CNA - Ch.8 + 9

nutrient

a necessary substance that provides energy, promotes growth and health, and helps regulate metabolism

water

most essential nutrient for life

complex carbohydrates

found in bread, cereal, potatoes, rice, pasta, vegetables, and fruits

simple carbohydrates

found in sugars, sweets, syrups, and jellies

- do not have the same nutritional value as complex carbohydrates

protein

needed for tissue growth and repair and energy

excess proteins are excreted by ________ or stored as ___________

the kidneys, body fat

vegetables and fruits should make up ___________ of a person's plate

half

vegetables include...

all fresh, frozen, canned, and dried vegetables, and vegetable juices

what type of protein foods should you eat more often?

plant-based

most dairy group choices should be...

fat free or skim(0%) or lowfat(1%)

low sodium diet

salt is restricted

fluid-restricted diet

limit amount of fluid intake; requires strict monitoring of fluid intake

low-protein diet

People who have kidney disease may also be on this diet which encourages food like breads and pasta

lowfat diet

People who have heart disease or who have had heart attacks may be placed on this diet, which at a minimum limits the intake of saturated fat.

diabetic diet

Carb counting may be part of this diet, as the amount of carbohydrates eaten must be carefully regulated

lacto-ovo vegetarian

excludes all meats, fish, and poultry but does include eggs and dairy products

lacto-vegetarian

eliminates poultry, meats, fish, and eggs, but allows dairy products

ovo-vegetarian

omits all meats, fish, poultry, and dairy products, but allows eggs

clear liquid diet

includes clear juices, broth, gelatin, and popsicles

full liquid diet

includes all the liquids served on a clear liquid diet, with the addition of cream soups, milk, and ice cream.

soft diet

similar to regular diet, but foods must require little chewing and be easy to digest. foods that are hard to chew, such as raw fruits and vegetables, and some meats will be restricted.

mechanical diet

chopped or blended foods that are easier to chew and swallow(prepared with blenders, food processors, or cutting utensils)

what should NAs do and not do regarding nutritional supplements?

- they need to make sure the resident takes the supplement at the ordered time

- they may not be allowed to prepare supplements and/or hand them to residents.

- the NA should not insist that a resident drink a supplement if they dont want to

NPO

nothing by mouth

guidelines for preventing dehydration

- encourage residents to drink every time you see them

- offer fresh water/fluids often. offer drinks that the resident enjoys.

- report to the nurse if the resident tells you they do not like the fluids being served

edema

swelling caused by excess fluid in the body tissues

swelling/edema of extremities can be a sign of...

fluid overload

guidelines for promoting appetites

- give oral care before eating if requested

- offer a trip to the bathroom or help with elimination needs before eating

clothing protectors

- residents have the right to refuse to wear a clothing protector

- NA can offer one, but should not insist

- it should not be referred to as a bib

dysphagia

difficulty swallowing (stroke or CVA can cause weakness and paralysis on one side of the body)

signs that a resident has swallowing problems

- choking during or after meals

- choking during meals

- clearing throat frequently during and after meals

- watering eyes when eating or drinking

- food/fluid coming up into nose

- breathing rapidly or with shorter breaths while eating or drinking

International Dysphagia Diet Standardisation Initiative(IDDSI) developed

developed different levels to identify food textures and drink thicknesses

aspiration

inhaling food, fluid, or foreign material into the lungs

aspiration can cause...

pneumonia or death

parenteral nutrition(PN)

IV delivery of highly concentrated nutrients & vitamins into bloodstream. PN is used when processes digestion is impaired

nasogastric tube

tube inserted through the nose into the stomach

percutaneous endoscopic gastrostomy (PEG)

tube placed into the stomach through the abdominal wall

gastrostomy

a surgically-created opening into the stomach that allows insertion of a tube

what can NAs do with tubes

- they may assemble equipment and supplies and hand them to the nurse

- NAs may position residents in sitting positions for feeding

- they may discard or clean and store used equipment and supplies\- observe, report, and document any changes in resident or problems with feeding

observing and reporting - tube feedings

- redness or drainage around the opening

- skin sores or bruises

- cyanotic skin

- tube falls out

guidelines for dining techniques

- give short and clear verbal cues to prompt the resident to do something

- give verbal cues one at a time, only after the resident has finished the previous task

- use the face of an imaginary clock to explain the position of what is in front of him

residents with special needs have the right to...

be treated as adults and have the right to self determination

Rehabilitation

care that is managed by professionals to restore a person to the highest possible level of functioning after an illness or injury

restorative care

care given after rehabilitation to maintain a person's function and increase independence

guidelines for restorative care

Be patient, positive, supportive. Focus on small tasks. Recognize setbacks, reassure. Be sensitive to needs.

observe and report - restorative care

increase or decrease in activities, change in attitude/motivation, depression or mood changes

ambulation

moving or walking, with or without an assistive device

a resident who is ambulatory...

can get out if bed and move or walk

when helping a resident who has a visual impairment walk...

the NA should be beside and slightly ahead of the resident. the resident should be able to place his hand on the NAs elbow.

phantom sensation

term used when a person feels that the body part is still there

phantom limb pain

occurs when the person feels pain in a limb that has been amputated

Active range of motion(AROM) exercises

are done by the resident without help

Active assisted range of motion(AAROM) exercises

are done by the resident with some help and support from the resident

Passive range of motion(PROM) exercises

are used when residents are not able to move on their own

Flexion

Bending a body part

Rotation

turning a joint

Pronation

turning downward

Opposition

touching the thumb to any other finger

When doing PROM exercises, the NA should...

- begin at the residents shoulders and work down the body

- give support above and below the joints

Are fingers included in a full body exercise?

Yes