetes

- the goals of diabetic foot care are to check for irritation or sores, to promote blood circulation, and to prevent infection.

- encourage residents to wear supportive well fitting shoes. shoes made of material that breathes such as leather, cotton, or canvas, help prevent buildup of moisture. to avoid injuries to their feet, residents should not go barefoot. socks made of cotton or wool are best.

normal changes of aging for females include

- A decrease in estrogen may lead to a loss of calcium. This can cause brittle bones and, potentially, osteoporosis

the lymphatic system consists of

lymph vessels and capillaries in which a fluid called lymph circulates. lymph is a fluid that carries disease fighting cells called lymphocytes.

guidelines for HIV/AIDS

- some people can lose their appetites, encourage residents to relax and eat in a pleasant settings. serve familiar foods + report trouble eating.

- residents with infections of the mouth may need food low in acid and neither cold nor hot. and no spice. soft + pureed food or drinking liquid meals may help. warm rinses may help ease painful mouth sores.

- a person who has nausea/vomiting should eat small, frequent meals slowly. soft, bland diet and lots of fluids is important.

- residents with mild diarrhea may have small, frequent meals that are low in fat, fiber, and milk products. fluid replacement is necessary-> water,juice,caffeine-free soda,and broth. avoid caffeine.

- numbness, tingling, and pain in the feet are treated with medication. loose, soft slippers and a bed cradle can decrease pain.

guidelines for cancer

- give back rubs for comfort. reposition residents who are weak or immobile every two hours.

- check the skin often to help prevent pressure injuries. dont apply lotion to areas receiving radiation therapy.

-help residents brush teeth regularly. you can help by using a soft bristled toothbrush, rinsing with baking soda and water, or using a prescribed rinse. do not use a commercial mouthwash.

- for residents with mouth sores, use oral swabs rather than toothbrushes.

cognition

the ability to think logically and clearly

Alzheimer's disease (AD)

the most common cause of dementia

People who have AD keep skills that...

the person has used over a lifetime

Guidelines for communicating with residents who have Alzheimers disease

- repeat yourself. use the same words and phrases as often as needed.

If the resident is frightened or anxious:

- speak slowly in a low, calm voice and in an area with few distractions.

- check your body language; make sure you are not tense or hurried.

Guideline for if the resident with AD doe not understand basic instructions or questions

Use signs, pictures, gestures, or written words. Combining verbal and nonverbal communication is helpful.

If the resident with AD has lost most verbal skills:

Use nonverbal skills. As speaking abilities decline, people with AD will still understand touch, smiles, and laughter for much longer. Approach touching very slowly and be gentle.

Assisting with ADLs for residents who have Alzheimers disease

- schedule bathing when resident is least agitated

- encourage the resident to pick clothes to wear

- lay out clothes in the order in which they are to be put on.

- use simple place setting with a single eating utensil. remove other items from the table. contrasting colors between the interior and exterior of the bowl work best.

Dealing with agitation in residents with AD.

try to remove triggers, keep a routine, and avoid frustration. redirect attention.

If a resident with AD is sundowning, the NA should...

- set a bedtime routine and keep it

- avoid stressful situations and plan calming activities just before sundowning occurs

- encourage resident to dress in regular clothes

- avoid caffeine

If the resident with AD displays inappropriate sexual behavior, the NA should...

the NA should not overreact, as this may enforce the behavior. trying to determine the cause might help. is the behavior intentional? is it consistent? if distracting the resident does not work, direct the resident to a private area.

If a resident with AD is hoarding and rummaging, the NA should...

- provide a rummage drawer(a drawer with items that are safe for the resident to take with them)

- label all personal belongings

- place a label on resident's door

validating

giving value to or approving

validation therapy

- letting residents believe they live in the past or in imaginary circumstances.

- when using validation therapy the NA should make no attempt to reorient the resident to actual circumstances.

reminiscence therapy

encouraging residents with AD to remember and talk about the past

activity therapy

- uses activities that the resident enjoys to prevent boredom and frustration

- activities may be done in groups or one-on-one

- activity therapy is useful in most stages of AD

perservating

a resident who has dementia may repeat words, phrases, questions, or activities over and over again.

arthritis

inflammation or swelling of the joints