CNA Review Too

Why is bedmaking important?

-promotes comfort and well-being of patient or resident

-infection control

-prevent skin breakdown and pressure ulcer formation

-it is a sign of capable, competent care by the facility

What direction should seams face?

away from the patient or resident to prevent pressure sores

what is the main bacteria on skin?

staph

What are common linens used in health care facilities?

-mattress pads

-fitted and/or flat sheets

-draw sheets

-bed protectors (chux)

-blankets

-bedspreads

-pillows and pillow cases

-bath blankets

What is a bed that has a person in it called?

an occupied bed

a bed that has the top linens fanfolded to the side has been prepared for what type of patient?

a patient who will be arriving on a stretcher

what is the purpose of a toe pleat?

to relieve pressure on the feet from tightly tucked sheets

when you are handling linens, always remember to:

hold the linens away from your body

what do you call a metal frame that is placed between the bottom and top sheets to keep the bed linens from resting on the person's feet?

a footboard

what personal protective equipment should be worn when removing used bed linens?

gloves

when are bed linens changed?

-when they become wet or soiled

-according to facility policy

-when they become excessively wrinkled

draw sheet

-a small, flat sheet that is placed over the middle of the bottom sheet, covering the area of the bed from above the person's shoulders to below his or her buttocks.

lift sheet

-is simply a draw sheet that is used to help lift or reposition a person who needs assistance with moving in bed

pressure-relieving mattress

may be placed on top of the regular mattress to help prevent breakdown of skin in residents or patients who must stay in bed for long periods of time

bed cradle

-a metal frame that is placed between the bottom and top sheets to keep the bedspread away from the person's feet

-are often used for people who are recovering from burns to prevent the blanket from touching the burned skin

footboard

-a padded board that is placed upright at the foot of the bed

-the person's feet rest flat against this, helping to keep the feet in proper alignment

mattress pad

-a thick layer of padding that is placed on the mattress to help make the bed more comfortable for the patient or resident, and to protect the mattress from moisture and soiling

bed protector (chux)

-a square of quilted absorbent fabric back with waterproof material

-may be disposable or laundered and reused

-used for people who are incontinent or have draining wounds

-sometimes only this needs to be changed, resulting in more efficient and economical care

blankets

-usually woven cotton and should be available as requested by a person for his or her comfort

-may be wool, cotton, or synthetic, depending on the person's preference and the climate

electric blankets

-should be checked for faulty wiring or plugs

-may not be safe if the person is incontinent or unable to adjust the controls independently

-can be turned on to warm the bed, then turned off once person gets into bed

-make sure to use according to facility policy

incontinent

-a patient or resident who have little or no control over their bowl, bladder, or both

bedspreads

-adds the finishing touch to a well-made bed and can add a decorative touch to a person's room

-long term care facilities may encourage their residents to use their own bed coverings to foster a sense of independence and individuality in residents

pillows and pillowcases

-are used for comfort and to aid in positioning

-they are covered in a waterproof material or treated with a waterproofing substance

-are always covered with clean pillowcases

-pillowcase opening faces away from the door

bath blankets

-a lightweight cotton blanket or flannel sheet that is used to provide modesty and warmth during a bed bath or a linen change

clean linens are a sign the facility is providing competent care. what do clean linens contribute to?

-patient and resident comfort

-infection control

-prevent skin breakdown

when handling linens what do you do first?

perform hand hygiene to prevent microbes being transferred to clean linen

why do you not hold linens against your uniform?

-microbes could be transferred to the clean linens from your uniforms

-microbes could be transferred to your uniform from the dirty linens

why should you only collect the linens you need for that person's bed?

-any extra linens brought into the person's room are now considered dirty

-creates additional cost, wear and tear on the linens, and shortens the life span of the linens

why should you collect linens in the order they will be used; flip stack over so first item in stack will be first one needed?

-helps you remember which linens you need to collect

-more efficient- avoids searching thought the stack

when making a bed why should you make sure the bed is high?

-so no linens accidentally touch the floor

-to keep strain off of your back while changing linens

why should you wear gloves when removing used sheets from the bed?

-any item contaminated with blood or bodily fluids is a potential source of pathogens

-standard precautions and PPEs help limit exposure

why should you roll linens toward the center of the bed?

-to confine soiled areas inside

-confining the soiled areas inside helps prevent exposure to other health care workers

pathogen

-disease causing microbe

PPE

personal protection equipment

why should you use a cleaning solution on mattress or bed frame if exposed to blood or body fluids with appropriate PPEs?

help prevent contamination of clean linens

Why do you place dirty linens in the dirty hamper immediately after taking them off the bed?

help prevent the spread of infection

T/F? no matter what type of bed or type of linens used, it is important to always handle the linens in the proper manner to help prevent spreading of any potential infections.

true

when is routine bedmaking usually done?

-in the morning

-before visiting hours

-while patients or residents are bathing or dressing

a person's bed must be remade each time any of the linens become __________ or __________, regardless of the time of day.

soiled; excessively wrinkled

mitered corner

-a way of folding and tucking the sheet so that it lies flat and neat against the mattress

-helps secure sheets to the mattress

closed bed

-an empty or unoccupied bed

open bed

-The top sheet, blanket, and bedspread are fan folded toward the foot of the bed.

-This makes it easier for the person to get in.

-the wheels should always be locked and the bed in the lowest position

-call light control is clipped to bottom sheet

surgical bed

-a bed that is ready to receive a patient or resident who will be arriving by stretcher

-raise bed to match stretcher height

-lock the wheels

-clear the path to the bed

occupied bed

-a bed made while a person is in the bed.

Why should you pull linens tight to avoid wrinkles and keep layering to a minimum

-wrinkles and extra layers can contribute to skin breakdown and lead to pressure ulcers

Why should you always place seams of sheets away from person's skin?

-they can rub the person's skin, causing irritation and leading to skin breakdown

Why should you not shake linens?

-can stir up dust, easily transferring any microbes from one surface to another surface

-can lead to contamination of surfaces which need to be clean

Why should you always explain to the individual in the occupied bed what you are going to do before starting to change the linens?

-prevent stress, frightening the individual, embarrassment, possible combativeness

why should you disconnect the call light control and any tubes or drains from the linens?

-prevent discomfort from pulling on or possibly accidental removal of tubes and drains

Why should you always check linens for personal items?

-personal items may become lost in linens

T/F? when making an occupied bed, it is a good idea to keep the side rail up on the opposite side from which you are working.

true

Florence Nightingale

-1820-1910

-started training programs for nurses

-set up practices that are still followed today

early nursing assistants were referred to as _______________or ______

"aides" ; "orderlies"

OBRA

Omnibus Budget Reconciliation Act

Omnibus Budget Reconciliation Act (OBRA)

-the competency evaluation

-the principle of reciprocity

-the federal registry

-continuing education

The federal registry

-Continuing education

The Principle of Reciprocity

-certificate may be valid across state lines

continueing education

- minimum of 12 hours required

OBRA requires a minimum of __ hours of training to become a CNA.

75 hours

reponsibilities of a nursing assistant

- Assist nurses in giving care to patients

- Meet the basic physical needs of patients and residents

-Meet emotional and spiritual needs of patients and residents

-act as observer and communicator

the nursing team

-licensed practical nurse (LPN) or licensed vocational nurse (LVN)

-registered nurse (RN)

-nursing assistant (CNA)

scope of practice

-describes the range of tasks the nursing assistant is legally permitted to do

-restricts tasks the nursing assistant is allowed to do

-defines the responsibilities of the nursing assistant

what should you do if you are asked to do something outside of your scope of practice?

politely tell them that the task is outside of your scope of practice and you cannot do it

what are the five rights of delegation?

-the right task

-the right circumstance

-the right person

-the right direction

-the right supervision

when should you refuse an assignment?

-not in job description

-may harm the patient or resident

-task is illegal or unethical

-nurse not available to supervise

-may not have proper equipment

-directions not clear

-have not received adequate training for task

guidelines for accepting or refusing an assignment

-always ask the nurse for clarification if there is something you do not understand

-never perform a task you have not received training for or you feel uncomfortable doing, unless you are supervised by a nurse

-never ignore an assignment because you do not know how to perform the task or the task is beyond your scope of practice

-are responsible to communicate with the nurse

what are some tasks that are beyond CNA scope of practice?

-administer medication/oxygen

-receive verbal orders from physicians

-diagnose illness and prescribe medications

-supervise other nursing assistants

-perform sterile procedures

-insert or remove tubes from the patient's body

ensuring the patient's or resident's needs are properly met requires teamwork from all members of the health care team. What is a good rule of thumb to use when asked to do something you are not familiar with?

see if it is listed in your job description

In the past health care providers were trained in ___________ health care skills rather than for __________ illnesses or conditions.

general; specific

charlatans

-used to offer ineffective "cures" in exchange for money

the ________ was the primary site for patient care.

home

Now health care professionals have to undergo intensive ___________________

educational preparation

large facilities provide __________ patient care

on-site

the family doctor is now called a __________ or ___________ and is supported by a team of specialists

general practitioner; family physician

holistic care

-focuses on the care of the whole person

-physically, emotionally, socially, and spiritually

all organizations have a purpose or ________.

mission

health care organizations

-disease prevention

-promote health

-rehabilitation

-emergency care

-education

-may focus on one or combine them

hospitals

-acute care settings

-may have specialized mission

patients

-People who receive the services of a hospital

inpatient care

a patient who has to stay at the hospital for one or more nights

outpatient care

a patient who goes home the same day that they arrived at the hospital

acute care

-sudden onset and short stay

-typically hospitals

subacute care units

-aka skilled nursing unit or skilled nursing facility

-provides care for a patient who has partially recovered but still requires skilled health care

-may be within a hospital, long-term care facility, or a separate facility

-after the acute care

long term care facilities (LTC)

-nursing homes

-for people who are unable to care for themselves at home, yet do not need to be hospitalized

-become the person's home, either temporarily or permanently

residents

people being cared for in long-term care facilities

assisted-living facilities

-type of long-term care facility

-for people needing limited help

-private apartment or rooms

-help available 24 hours a day

-residents typically just need the lowest level of care

-typically still have to be able to walk

-memory care are licensed as this

residents in assisted-living facilities can receive help with:

-medications

-transportation

-meals

-housekeeping

home health care agencies

-provide skilled care in a person's home

-available for people of all ages with any number of medical needs

clients

people receiving care in the home health care setting

hospice organizations

-people can receive services when they know that they have 3 to 6 months to live

-services are provided for both the dying person and the family

-can be freestanding, in nursing home, or at home

-cannot be provided in hospital

what are the main focuses of hospice care?

-pain relief

-emotional and spiritual support

palliative care

"hospice" in hospital but not skilled

individuals who may need limited assistance with medications, transportation, meals, and housekeeping are often found what health care organization?

assisted-living facilities

board of trustees or board of directors

usually govern health care organizations

an __________ or ________________ is the link between the board and the organization.

administrator; chief executive officer (CEO)

each division of health care organizations is managed by the ___________ or ________________

division director; division manager

nursing services is headed by a _______________ or ____________

director of nursing (DON); chief nursing officer (CNO)

care of patients or residents is provided by a _____________

health care team

each member of the health care team should share the same basic goal:

provide the best holistic care for each patient, resident, or client possible

government and private regulations make sure that:

-providers are properly trained and competent

-health care facilities meet standards of cleanliness and quality

-all products used in the delivery of health care are safe

-quality health care is available to everyone