CNA Test 2

gait

a manner of walking or moving on foot

incident

any event that has harmed or could harm a resident, visitor, or staff member

incident report

documentation of facts surrounding any unexpected event in healthcare setting; also called an occurrence, accident or event report

punitive

inflicting, involving, or aiming at punishment

incident reporting

method of documenting facts surrounding an unexpected event in healthcare setting

when is incident report required?

resident falls, verbalizes or shows fear or signs of harm, develops unusual signs of pain, has visible misalignment of an extremity or develops a noticeable change in gait, mistake is made while providing resident care, nurse aide performs task out of range of function, inappropriate actions, something broken or damaged, sexual remark, healthcare team injured or exposure to blood pathogen, angry outburst, item of value missing

what is included on incident report

location, who was present, what was seen or heard, time, sequence, reaction, facts, action taken to care, outcomes, complete ASAP

truth about incident reports

track negative impact on resident, new policies to prevent incidents, protective measure

critical thinking

exercising or involving careful judgment based on facts and observations, required to provide safe, competent care to residents, immediately reports to nurse, a resident who is confused today and was appropriate yesterday

importance of critical thinking

allows nurse aide to put theory into practice when caring for resident and administer care in safe manner

critical thinking questions

what problem do i need to solve? what info do i need and where can i get it? what am i missing? how do i solve the problem?

how to react if both resident arms in cast and she asks for drink of water?

ask the resident what help you can provide, offer to hold cup while she drinks it

how to react if two patients ringing call bells at same time and one needs a drink and the other needs the bathroom?

help resident to bathroom and provide drink the next resident after

how to react if doctor has order jones to be NPO before surgery and his meal tray was set up on the cart and he eat its?

may have his surgery cancelled or delayed for 8-12 hours 

how to react if smith is unable to control swallowing and she asks for coffee on thickened liquid diet?

mix coffee and thickener according to manufacturer and resident care plan

how to react if salt packet on tray to be delivered for patient that is on sodium controlled diet?

remove salt packet from tray before delivered to resident 

family

group of individuals related by blood, marriage, or a feeling of closeness 

family support

offers of encouragement, assurance, and sense of connection for the resident offered by blood relatives or group of individuals close to the resident

importance of family support

gives resident sense of connection, help resident make difficult decisions, gives assurance that specific wishes be honored, helps meet safety and security, and love and belonging

nurse aide role in family support

orient family to facility, learn names, get to know family, work on building relationship, keep communication lines open, be respectful, reassure family members

what would nurse aide report to nurse about family?

resident is crying after visiting with family members

which of these factors will negatively affect family member’s decision to place their loved one in facility where you work?

strong smell of urine, residents are still in bed and undressed at 11am, signaling device light on for more than 5 minutes

what is important to ask family of aphasic resident

their likes and dislikes

which questions can be answered by nurse aide?

how did mom sleep? did mom go to therapy yesterday? 

adaptive devices

assistive devices, special equipment that helps a disabled or ill resident perform activities of daily living 

amputation

surgical removal of a body part

basic restorative care

care provided after resident’s highest possible functioning is restored through rehabilitation following illness or injury

bladder/bowel training

measures taken to restore function of voiding and defecating by resident, with the ultimate goal of continence

contraindication

specific situation or factor that makes a procedure or course of treatment inadvisable because it may be harmful to a person

defacation

process of emptying the rectum of feces

empathy

being able to identify with and understand how a resident feels with the willingness to alter one’s behavior in light of how others feel

enema

introduction of fluid into colon to eliminate stool or feces or stimulate bowel activity

functional loss

partial or complete loss of function of a body part

incontinence

the inability to control urination or defacation

orthotic device

medical device designed to support, align, or enhance the function of a person’s muscoskeletal system and may help with one’s appearance 

prosthetic device

artificial replacement device for a body part that is missing or deformed and specifically fitted to one person; intended to improve a person’s function and appearance

range of motion

amount that a person can move a joint voluntarily 

rehabilitation

restoration of a resident’s highest possible functioning following illness or injury

supportive device

special equipment that helps a disabled or ill resident with movement

urination (or voiding)

the process of emptying the bladder

assistive devices for positioning

pillows, bed cradle

what are footboards used for

help prevent plantar flexion (foot drop)

goals of restorative care

maintaining and/or improving residents existing abilities, preventing further complications, move resident toward increased independence, focuses on whole person 

as healthcare providers, we should remember

encourage resident to be as independent as possible 

which of the following can be part of bowel and bladder training

encourage regular exercise, offer fluids per schedule, responding quick to signal device 

NA role in bowel/bladder training

support explanation of training schedule, keep accurate record of amount, answer call light, don’t rush, positive, assist to bathroom, provide privacy, offer fluids, keep bedding clean

how long can bladder/bowel training take

8-10 weeks

purpose of the enema

clean colon by eliminating stool or feces or stimulate bowel activity 

guidelines for assisting with bladder retaining include all of following except

limiting fluids

when are residents encouraged to urinate

one hour before meals, every two hours between meals, when patient wakes up, every two hours during the night

benign tumor

non-life-threatening, non-cancerous tumor that does not spread to other body parts

cell theory

basic unit of all living tissues or organisms, all living organisms made of cells, and cellular function is essential process of living things

cells

building blocks of the human body and when combined, form tissue

chemo

medical treatment that uses medications given orally or intravenously to kill cancer cells

connective tissue

tissue that anchors, connects, and supports other tissues, located in every part of body, blood is form of connective tissue

epithelial tissue

tissue that covers internal and external body surfaces;m lines nose, mouth, respiratory tract, stomach, and intestines, skin, hair nails, glands

malignant tumor

cancerous tumor that invades and destroys nearby tissues and can spread to other parts of body

metastasis

when cancer spreads to other parts of body by breaking off and traveling to other parts of body

muscle tissue

tissue that stretches and contracts to let body move 

neoplasia

benign or malignant tumor

nerve tissue

tissue that receives and carries impulses to the brain 

organ

made of tissue, may be several different types of tissue that carry on a special function, combine to form system 

organelle

carry on work of cell

organism

made up of system functioning together to perform activities of daily living that are needed for continued life

orthostatic hypotension

abnormal low blood pressure occurring when the resident suddenly stands up; resident complains of weakness, faintness, dizziness, and seeing spots 

radiation

medical treatment that kills cancer cells using x-ray beams aimed at the tumor, or radioactive material implanted at or near the tumor

system

made of groups of several organs functioning together for a specific purpose or purposes 

tissue

cells grouped together to carry out a particular activity or function; when grouped together tissues become organs

tumor

growth of abnormal cells which may be benign or malignant 

avoidable pressure injury

one that develops from improper use of nursing process 

bedfast

confined to bed

bony prominences

areas of body where bone is close to skin, elbows, shoulder blades, sacrum 

deep tissue pressure injury

purple or deep red localized area of discolored intact skin or blood-filled blister; usually due to damage of underlying soft issue from pressure and/or shear

dermatitis

inflammation of skin

dermis

layer of skin under the epidermis

eczema

red, itchy areas on the surface of skin

epidermis

outer layer of skin

friction

rubbing of one surface against another; skin is dragged across a surface 

integumentary system

skin, largest organ and system in body, responsible for providing a natural protective covering of the body 

pressure injury (pressure ulcer)

any lesion caused by unrelieved pressure that results in damage to underlying tissues 

pressure injury stage 1

intact skin, redness over bony prominence

pressure injury stage 2

skin loss, partial, may see blister or shallow reddish pink ulcer, blister may be intact or open 

pressure injury stage 3

skin loss, full, skin gone, subcutaneous fat, dead soft tissue, stringy loose or attached

pressure injury stage 4

full thickness skin and tissue loss with muscle, tendon, bone exposure, thick dead tissue, black or brown

shear

layers of skin rub against each other, skin remains in place, tissues underneath move/stretch

shingles

herpes zoster, disease caused by virus, people over 50, rash/blisters, burning pain, numb, itchy

stasis dermatitis

a skin condition affecting lower legs and ankles that occurs from a buildup of fluid under skin and causes problems with circulation 

30 degree lateral position

position of a resident when bed is not raised more than 30 degree and pillows are placed under head, shoulder, and leg to lift the hip at about a 30 degree angle to avoid pressure on hip

unavoidable pressure injury

pressure injury occurs despite efforts to prevent one through proper use of nursing process

unstageable pressure injury

full-thickness tissue loss with injury covered by slough and/or eschar 

abduction

moving body part away from midline

adduction

moving body part toward the midline

amputation

removal of all or part of a limb because of a disease or an accident

arthritis

inflammation or swelling of joints causing stiffness, pain, and decreased mobilitiy 

ball-and-sock joint

joint that allows movement in all directions, made up of the rounded end of one bone fitted into the hollow end of another bone, hip and shoulder 

bone marrow

soft and spongy tissue located in the inside part of the bone

bones

hard and rigid structures that make up the skeleton and togeth form framework of body

cardiac muscle

striated, involuntary muscle of heart

cartilage

connective tissue that cushions bones at the joints and keeps them from rubbing together

closed fracture

broken bone that does not break the skin