health tech quiz 2

Homeostasis

The dynamic balance and physiological stability maintained within the body's internal environment.

Integumentary System

Skin, hair, nails, and glands; acts as an external barrier against infection, prevents dehydration, regulates temperature, and senses touch.

Musculoskeletal System

Bones, joints, muscles, tendons, and ligaments; provides body framework, enables locomotion, shields internal organs, stores calcium, and synthesizes blood cells.

Muscle Atrophy and Its Effects

Wasting or decrease in muscle size and strength from disuse or disease, causing pronounced weakness, impaired balance, and high fall risk.

Age-Related Respiratory Changes

1) Stiffening of chest wall and lungs reducing expansion capacity. 2) Decreased alveolar surface area impairing oxygen-carbon dioxide gas exchange.

Effects of Decreased Vascular Elasticity from Aging

Arterial hardening causing higher vascular resistance, elevated blood pressure (hypertension), poor distal perfusion, and orthostatic hypotension.

Major Effects of Aging on the Nervous System

1) Slower nerve conduction producing delayed reflexes and response times. 2) Blunted sensory reception to pain, touch, and temperature.

Constipation in Older Adults

Difficult passage of hard, dry feces; caused by slowed GI peristalsis, decreased dietary fiber/fluids, immobility, and medication side effects.

Age-Related Urinary Changes and UTI Risk

Decreased bladder capacity and weakened muscle tone lead to incomplete emptying (urinary retention); stagnant residual urine breeds bacterial growth.

Pressure Ulcer Formation

Unrelieved pressure over a bony prominence occludes capillary blood flow, depriving cells of oxygen and causing tissue ischemia and necrosis.

Osteoporosis

Systemic bone disease marked by low bone mass and porous bone structure, making bones brittle and highly vulnerable to pathological fractures.

Care Considerations for Osteoporosis

Handle and transfer residents gently to avoid fractures, enforce strict fall precautions, promote prescribed weight-bearing exercise, and ensure calcium/vitamin D intake.

Hip Fracture Care and Observations

Maintain an abduction pillow between legs, prohibit hip flexion past 90 degrees, prevent leg crossing, and monitor for surgical infection or leg shortening/external rotation.

Cast Care Guidelines and Observations

Perform regular neurovascular checks on exposed digits (color, pulse, warmth, sensation, movement), keep cast dry, never insert items inside, and report numbness or odors.

Phantom Limb Pain

Real pain or burning perceived in a missing extremity following amputation, caused by lingering neurological signals from severed nerve endings.

Procedure for Collecting a Sputum Sample

Collect first thing in the morning; have resident rinse mouth with water only (no mouthwash), then cough deeply from the lungs directly into a sterile cup without touching the interior.

Comfort Measures for Respiratory Distress

Elevate bed to high Fowler's or orthopneic position, loosen tight clothing around neck and chest, coach pursed-lip breathing, supply prescribed oxygen, and reduce anxiety.

Symptoms of Bronchitis

Productive cough producing thick yellow, green, or clear sputum, dyspnea, audible wheezing, chest discomfort, fatigue, and low-grade fever.

Angina Pectoris

Paroxysmal chest pressure, tightness, or radiating pain caused by transient myocardial ischemia due to narrowed coronary arteries, often induced by stress or exertion.

Transient Ischemic Attack (TIA) vs. Stroke (CVA)

A TIA is a temporary decrease in brain blood flow resolving completely within 24 hours without permanent deficits; a stroke causes permanent cerebral infarction and brain damage.

Hemiplegia

Total paralysis of one lateral side of the body, most frequently caused by a unilateral stroke (CVA) or traumatic brain injury.

Aphasia

Acquired neurological language deficit caused by brain damage, impacting the capacity to speak, comprehend, read, or write.

Expressive Aphasia (Broca's Aphasia)

Condition where the individual understands spoken words but cannot produce words or speak/write fluently.

Receptive Aphasia (Wernicke's Aphasia)

Condition where the individual can produce fluent speech but cannot comprehend spoken or written language, making speech meaningless or incoherent.

Parkinson's Disease

Progressive neurodegenerative disorder from dopamine depletion in the brain; characterized by resting pill-rolling tremors, muscular rigidity, bradykinesia, and a shuffling gait.

Classifications of Spinal Cord Injury

Paraplegia: paralysis of lower trunk and legs from thoracic/lumbar injury. Quadriplegia (tetraplegia): paralysis of all four limbs and trunk from cervical injury.

Cataracts

Progressive clouding and opacity of the eye's crystalline lens, causing blurry vision, poor night sight, glare sensitivity, and faded color perception.

Care Guidelines for Visually Impaired Residents

Identify yourself upon entering/leaving, explain procedures before touching, describe meal plates using clock-face directions, keep paths clear, and never move personal items unannounced.

Signs and Symptoms of Hypoglycemia

Diaphoresis (cool, clammy skin), tremors, tachycardia, dizziness, acute confusion, extreme hunger, irritability, and headache.

Signs and Symptoms of Hyperglycemia

Polyuria, polydipsia, polyphagia, warm dry skin, sweet fruity breath odor, nausea, drowsiness, and rapid deep breathing (Kussmaul respirations).

Kidney Stones (Renal Calculi) and CNA Responsibilities

Mineral deposits forming in the urinary tract; CNA must push fluids, strain all urine through a filter to catch passed stones, record strict I&O, and report severe flank pain.

Coping Mechanisms

Conscious behavioral and cognitive tactics utilized by an individual to handle, adjust to, or mitigate emotional stress and life demands.

Defense Mechanisms

Unconscious mental protection strategies (e.g., denial, projection, rationalization, repression) used by the ego to defend against psychological anxiety.

Obsessive-Compulsive Disorder (OCD)

Anxiety disorder involving recurrent, involuntary thoughts (obsessions) driving repetitive, ritualistic behaviors (compulsions) performed to reduce tension.

Clinical Depression (Major Depressive Disorder)

Affective mood disorder characterized by persistent sadness, loss of pleasure (anhedonia), insomnia or hypersomnia, appetite loss, fatigue, worthlessness, and suicidal thoughts.

Hallucination

A false sensory perception involving sight, sound, smell, taste, or touch without any actual external physical stimulus.

Disability

A measurable physical, sensory, cognitive, or mental limitation that substantially hinders execution of daily activities of daily living (ADLs).

Three Phases of the Rehabilitation Process

1) Acute Phase: Immediate medical stabilization and prevention of complications (contractures, bedsores). 2) Subacute Phase: Active restorative therapy for ADL recovery. 3) Chronic Phase: Preserving functional gains.

Physical Therapy (PT)

Rehabilitative treatment dedicated to restoring gross motor skills, leg strength, joint mobility, transfer techniques, and safe ambulation.

Occupational Therapy (OT)

Rehabilitative treatment focused on fine motor control and adaptive techniques to restore independence in self-care ADLs (eating, bathing, dressing).

Speech-Language Therapy (ST)

Rehabilitation addressing voice production, language comprehension/expression, cognitive communication, and swallowing rehabilitation for dysphagia.

Fowler's Position and Clinical Uses

Semi-upright sitting posture with head of bed elevated 45 to 60 degrees; used during meals, oral meds, mouth care, and to ease dyspnea.

Danger of Lifting or Pulling by Extremities

Produces severe shear and tensile stress on fragile geriatric tissues, causing skin tears, subcutaneous bruising, and joint dislocations.

Repositioning Frequency for Immobile Residents

Reposition at least every 2 hours while in bed, and shift weight at least every 1 hour when seated in a chair or wheelchair.

Benefits of Resident Ambulation

Enhances venous return, stimulates bowel peristalsis, increases lung expansion, preserves skeletal/muscular strength, and supports independence.

Purpose of a Bed Blanket (Bath Blanket)

Provides thermal warmth while safeguarding resident modesty, dignity, and bodily privacy during bed baths and hygiene procedures.

Clean Linen Handling Guidelines

Hold clean linens away from personal uniform, set only on disinfected barrier-protected surfaces, and never return unused linen to hall supply carts once brought into a room.

Dirty (Soiled) Linen Handling Guidelines

Roll soiled surfaces inward, hold bundle away from uniform without shaking, never place on floors or clean furniture, and discard straight into dirty hampers.

Indications for Wearing Gloves During Bed Changes

Whenever linens are damp, wet, or visibly soiled with blood, urine, feces, emesis, or wound exudate under Standard Precautions.

Clinical Significance of a Neat, Well-Made Bed

Creates a sanitary, comfortable, and dignified recovery environment while eliminating sheet wrinkles that damage fragile skin.

Negative Effects of Wrinkled Sheets on Skin

Concentrates focal pressure and produces frictional shear against skin tissues, accelerating skin tears and pressure ulcer development.

Frequency of Bed Linen Changes

Immediately whenever linens become damp, wet, or soiled, and routinely on designated shower/bath days per facility policy.

Importance of Checking Linens Before Removal

Prevents inadvertent disposal or laundering of resident personal items like dentures, eyeglasses, hearing aids, and call buttons.

Proper Bed Positioning During Linen Changes

Raise bed to caregiver waist level to maintain proper ergonomics and prevent back injury; keep side rail up on the opposite side to prevent resident falls.

Importance of Good Personal Hygiene

Eliminates dirt, sweat, and pathogens to prevent infections and body odor, preserves epidermal integrity, stimulates circulation, and boosts morale.

PRN (Pro Re Nata) Care

Nursing care, treatments, or medications provided on an as-needed basis determined by resident condition, rather than on a fixed schedule.

Importance of Flossing in Addition to Brushing

Dislodges food remnants and bacterial plaque from interproximal spaces and beneath the gumline where bristles cannot reach, preventing gingivitis and decay.

Standard Precautions During Oral Care

Gloves are required because saliva contains microbial pathogens and irritated oral tissues frequently bleed, posing bloodborne pathogen risks.

Two Main Reasons for Providing Proper Perineal Care

1) Prevents bacterial migration up the urethra causing UTIs. 2) Prevents skin maceration and chemical dermatitis from acidic/enzymatic urine and feces.

Technique for Protecting Modesty During Perineal Care

Pull privacy curtains, close doors, cover resident with a bath blanket, and expose only the immediate perineal area undergoing active cleansing.

Indications for a Partial Bed Bath

Given to residents too frail or exhausted for full baths, those with dry skin, or on routine non-bath days to wash face, hands, axillae, and perineum.

Preventing Contamination During a Complete Bed Bath

Clean from cleanest to dirtiest areas (eyes and face first, perineum last), and use a fresh, clean fold of the washcloth for every wipe.

Action Required Prior to Reinserting Dentures

Swab or brush the resident's gums, tongue, palate, and cheeks to clear food debris, and wet dentures with cool water for comfortable reinsertion.

Pressure Points: Definition and Common Locations

Bony prominences with minimal protective fat: sacrum, coccyx, heels, greater trochanters, ischial tuberosities, elbows, and scapulae.

OBRA Regulatory Mandate Regarding Pressure Ulcers

Federal mandate requiring that residents admitted without pressure sores remain free of them unless clinically unavoidable, and existing sores must receive healing care.

Nurse Aide's Role in Pressure Ulcer Prevention

Reposition residents at least every 2 hours, maintain clean and moisturized skin, eliminate sheet wrinkles, encourage hydration/protein, and report redness immediately.

Pressure Ulcer Findings to Report Immediately to the Nurse

Non-blanchable erythema, local warmth, tissue hardness (induration), localized edema, blisters, skin peeling, or open ulcers over bony landmarks.

Rationale for Repositioning Every Two Hours

Releases continuous mechanical capillary compression, restoring oxygenated blood perfusion to tissues before irreversible ischemic necrosis occurs.

Importance of Good Skin Care in Pressure Ulcer Prevention

Clean, hydrated, intact skin preserves the stratum corneum barrier, reinforcing tissue defenses against pressure, shear, and friction breakdown.

Importance of Prompt Perineal Care for Incontinent Residents

Caustic digestive enzymes and moisture in urine and feces break down the epidermal layer (dermatitis), drastically speeding pressure sore formation.

The Underlying Etiology of All Pressure Ulcers

Prolonged, unrelieved pressure over a bony prominence that exceeds capillary closing pressure, cutting off blood supply and producing tissue ischemia.

Stages of Pressure Ulcers

Stage 1: Non-blanchable red intact skin. Stage 2: Partial-thickness skin loss, shallow crater or blister. Stage 3: Full-thickness skin loss, visible subcutaneous fat. Stage 4: Full-thickness loss with exposed muscle, tendon, or bone. Unstageable: Slough/eschar obscures base. DTI: Deep red/purple intact skin discoloration.

Direction for Cutting Fingernails

Clip straight across with nail clippers, then smooth edges with an emery board into a gentle curve to prevent ingrown nails and skin scratches.

Direction for Shaving a Resident's Beard

Pull skin taut and shave in the direction of hair growth (downward on cheeks/chin, upward on neck) using short, gentle strokes to avoid nicks and irritation.

Indications for Using an Electric Razor

Required for residents receiving anticoagulant (blood-thinning) therapy, those with bleeding diatheses, or individuals with tremors or severe dementia.

Importance of Assuring Resident Comfort

Reduces physical strain and anxiety, prevents muscular guarding, encourages restful sleep for physiological healing, and conveys dignity.

Benefits of a Therapeutic Back Massage

Boosts local skin circulation, relaxes tight muscles, reduces tension and anxiety, provides comfort, and prepares the resident for restful sleep.

Action When Discovering a Reddened Area During a Back Massage

Do not rub or massage the reddened area, as friction destroys damaged microcapillaries; position resident off the site and report it immediately to the nurse.

Nonverbal Signs of Pain

Facial grimacing, clenching teeth, furrowed brow, guarding body regions, restlessness, groaning, rapid breathing, diaphoresis, and pulling away.

First Action When Noticing a Resident in Pain

Halt the current transfer or activity, reposition the resident into a safe and comfortable position, and immediately inform the supervising nurse.

Physiological Effects of Heat Application

Produces local vasodilation, increasing oxygenated blood flow, relaxing skeletal muscle spasms, easing joint stiffness, and expediting tissue healing.

Physiological Effects of Cold Application

Produces local vasoconstriction, reducing capillary blood flow to control acute edema/swelling, numbing peripheral sensory nerves, and curbing inflammation.

Age-Related Respiratory Changes

1) Stiffening of chest wall and lungs reducing expansion capacity. 2) Decreased alveolar surface area impairing oxygen-carbon dioxide gas exchange.

Effects of Decreased Vascular Elasticity from Aging

Arterial hardening causing higher vascular resistance, elevated blood pressure (hypertension), poor distal perfusion, and orthostatic hypotension.

Major Effects of Aging on the Nervous System

1) Slower nerve conduction producing delayed reflexes and response times. 2) Blunted sensory reception to pain, touch, and temperature.

Constipation in Older Adults

Difficult passage of hard, dry feces; caused by slowed GI peristalsis, decreased dietary fiber/fluids, immobility, and medication side effects.

Age-Related Urinary Changes and UTI Risk

Decreased bladder capacity and weakened muscle tone lead to incomplete emptying (urinary retention); stagnant residual urine breeds bacterial growth.

Pressure Ulcer Formation

Unrelieved pressure over a bony prominence occludes capillary blood flow, depriving cells of oxygen and causing tissue ischemia and necrosis.

Osteoporosis

Systemic bone disease marked by low bone mass and porous bone structure, making bones brittle and highly vulnerable to pathological fractures.

Care Considerations for Osteoporosis

Handle and transfer residents gently to avoid fractures, enforce strict fall precautions, promote prescribed weight-bearing exercise, and ensure calcium/vitamin D intake.

Hip Fracture Care and Observations

Maintain an abduction pillow between legs, prohibit hip flexion past 90 degrees, prevent leg crossing, and monitor for surgical infection or leg shortening/external rotation.

Cast Care Guidelines and Observations

Perform regular neurovascular checks on exposed digits (color, pulse, warmth, sensation, movement), keep cast dry, never insert items inside, and report numbness or odors.

Phantom Limb Pain

Real pain or burning perceived in a missing extremity following amputation, caused by lingering neurological signals from severed nerve endings.

Procedure for Collecting a Sputum Sample

Collect first thing in the morning; have resident rinse mouth with water only (no mouthwash), then cough deeply from the lungs directly into a sterile cup without touching the interior.

Comfort Measures for Respiratory Distress

Elevate bed to high Fowler's or orthopneic position, loosen tight clothing around neck and chest, coach pursed-lip breathing, supply prescribed oxygen, and reduce anxiety.

Symptoms of Bronchitis

Productive cough producing thick yellow, green, or clear sputum, dyspnea, audible wheezing, chest discomfort, fatigue, and low-grade fever.

Angina Pectoris

Paroxysmal chest pressure, tightness, or radiating pain caused by transient myocardial ischemia due to narrowed coronary arteries, often induced by stress or exertion.

Transient Ischemic Attack (TIA) vs. Stroke (CVA)

A TIA is a temporary decrease in brain blood flow resolving completely within 24 hours without permanent deficits; a stroke causes permanent cerebral infarction and brain damage.

Hemiplegia

Total paralysis of one lateral side of the body, most frequently caused by a unilateral stroke (CVA) or traumatic brain injury.

Aphasia

Acquired neurological language deficit caused by brain damage, impacting the capacity to speak, comprehend, read, or write.