CNA Review

Elastic Stockings criticals

1) Pre-procedure hand hygiene

2) Removed twists, creases, and/or wrinkles without damaging the skin

3) Hand hygiene after procedure

4) Lowered the bed to a safe level

50 post - procedure performed hand hygiene

Elastic stockings skill quiz -

Under what condition might a patient need to wear elastic stockings?

When a patient has limited mobility

Elastic stockings skill quiz - Question 2: 

What is an embolism?

A blood clot that can travel from where it was formed

Elastic stockings - Skill Quiz Question 3: 

What is another name for elastic stockings?

Anti-embolic stockings

Elastic Stockings Skill Quiz - Question 4: When should elastic stockings be applied?

First thing in the morning before the patient gets out of bed

Elastic Stockings Skill Quiz - Question 5: How should a knee-high elastic stockings look when it has been applied correctly? 

It should fit smoothly over the leg with no twists or wrinkles

Elastic Stockings Skill Quiz - Question 6: What should the heel of the elastic stockings be?

Over the heel of the foot

Elastic Stockings Skill Quiz

Question 7: Avoid rubbing the elastic stockings up the leg to get the wrinkles out of the stocking to prevent …

Shearing

Assisting a Male Patient with a Urinal - Question 1: 

To position the urinal properly the handle should be in this position? 

Up

Skill Quiz - Urinal 

If the patient shares a bathroom, the urinal should be…

Labeled with patient’s name and room number

Skill Quiz - Urinal

Patients may be embarrassed about needing help with elimination. The key points the NA should focus on are…

Dignity, privacy, and professionalism

Skill Quiz - Urinal

A Male may use the urinal in the standing, sitting, or lying position; however males generally urinate easiest in which position?

Standing

Skill Quiz - Urinal

For this skill…

a) Only the head of the bed is raised

b) the bed itself is not raised

c) a bath blanket is not needed

d) all of the above

D) all of the above

Urinal critical steps

1) Pre- procedure hand hygiene

2) Procedural hand hygiene and put on gloves

3) Procedural removal of gloves and hand hygiend

4) post-procedure hand hygiend

5) Report and Record color, amount, and characteristics of urine

Urinal - Supplies needed

Urinal (patient’s name and room #), towel/barrier, wipes, trash bag, spray bottle, and nonskid foot wear

Skill Quiz - Ambulate

When a nursing assistant helps a patient Ambulate the NA is

Walking with the patient

Skill Quiz - Ambulate

A nursing assistant should use a gair belt to …

Ensure safety when assisting a patient to walk

Skill Quiz - Ambulate

Allowing the patient to sit on the edge of the bed with feet on the floor before standing…

Helps the patient establish balance and determine if they are dizzy

Skill Quiz - Ambulate

What kind of shoes should a patient wear for ambulation?

Sturdy, nonskid shoes with fasteners

Skill Quiz - Ambulate

When ambulating a patient, a nursing assistant should …

Walk behind the patient on the weaker side with both hands on the gait belt in an upward grasp- one hand on the weak side and the other hand grasping the back

Skill Quiz - Ambulate

Transfer belts should be removed…

Slowly and gently to avoid bruising the patient’s skin

Skill Quiz - Ambulate

When assisting a patient to Ambulate with a cane, the nursing assistant should direct the patient to move the cane?

In front of the stronger leg

Skill Quiz - Ambulate

How should the NA assist a falling patient?

The NA should move close to the patient and use their body to lower the patient to the floor

Supplies needed- Ambulate

cane, walker, gait belt, nonskid footwear

Ambulate - critical

(not including hand hygiene)

1) Confirmed the bed is in a position that is a safe and comfortable level for the patient. Locked the bed wheels

2) immediately stood on patient’s weak side while patient gained balance. Held gait belt at the patient’s weak side and back

3) Placed the call light and other personal items within reach

Supplies needed - Commode

Commode w/basin, towel, toilet paper, wipes, spray bottle, gait belt, and nonskid footwear 

Skill Quiz - Commode

When the NA is assisting a patient to use the commode, proper terms for bodily functions and using a towel or blanket to cover the patients private parts promotes…

Dignity

Skill Quiz - Commode

The portable commode is useful for the patient who…

Is able to get out of bed cannot walk to the bathroom

Skill Quiz - Commode

The removable container underneath the commode’s toilet seat should be cleaned…

After every use

Skill Quiz - Commode

To help a patient who has a weak side transfer to the bedside commode, the NA should…

Use a gait belt, lock the wheels of the bed and commode, transfer toward the strong side

Commode criticals

1) Pre - procedure hand hygiene

2) procedure - hand hygiene and gloves

3) Procedure remove gloves - hand hygiene

4) Before re-entering room - hand hygiene

5) post - procedure Performed hand hygiend and put on gloves

6) Post procedure - discarded gloved and hand hygiene

Skill Quiz - Bed pan

What is a bedpan used for?

A bedpan is used by patients who cannot get up to use a toilet

Skill Quiz - Bedpan

Which of the following is an important privacy measure for this procedure? 

Covering the patient for privacy during the procedure

Skill Quiz - Bedpan

Which of the following bedpans is most indicated for people who cannot assist with lifting their hips

Fracture bedpan

Skill Quiz - Bedpan

After the nursing assistant leaves the room to provide for the patient’s privacy, how much time should they give the patient?

The nursing assistant should come back in the room immediately after the patient signals

Skill Quiz - Bedpan

What should be observed about the contents of the bedpan? 

Color, consistency, and amount of contents

Skill Quiz - Bedpan

A regular bedpan should be positioned …

With the wider end aligned with the patient’s buttocks

Bed pan - Supplies needed

fracture and standard bedpan, trash bag, bed protector, toilet paper, wipes, gloves

Skill Quiz - Incontinent Brief

The Na should never refer to an incontinent brief as a diaper because of the key concept of…

Dignity and Professionalism

Skills Quiz - Brief

When removing a soiled brief, the Na should…

Roll it inward, working from front to back

Skills quiz - Brief

Your patient is wearing an incontinent brief. Wet briefs should be changed …

Immediately

Skills Quiz - Incontinent brief

Which of the following are true statements about urinary incontinence

a) urinary incontinence is a normal part of aging

b) urinary incontinence is not a normal part of aging

c) urinary incontinence is irritating to the skin and a major risk factor for pressure injuries

d) both b&c

Both B&C

Supplies needed - Incontinent Brief

Disposable pad, wipes, clean brief, trash bag, bath blanket, linen bag, and marker/pen - gloves

Incontinent Brief Criticals - outside of hand hygiene

Asked patient if the brief was comfortable if it felt to loose or tootight

made sure brief did not rub or irritate the groin and adjusted as needed

Skills Quiz - Dentures

How should Dentures be handled?

Dentures are very expensive and must be carefully and safely handled

Skills quiz - dentures

which of the following liquids can be a substitute for denture solution in a storage cup

clean, cool water

Skills Quiz - Dentures

Why should a nursing assistant line the sink with a towel before cleaning dentures?

It protects against accidental damage if the nursing assistant drops a denture

Skills quiz - dentures

What information should be on a denture cup?

The patient’s name and room number

Skills quiz - denture

Which parts of the dentures must be cleaned?

The entire denture, including the chewing and gum - surface areas

skills quiz - Dentures

After removing dentures from a patient’s mouth they should be put in the ———  ———- because they are considered dirty. Once they are brushed and rinsed, they are placed in the ——- ——- or returned to the patient because they are considered clean. 

Emesis basin, denture cup

Supplies needed - Dentures

Dentures, denture brush, toothbrush, sponge swab, toothpaste, kidney basin, denture cup, cleansing tablets, 2 towels, cup for water, cup for mouthwash, mouthwash, barrier, gloves, 2 gauze squares

Criticals ( not hand hygiene) - Dentures

Line the bottom of wash basin with a towel 

Skill Quiz - pulse

What is the most common site for checking the patient’s pulse

Inner wrist

Skill Quiz - pulseWhat is the name of the most common pulse site?

Radial pulse

Skill quiz - pulse

What does the term pulse rate mean?

the number of times the heart beats per minute

Skill quiz - pulse

For how many seconds should a nursing assistant count the pulse rate? 

60 seconds

skill quiz - pulse

Which of the following should be reported immediately?

Irregular pulse rate

Skill quiz - Respirations

What makes Sup a true respiration?

One full inhale and full exhale

Skill Quiz - Respirations

Respiration rate should be counted immediately after doing what?

counting a patient’s pulse rate

Skill Quiz - Respiration

What is the purpose of measuring respiratory rate at that time? 

The patient will be less likely to alter breathing patterns if they believe another vital sign is being monitored

Skill quiz - Respirations

Terms that describe respiration characteristics

speaking in phrases, absent, quiet, steady, irregular, regular, noisy, shallow, periods of apnea

Skill Quiz - Pulse

Terms that describe pulse characteristics

Regular, Irregular, strong, faint, skipping beats, steady, bounding, quiet, absent, even

Supplies needed - Pulse and Resp

Clock/watch, pen, paper/report sheet

Criticals - Pulse and Resp

1. Counted pulse for 1 min remembered the number and special characteristics

pulse mustbe within 2 beats to be considered accurate

2. Counted resp for 1 min starting with inspiration remembers number and special characteristics

3. must be withing two resp to be acaccurate noted who, what, when , where, why on paper sheet

Skill quiz - PPE

Proper order for donning

Gown, mask, goggles, gloves

Skill Quiz - PPE

What is the proper orderfor doffing PPE?

Gloves, goggles, gown, mask

How should a nursing assistant remove the gown?

The NA should roll from the neck to the hem touching only the inside

Should gloves be on the inside or the outside of the gown?

Gloves should be overing the outside cuff of the gown

Body fluids include…

tears, saliva, sputum, vomit, urine feces, semen, vaginal secretions, pus, and other wound drainage

Criticals - PPE

Not hand hygiene

• Reached behind and pulled gown until it overlapped in back and completely covered clothing (neck to knees) and covered arms to the end of wrists

• Unfastened gown at neck and waist and removed gown properly without touching outside of gown

Supplies - PPE

gown, mask, goggles.gloves, red Bio bag

What does USA & DFW mean?

Undress Strong Always

Dress First Weak

Skills quiz - Dressing a patient

What are acceptable words to use when referring to a patient’s affected side?

Involved, weaker

Skill quiz - Dressing a patient

When the patient cannot offer much help, what can the nursing assistant do to make dressing patient easier?

Roll sleeves and pant legs to make working them over limbs easier

Supplies needed - dressing a patient

Bath blanket, shirt, pants, or gown, and nonskid footwear

Critical - Dressing a patient

What is the order for undressing and dressing?

Undress fully using doing the strong side first

Then dress top half 

then dress bottom half

Skill quiz - Catheter drainage

What is fluid balance?

Fluid balance refers to taking in and eliminating the same amount of fluid

Skill quiz- Catheter drainage

In healthcare what is a hat used for?

to collect urine or feces in a toilet

What unit of measure is used for urine output measuring?

Mililiters

Supplies needed - catheter drainage

Graduate, 2 barriets, alcohol wipes, paper towels, gloves, I&O sheet,  pen, and report sheet

Criticals - Catheter drainage

not hand hygiene

Cleaned the end of the drain with an alcohol wip,

closed and position the clamp

recorded amount and time accurately on the patient’s I&O sheet

Skill Quiz - Bed bath

What is the correct order for washing a patient’s face?

Eyes, ears, then neck

Skills quiz - Bed bath

What is the correct order for washing a patient’s body?

Face, arm, hand, chest, abdomen, leg, foot, back

Skill quiz - Bed bath

To avoid contaminating areas of the body already washed, the NA should wash, rinse, and dry in what manner?

Top to bottom, one body part at a time, most distal to proximal

Supplies needed - Bed bath

Bath blanket, bath towels, 3 washcloths, clothing, gown, bath basin, lotion, soap, deodorant, brush/comb, orangewood stick, nail file, barrier, gloves, and linen bag

Criticals - Bed bath

Not hand hygiene

• filled basin to comfortable water temperature

• Placed call light and other personal items within reach

Which is the correct order of steps when a nursing assistant is providing perineal care for a female patient?

the NA should wash the labia, the groin onto the thighs, and the anal area

What is the correct order of steps when a nursing assistant is providing perineal care for a male patient?

The NA should wash the penis, the scrotum, the groin onto the things, then the buttocks, and anus area

It is a critical that the foreskin of the ——— male be replaced to its normal position as soon as the area is ——- to prevent affecting circulation to the head of the penis

uncircumcised, rinsed

Supplies needed - perineal care

blanket, clean towel or paper towels /barrier, bath basin, bath thermometer, soap, or other cleaning agent as directed, 8-12 washcloths, bath towel, waterproof pad, gloves, linen bag, trash bag

Criticals of Perineal

Spread the labia and remove and replace the foreskin of penis

Gloves are worn anytime except…

When giving a back rub to someone with intact skin

Gloves are also/should be worn…

When performing personal care on nonintact skin, if the caregiver has sores or cuts on their hands, When disposing of soiled substances, When touching a contaminated surface or equipment

When should gloves be changed?

If they are wet or worn, soiled, or torn 

Dirty linen is folded toward the ——- and rolled from —— to ——. 

Center, head, toe

Carry dirty linen ——— your uniform

Away from

Only touch the inside of the linen or trash bag with ——- 

gloves

Supplies needed - soiled linens

gloves, linen, linen bags, disinfectant, equipment

Soiled linen should be rolled inside itself…

to middle of bed toward the patient

In what order from bottom to top should an NA’s clean linen be stacked 

Glat sheet, pillowcase, fitted sheet, bathblanket

Criticals - Occuped bed

Made a 2-inch toe pleat across the foot of the bed approximately 6-8 inches from the foot of the bed