Chapter 7 - Basic Nursing Skills

A complete set of vocabulary flashcards covering admission procedures, vital signs, physical restraints, fluid balance, specimen collection, catheters, oxygen therapy, and basic bed-making and wound care skills based on CNA Chapter 7.

What is admission?

The process of a resident entering and becoming established in a healthcare facility.

What should an NA do to help a new resident feel comfortable during admission?

Prepare the room, introduce herself and her position, explain routines, learn the resident's preferences, and make the resident feel welcome.

How should an NA address a new resident?

Use the resident's formal name until the resident says what they prefer to be called.

What should a new resident receive regarding legal rights?

A copy of the resident's legal rights.

Why is it important to observe a new resident carefully?

To notice and report important information or changes that may have been missed.

What is a transfer?

Moving a resident to another room, unit, facility, or hospital.

When should residents be told about a transfer?

As early as possible.

How can an NA help with a transfer?

Explain what is happening, help organize belongings, introduce the resident to the new area, and help the resident adjust.

Who orders a resident's discharge?

A doctor or other authorized provider; the NA does not write the discharge order.

What does OBRA require regarding discharge?

Residents have the right to receive advance notice before discharge.

What can changes in vital signs indicate?

A change in the resident's condition, including possible illness or other health problems.

What vital-sign changes should an NA report?

Readings that differ from the resident's normal range or baseline, especially abnormal readings.

What are the main vital signs?

Temperature, pulse, respirations, and blood pressure; pain and oxygen saturation are also commonly monitored.

What is the normal oral temperature range in this chapter?

$97.6^{\circ}\text{F}$ to $99.6^{\circ}\text{F}$.

What is a tympanic thermometer?

A thermometer that measures temperature in the ear.

What does axillary mean?

The armpit area.

Which temperature site is considered most accurate in the chapter?

Rectal.

What color is a rectal thermometer traditionally coded?

Red.

What is the most common site for taking a pulse?

The radial pulse at the wrist.

What is the normal adult pulse range?

$60$ to $100$ beats per minute.

What is inspiration?

Breathing air into the lungs.

What is expiration?

Breathing air out of the lungs.

What is the normal adult respiration range?

$12$ to $20$ breaths per minute.

Why should an NA count respirations without telling the resident?

A person may change the rate or pattern of breathing if they know it is being observed.

What is systolic blood pressure?

The first/top measurement, reflecting pressure when the heart contracts and pushes blood out.

What is diastolic blood pressure?

The second/bottom measurement, reflecting pressure when the heart relaxes.

How is blood pressure recorded?

As a fraction-like reading: systolic over diastolic, such as $120/80\,\text{mmHg}$.

What equipment is used to measure blood pressure?

A sphygmomanometer (blood pressure cuff); a stethoscope may also be used with a manual cuff.

What does a pulse oximeter measure?

Blood oxygen saturation and pulse rate.

What should an NA ask when a resident reports pain?

Ask where the pain is, when it started, what it feels like, how severe it is, what makes it better or worse, and whether it spreads.

What can an NA do to help reduce pain?

Report pain, position the resident comfortably, provide ordered comfort measures, reduce noise, and help the resident relax.

Why must an NA report a resident's weight loss?

Unexpected weight loss can signal illness, poor nutrition, dehydration, or another change in condition.

How many inches are in one foot?

$12\,\text{inches}$.

How is weight read on a balance-beam scale?

Add the value of the large bottom weight to the value indicated by the pointer on the small top weight.

What is the purpose of a restraint?

To restrict a person's voluntary movement or behavior.

What is a physical restraint?

A device or method that restricts a resident's freedom of movement, such as certain raised side rails when used as a restraint.

What is a chemical restraint?

Medication used to control a person's behavior or movement rather than to treat a medical condition.

Why is restraint use restricted?

Restraints can be abused and can cause physical and psychological harm.

When may a restraint be used?

Only when properly ordered and allowed by law and facility policy, after alternatives have been considered.

What is restraint-free care?

Care that does not use restraints and instead uses safer alternatives.

What are restraint alternatives?

Measures used in place of restraints to promote safety while allowing as much freedom as possible.

How often must a restrained resident be checked according to the workbook question?

At least every $15\,\text{minutes}$, following facility policy.

What care is generally needed at least every two hours for a restrained resident?

Release/remove the restraint as directed, reposition, provide skin care, offer food/fluids, assist with toileting, and provide range-of-motion as directed.

What is fluid balance?

Maintaining a proper balance between the amount of fluid taken into the body and the amount eliminated.

What is intake?

Fluid a person consumes, including liquids and semiliquid foods such as soup or gelatin.

What is output?

Fluid eliminated from the body, including urine and other measurable body fluids.

Is all body fluid output urine?

No. Urine is an important form of output, but it is not the only type.

What is a specimen?

A sample collected for analysis to help make a diagnosis.

What is a clean-catch or midstream urine specimen?

A urine specimen that excludes the first and last urine voided from the sample.

What is a routine urine specimen?

A urine sample collected when the resident voids, according to facility instructions.

What is a hat used for?

A collection container placed in a toilet to collect and measure urine or stool.

When is sputum often best collected?

Early in the morning.

What should not be included with a stool specimen?

Urine or toilet paper.

What is a catheter?

A thin tube inserted into the body to drain or inject fluids.

What is a urinary catheter?

A thin tube used to drain urine from the bladder.

What is an indwelling catheter?

A urinary catheter that remains inside the bladder for a period of time.

What is a straight catheter?

A urinary catheter inserted to drain urine and removed immediately afterward.

What is a condom catheter?

An external urinary catheter with an attachment that fits over the penis.

Who prescribes oxygen therapy?

A doctor or other authorized provider.

Can an NA adjust a resident's oxygen flow rate?

No. The NA should not change oxygen settings unless specifically permitted by scope and facility policy; report concerns to the nurse.

Why are flames and smoking prohibited around oxygen?

Oxygen supports combustion and makes fires burn more rapidly.

Should flammable liquids such as alcohol be kept near oxygen?

No.

What should happen to oxygen in the event of a fire?

Follow facility fire procedures; oxygen may need to be turned off as directed.

What should an NA observe around oxygen masks and tubing?

Check the skin for irritation or pressure areas and report problems.

Why should petroleum jelly such as Vaseline not be used around oxygen?

Petroleum products are a fire hazard around oxygen; use only facility-approved products.

What does IV therapy provide direct access to?

The bloodstream.

What is an NA's responsibility regarding IV therapy?

Observe and document/report findings as allowed; the NA does not insert, remove, or independently manage the IV.

What should an NA do if an IV bag is nearly empty?

Notify the nurse.

How should a resident's room be treated?

As the resident's home, with respect and privacy.

What should an NA do before entering a resident's room?

Knock and wait for permission before entering, except in an emergency.

Whose comfort should guide the room temperature?

The resident's comfort, not the NA's preference.

Where should urinals and bedpans be stored?

In the proper designated area, not on the overbed table.

How quickly should call lights be answered?

Promptly.

Where should the call light be placed?

Within the resident's reach, preferably near the stronger hand when appropriate.

Do privacy curtains block sound?

No. They provide visual privacy but do not make conversations private from sound.

Do residents have a legal right to privacy during care?

Yes.

Where should soiled linen be placed?

In the proper linen container or bag at the point of origin, according to facility policy.

Should an NA wait hours before removing a meal tray?

No. Meal trays should be removed according to facility routine and resident needs.

What should an NA do if asked to use unfamiliar equipment?

Ask for help and instruction before using it.

What are common things that can disrupt sleep?

Pain, noise, light, uncomfortable temperature, anxiety, illness, and the need to urinate.

What problems can lack of sleep cause?

Irritability, difficulty concentrating, fatigue, and increased risk of accidents or falls.

Why should bed linens be changed regularly?

To prevent infection and promote comfort.

Why should used bed linen be carried away from the NA's body?

To prevent contamination of the NA's clothing.

How should dirty linen be handled when removing it?

Roll it with the soiled area inside; do not shake it.

What should an NA do to the bed before making it?

Raise the bed to a safe working height.

Where should soiled linen be bagged?

At the point of origin.

What is a closed bed?

A bed made with the bedspread and blankets pulled up and in place.

What do sterile dressings cover?

New, open, or draining wounds.

Who changes sterile dressings?

A nurse.

What are nonsterile dressings generally used for?

Dry, closed wounds that have less risk of infection, according to orders and facility policy.

What are elastic bandages also called?

Nonsterile bandages, ACE bandages, or ACE wraps.

What are elastic bandages used for?

To hold dressings in place, secure splints, support/protect body parts, and help decrease swelling after an injury.

How should an elastic bandage be applied?

Snugly but not too tightly, evenly, often in a figure-eight pattern, without pinching the area.

Why should an elastic bandage never be tied?

A knot can cut off circulation; secure the end with clips or tape.

When should circulation be checked after an elastic bandage is applied?

About $10$ to $15\,\text{minutes}$ after application and regularly afterward.

What are signs of poor circulation under an elastic bandage?

Swelling; pale, gray, bluish, or discolored skin; shiny tight skin; cold skin; sores; numbness; tingling; pain or discomfort.

What should an NA do if signs of poor circulation occur with an elastic bandage?

Loosen the bandage and notify the nurse immediately.

Why should an elastic bandage be checked often?

It can wrinkle, loosen, or bunch up, reducing effectiveness and causing pressure or discomfort.