Care One CNA Test 2 Review

What is basic restorative care?

Care provided after rehabilitation when the patients highest possible functioning has been restored following illness or injury.

What is the role of the NAI for basic restorative care?

Be positive, supportive, emphasize abilities, explain planned activities, treat them with respect, allow patient to express how they feel. (develop empathy for situations, praise their accomplishments)

What is bowel and bladder training, the NA role, and how long does it take to be successful?

- measures taken to restore function of urination and defecation by resident, with ultimate goal of continence

- success can take 8-10 weeks

Range of motion

the capability of a joint to go through its complete spectrum of movements

Abduction

moving a body part AWAY from the center of your body

Adduction

Moving a body part TOWARDS the center of your body

Flexion

the bending of a body part

Extension

the straightening of a body part

What are the changes in the integumentary system in the elderly?

- Skin is thinner and more fragile

- Skin loses elasticity

- Person feels cold

- Hair thins and may gray

- Nails harden and become more brittle

- Skin starts to wrinkle and brown spots may appear

- Reduced circulation to the skin which leads to dryness and itching

- development of skin tags, warts, and moles

Explain what a pressure injury is and list ways to prevent them

Any lesion caused by unrelieved pressure that results in damage to underlying tissue

- handling, moving and positioning of the residents

- providing skin care

How often should you reposition a non-ambulatory patient and why?

Every 2 hours

- This promotes well-being and comfort

- easier breathing

- promotes circulation

- prevents pressure ulcers and contractures

What changes occur in the musculoskeletal system as one ages?

- Muscles weaken and lose tone

- Bones lose density and become brittle

- Slower movement and nerve interaction

- Joints stiffen and decrease in their range of motion and flexibility

Range of motion exercises are important because it can help prevent which two conditions?

1. Contractures

2. Skin pressure ulcers

How do you care for a resident with a stroke (CVA)?

(will vary depending on severity)

- Assist team to strengthen muscles and keep joints mobile

- Provide range of motion

- Maintain correct body alignment and support extremities with pillow and other measures

- Maintain positive attitude

- Encourage independence and self esteem by letting resident do as much care whenever possible

- Be very observant to changes in skin condition especially those areas at risk for pressure injury development

- Be aware with bath water temperature

- Adapt self care activities to limitations of the residents conditions

What is constipation and what changes in elderly persons increases their risk for constipation?

Occurs when stool moves too slowly through intestine

Can result from

- decreased fluid intake

- poor diet

- inactivity

- medications

- aging

- certain diseases

- not taking the time to have a bowel movement

What are the functions of the urinary system?

Kidneys:

- filter waste from blood and produce urine

- help maintain water balance and blood pressure in body

- regulate the amount of electrolytes in the body

Urinary bladder

- stores the urine till it passes from the body

What changes occur in the urinary system due to aging?

- Decreased kidney size and ability to filter blood

- Decreased capacity, elasticity, and muscle tone of bladder

- Decreased ability to concentrate urine

- Enlargement of prostate in males

- May awaken several times at night to urinate

- Sense of thirst lessens (results in less intake and output)

What is the difference between male and female urinary systems?

The length

What is urine incontinence?

The inability to control the bladder, leading to involuntary loss of urine

What is the function of the endocrine system?

- Maintains homeostasis (balance)

- Influences growth and development

- Regulates sugar in blood and calcium in the bones

- Regulates reproduction

- Regulates how fast cells burn food

What is diabetes?

The most common disorder of the endocrine system and occurs when the pancreas does not produce enough insulin

How does diabetes affect us?

- Our body cannot make enough insulin

- Glucose levels rise and stays in our blood causing health problems like heart disease, vision loss, and kidney disease

What is the role of the NAI in taking care of diabetics?

- Ensure meals are served and resident eats diet, report to nurse if resident refuses meal, observe intake and document

- Encourage resident to follow exercise program

- Observe for sings of low blood sugar (hypOglycemia) and high blood sugar (hypERglycemia); report to nurse

- Provide foot care as directed and observe for irritation or sores, report immediately to nurse

What are good body mechanics?

Good body mechanics

- Maximize strength

- Minimize fatigue, muscle strains, injury

- NA is required to move lift objects regularly

What are the ABCs of good body mechanics?

- Alignment

- Base of support

- Coordination

What type of injury can happen to an NAI who doesn't practice good body mechanics?

strained back

How should a NAI lift and transfer residents?

- Maintain correct body alignment

- Use large muscles of upper arms and thighs to lift

- Keep movements smooth when lifting, do not make jerky movements

What are the NAI responsibilities when transferring and breaking a fall during ambulation?

- Control the direction of the fall by easing the resident to the floor, PROTECTING THEIR HEAD

- Keep the resident still until the nurse can check for injuries

- DO NOT try to hold resident up because it can hurt both the NA and resident

- DO NOT try to hold the resident up because NA may lose balance

Supine

When a resident is positioned flat on their back

Fowler

Resident is reclined in sitting position (45 - 50 degrees)

Semi - fowler

Resident is reclined at a 30 - 45 degree angle

What is output?

Amount of fluids eliminated each day.

What is intake?

Amount of fluids taken in each day.

What is an important first step before giving a patient a meal tray?

Check the diet card and ask for residents name

What are the 3 Rs when delivering a meal tray?

Right RESIDENT

right MEAL TRAY

right DIET

How does an NAI care for a resident on a feeding tube?

- Keep head elevated

- Being careful not to pull tube out

Define aspiration.

The accidental breathing in of food, fluid, vomit, or other object into the lung

What is the Nurse Aides role in prevention of aspiration?

- Place resident upright

- Feed slowly

- Avoid distractions

- Small bites

- Thickened liquid

Name two medical conditions where a patient is placed on fluid restrictions and I&O?

1. Aspiration

2. Edema (heart and kidney)

What are the functions of sodium in the body?

Conducts nerve impulses

What are the functions of calcium in the body?

Muscle contractions

How many mLs are in an ounce?

30 mL

How many mLs are in 4 oz?

120 mL

How many mL are in 8 oz?

240 mL

What are some precautions regarding placing restraints on patients?

- Must protect the person

- Doctors order required

- Only used when other measures fail

- Least restrictive method used

- Informed consent

- Must be monitored

- Every 15 min monitor every 2 hour release

Define false imprisonment

Unlawful restraint or restriction or residents freedom of movement

What is the responsibility of the NAI when caring for a patient in restraints?

- Follow care plan

- Consider residents needs

-Report changes in skin color and temperature

- Take time with meals and encourage fluids

- Make patient comfortable

- Check restrains

How does a nurse aide check a vest restraint?

Hand has to fit between chest and vest

How does a nurse aide check a wrist restraint?

One finger fits between wrist and restraint

How does a nurse aide check hand mitten restraints?

One finger fits between the wrist and restraint

Define hippa

Healthcare insurance and accountability act;

Protects privacy and security of healthcare information

How do you promote confidentiality in the workplace?

Only giving patient information when necessary

What does it mean to let a resident move at their own pace? Why is this important?

Go at the residents pace and give them time

Important for them to feel like they are capable of doing so

Where do arteries cary blood?

Takes oxygenated blood away from heart

Where do veins cary blood?

Takes deoxygenated blood towards heart

Define objective

-unbiased

-based on NA observations

-factual, measurable

Define subjective

- opinion

- reported from patient

-feeling

Define prosthetic devices.

Replacement for loss of body part, specifically fitted to one person.

What is the NAI role for prosthetic devices?

-handle device with care

- keep prosthetic and skin clean and dry

- observe skin under and near frequently for signs of skin breakdown caused by pressure and abrasion

Define orthotic devices.

Helps support and align a limb and improves function.

What is the NAI role for orthotic devices?

- devices are specific to resident and should only be used by them

- always be alert for devices that might rub a bony prominence and report to nurse immediately

- keep the orthotic device and the skin clean and dry