CNA 24/25

What toileting device is safest for someone who recently had hip surgery and cannot get out of bed

A fracture pan

What toileting device is safest for someone who is able to get out of bed but cannot walk to the bathroom

Bedside commode (BSC)

What device measures urine for someone using a standard toilet or commode?

A commode hat

What should a CNA report to the nurse regarding urination?

• Hematuria, nocturia, dysuria, polyuria, oliguria, Andria

• Frequency-voiding that occurs more often than usual

• Urgency-need to urinate immediately

• Urine is cloudy or contains particles, has an abnormal color, or odor

• A person is having incontinence episodes or more frequent incontinence accidents

What is the major difference between routine urine specimen and midstream (clean-catch) specimen?

A midstream specimen requires sterile collection with cleansing of the urethral area, where a routine urine specimen does not

How should a patient be positioned to receive an enema?

Left-side sims’ position

What is a suprapubic catheter?

A catheter that enters the bladder through a small opening above the pubic bone, the opening is initially made surgically

What should you do if a patients stool appears black and tar like

Notify nurse immediately

How should a condom catheter be secured?

With spiral taping

How many inches of catheter tubing should be cleaned from the body outward

4 inches

How should tubing for an in dwelling catheter be secured?

Coil it gently and clip it to the bed linens

How should urine drainage be emptied from a drainage bag

Drain into a graduate container placed on a paper towel beneath the bag

When starting a 24-hour urine collection, what should be done with the first urine of the day?

Discard it

What is the most comfortable position for using a bedpan?

Fowler’s position

Why must the drainage bag of an in dwelling catheter stay below the bladder level?

To prevent urine from flowing backward into the bladder and causing an infection

What type of stool is expected from someone with an ileostomy?

Liquid stool that drains continuously

Who is most appropriate for a urinary catheter?

Someone who is incontinent and has pressure ulcers

What does normal urine look like?

Clear and yellow/straw like

Which dietary items should be recorded as fluid intake?

All liquids including jello, milk on cereal, and ice cream

Why must CNAs know each residents ordered diet?

To recognize if incorrect food is delivered

How can a CNA reduce dry mouth for a resident who is NPO?

Provide frequent oral care

What foods are allowed on a clear liquid diet?

Substances that can be poured at room/body temp and you can see through.

• water, gelatin, fat0free broth or bullion, clear juices, clear carbonated sodas, coffee and tea without cream

What IV-related related issues must be reported to the nurse immediately?

• tubing that has become disconnected

• The fluid bag is empty

• IV fluid is not dripping into drip chamber

• Blood has backed up the IV tubing

• The person complains of pain at the IV site

• Swelling or redness at the IV site-infiltrated IV

Which nutrient best supports healing of a pressure ulcer?

Protein

Why should meals be served while still hot?

Cooling food increases risk of bacterial growth

Which diet is used for stomach irritation or information of the intestinal tract?

Bland diet

What adaptive device would help a person with one hand maintain independence?

A plate with raised rim

Who is most likely to need a carbohydrate-controlled diet?

A person with diabetes taking insulin, but can also be diabetic who does not take insulin

What is the liquid texture that coats a fork and drips slowly?

Honey thick

How should a tube-fed residents bed be positioned to reduce aspiration risk

Head of bed raised to at least semi-fowlers

How should vomit one linens be measure for output?

Estimate the amount

How many mL are in 1 oz?

30 mL

What is the liquid texture that quickly sinks through the prongs of a fork?

Nectar thick liquid

What is the liquid texture that remains one the fork and holds well together?

Pudding thick liquid

Hematuria

Blood in urine

Nocturia

Frequent urination at night, more than once or twice

Dysuria

Difficulty voiding that may or may not be associated with pain (burning or cramping)

Polyuria

Excessive urination

Oliguria

100-400mL of urine in 24 hours

Anuria

Under 100mL of urine in 24 hours

What foods are allowed on a full liquid diet?

It is the clear liquid diet, plus any food that can be poured at room or body temp

• milk, plain frozen desserts, pasteurized eggs, cereal gruels, strained soups, juices

Contain more nutritions than clear liquids, high proteins liquid dietary supplement can be added if someone is on full liquid diet for 3+ days

Why might someone be on a clear liquid diet?

Some medical tests require it for a short period, a person who is nauseous or vomiting, just had surgery, recovering from illness or trauma. Not nutrient dense, not long lasting

What must be reported to the nurse regarding a patient with an in dwelling urinary catheter?

Change in color, clarity, or odor of urine, failure of urine to flow freely through tubing, complaints about pain or discomfort, redness, swelling, discharge

What is a mechanical soft diet?

Changed slightly to remove foods that are hard to chew or digest. Texture of foods is changed to make them easier to eat. Fried or high-fiber foods might be eliminated or limited. Mechanical chopped diet is foods cut in small pieces to make them easier to chew.

What foods are allowed in a mechanical soft diet?

Foods that are ground up, sirloin steak is put through meat grinder to make sirloin patty, veggies can be altered so they’re easier to chew

What is a purée diet?

Food is blended into smooth consistency, similar to pudding or very moist mashed potatoes

Who is a purée diet ordered for?

Those who have very poor dentition, dysphasia, are frail, or have end-stage disease

How do you assist a resident with poor eyesight in eating a meal?

A clock face is used to reference location of food on the tray

What is dysphasia?

Difficulty swelling

What are the aspiration precautions?

• small bites

• Small sips

• Alternate liquid and solid swallows

• Ensure oral clearance

• Sit upright (90 degrees) when eating and drinking and for 30 min after eating

• Multiple swallows beer bite/sip

• Small, frequent meals throughout the day

• No straws

What is edema?

Swelling that occurs when there is too much fluid in the body

How can a CNA promote normal bowel and bladder elimination?

• encourage/push fluids

• Answer call lights and take people to bathroom or use bedpan ASAP

• Encourage people to call when they have an urge to use bathroom

• Ensure privacy and comfort

What would be considered bodily fluid output?

Urine, vomit, blood, wound drainage, and diarrhea

What urine specimens is needed to accurately check for a UTI?

A midstream (clean-catch) urine sample