CNA 23 Skills

STEPS AFTER ENTERING THE ROOM FOR MOST SKILLS

1. Knock & Wait

2. Wash hands

3. Provide Privacy

4. Introduce

5. Check Wristband,

6. Bed locked

7. Bed At Working Level

8. Call light within reach

9. Explain Supplies

LAST THREE STEPS BEFORE LEAVING THE ROOM

1. Call Light within reach

2. Bed Locked & Lowest Position,

3. Open Curtain

4. Wash Hands

HAND WASHING

1. Turn on sink water

2. Wet hand thoroughly

3. Apply Soap

4. Lather thoroughly causing friction (hands for 20 seconds)

5. Keep hands lower than elbows

6. Finger tips downs

7. Clean fingernails using the opposite hands

8. Discard paper towel & use clean on to turn faucet off starting at fingertips

9. NOT TOUCH SINK AT ANY TIME

APPLYING ONE KNEE HIGH ELASTIC STOCKING

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Supplies: Elastic Stocking

1. supine position (lying down in bed)

2. turn stocking inside out

3. pull over toe, foot & heel

4. then pull up leg (no twists or wrinkles)

5. Call Light, Bed Locked & Lowest Position, Open Curtain & Wash Hands

ASSIST TO AMBULATE W/TRANSFER BELT

Knock_&_Wait-Wash hands-Provide Privacy, Introduce-Check_Wristband-Bed locked-Bed_At_Working_Level-Explain Supplies

Stocking: Transfer Belt

1. bed locked & lowest position

2. have shoes ready & assist to sit

3. apply shoes & belt (hold belt upward)

4. give singal (1, 2, 3… on 3)

5. walk slightly behind & to one side for 10 ft.

6. assist to bed & remove belt

7. Call Light, Bed Locked & Lowest Position, Open Curtain & Wash Hands

ASSIST W/USE OF BEDPAN

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Supplies: Bedpan, Toilet Paper, Hand Wipes, 2 Sets of Gloves, 1 Barrier, Trash can w/in reach

1. lower head of bed

2. raise opposite bed rail

3. put on gloves

4. roll client toward rail

5. Put barrier underneath patient but

6. place bedpan under buttocks

7. discard gloves & wash hands

8. raise head of bed

9. toilet paper, instruct on hand wipes, & call light w/in reach (signal when finished)

10. lower head of bed

11. put on gloves

12. put up rail & roll client while holding bedpan

13. remove bedpan, empty in toilet, rinse empty in toilet, & place in dirty area

14. remove gloves & wash hands

15. Call Light, Bed Locked & Lowest Position, Open Curtain

CLEANS UPPER OR LOWER DENTURE

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Supplies: Tooth brush, tooth paste, gloves, 1 Barrier, c-basin, dentures & dentures cup

1. put on gloves\

2. line sink w/ wash cloth

3. run luke warm water

4. put tooth paste on tooth brush

5. Brush dentures

6. Rinse cup & fill with water

7. Place dentures in cup

8. Clean

DONNING & REMOVING PPE (GOWN & GLOVES)

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Supplies: Gown & Gloves

1. unfold gown

2. put it on, tie neck & overlap back & tie waist

3. put on gloves (over cuff)

4. remove gloves

5. untie gown at neck & waist

6. roll off dirty side in

7. Wash hands

COUNT & RECORD RADIAL PULSE

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Supplies: watch w/second hand

1. place finger on thumb side of client's wrist

2. count beats for 1 full minute

3. record

4. Call Light & Wash Hands, Open Curtian

COUNT & RECORD RESPIRATIONS (VITAL SIGNS)

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Supplies: watch w/second hand

1. have client cross their arms across chest

2. count for 1 full minute

3. record

4. Call Light & Wash Hands

DRESSING CLIENT W/AFFECTED RIGHT ARM

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Supplies: two options (shirts or gowns)

1. give client choice of clothing

2. remove gown from unaffected arm (left arm) 1st, then affected side (right arm)

3. dress affected side (right arm) 1st, then unaffected side (left arm)

4. place soiled linens in hamper

5. Call Light, Bed Locked & Lowest Position, Open Curtain & Wash Hands

FEEDING CLIENT WHO CANNOT FEED THEMSELVES

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Supplies: food tray and hand wipes

1. pick up name card & ask client to state name

2. set bed to 75-90 degree (High Fowlers position )

3. clean clients hands w/wipes

4. tell client what foods are available & what they would like to try 1st

5. offer one bite of each food, tell them what it is

6. offer beverage at least once during meal

7. wipe month & hands w/wipes

8. remove tray, place food in trash & tray in dirty area

9. Call Light, Bed Locked & Lowest Position, Open Curtian

10. Wash Hands

GIVES MODIFIED BED BATH (FACE AND ONE ARM, HAND AND UNDERARM)

Knock_&_Wait-Wash hands-Provide Privacy, Introduce-Check_Wristband-Bed locked-Bed_At_Working_Level-Explain Supplies

Supplies: Basin, Soap, Gloves, 3 Barrier, 3 washclothes, & 1 Gown

1. remove gown

2. client check water temperature

3. put on gloves

4. wash face, start with eyes, far eye first, use different part of cloth (NO SOAP)

5. dry face (pat dry)

6. expose arm & place towel under arm

7. soap wet cloth

8. wash, rise, dry arm, hand, & underarm (underarm last)

9. put on clean gown

10. empty, rise, & dry basin & place in dirty area

11. dirty gown in hamper

12. gloves in trash

13. wash hands

14. Call light, bed locked & lowest position, open curtain

MANUAL BLOOD PRESSURE

Knock_&_Wait-Wash hands-Provide Privacy, Introduce-Check_Wristband-Bed locked-Bed_At_Working_Level-Explain Supplies

Supplies: stethoscope, bp cuff, 6 alcohol wipes

1. wipe stethoscope (both instructors and yours) ear & bell

2. follow pinky to find brachial artery

3. make sure to close valve

4. pump between 180 - 160

5. call light, open curtain, wash hands

MEASURE & RECORD URINARY OUTPUT

Supplies: Gloves

1. pour the contents from bedpan into measuring container over toilet

2. close toilet lid and place container flat

3. empty into toilet

4. rinse bedpan & measuring container & pour rinse into tiolet

5. trash gloves

6. wash hands

7. record in cc's (30 cc's = 1 oz)

MEASURE AND RECORDs WEIGHT OF AMBULATORY CLIENT

Knock_&_Wait-Wash hands-Provide Privacy, Introduce-Check_Wristband-Explain Supplies

1. ensures client has their shoes on

2. walk to scale & set scale to zero

3. stand on side and assist if need be

4. determine weight

5. stand to side and assist if need be

6. record weight

7. walk back & call light, wash hands

PASSIVE RANGE OF MOTION (ROM) KNEE & ANKLE

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1. instruct me if you have pain during experience

2. support leg at knee & ankle while peforming ROM for knee

3. bend knee and then return leg to normal position 3x while saying FLEXION then EXTENSION(ask about pain)

4. support foot & ankle close to the bed while performing ROM for ankle

5. pushes/pulls foot towards head and pushes/pulls foot down, toes, point down 3x while saying DORSIFLEXION then PLANTAR-FLEXION (ask about pain)

6. Call light, bed locked & lowest position, open curtain, wash hands

PASSIVE RANGE OF MOTION (ROM) SHOULDER

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1. instruct me if you have pain during experience

2. support arm at elbow & wrist while performing ROM on shoulder

3. raises client's straightened arm away from the side position upward towards head to ear level & return arm down to side of body 3x while saying FLEXION then EXTENSION (ask about pain)

4. move straightened arm away from the side of body to shoulder level & return to side of body 3x while saying ABDUCTION then ADDUCTION(ask about pain)

5. call light within reach, bed locked & lowest position, open curtain, wash hands

POSITION ON SIDE

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Supplies: 3 pillows

1. lower head of bed if not down

2. raise side rail on side body will be turned

3. assist client slowly roll onto that side

4. adjust or place pillow under head

5. make sure not lying on arm

6. support back by folding pillow #1 (long) & tucking by their back and have them lay on it

7. support top arm with pillow #2 fold in half

8. support top knee flexed pillow #3 and ankle with pillow #4

9. call light, bed locked & lowest position, open curtain, wash hands

PROVIDE PERINEAL CARE FOR FEMALE

Knock_&_Wait-Wash hands-Provide Privacy, Introduce-Check_Wristband-Bed locked-Bed_At_Working_Level-Explain Supplies

Supplies: basin, soap, 6 wash clothes, 2 barriers

1. have client check water temp

2. put on gloves

3. place chuck under peri area

4. wet 1st washcloth then apply soap, hold cath and clean 2 strokes

5. wet 2nd washcloth hold cath and rinse 2 strokes

6. hold cath and dry 2 strokes

7. empty, rinses, & dry basin and put in dirty area

8. dispose of dry linens in hamper

9. trash gloves & wash hands

10. call light, bed locked & lowest position, open curtain

PROVIDE FOOT CARE ON ONE FOOT

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Supplies: 2 barriers, 3 washcloth, soap, lotion, basin

1. have client check water temp with toe

2. put on gloves

3. place foot in water & apply soap to wet washcloth

4. lift and wash foot, including between the toes

5. rinse foot in water, including between the toes

6. dries foot, including between the toes

7. apply lotion on top and bottom of foot (NOT between toes) & dry off excess

8. empty, rinse & dry basin but in dirty area

9. dispose of dirty linens

10. trash gloves & wash hands

11. call light, open curtain

PROVIDE MOUTH CARE

Knock_&_Wait-Wash hands-Provide Privacy, Introduce-Check_Wristband-Bed locked-Bed_At_Working_Level-Explain Supplies

Supplies: emesis basin (c shape basin), tooth brush, tooth paste, a small cup of water, gloves

1. raise head of bed 45-90 degrees

2. put on gloves

3. place clothing protector across clients chest

4. mositen toothbrush & apply toothpaste

5. clean mouth including tongue & surfaces of teeth

6. place toothbrush on paper towel

7. have client rinse, place basin under chin

8. wipe mouth and remove clothing protector

9. empty, rinse, & dry basin and place toothbrush in basin and place in dirty area

10. dispose of clothing protector

11. trash gloves & wash hands

12. call light, bed locked & lowest position, open curtain

PROVIDE PERI-CARE FOR FEMALE

Knock_&_Wait-Wash hands-Provide Privacy, Introduce-Check_Wristband-Bed locked-Bed_At_Working_Level-Explain Supplies

Supplies: basin, 6 washclothes, 2 towels, soap, gloves

1. have client check water temp

2. put on gloves

3. apply bath blanket

4. place chuck pad under peri area

5. apply soap to wet 1st washcloth & wash genital area from front to back using clean area of cloth with each stroke

6. use 2nd washcloth to rinse (no soap) from front to back using clean area of cloth with each stroke and pat dry

7. raise side rail and have client turn over on their side

8. apply soap to wet 3rd washcloth & wash rectal area from front to back using clean area of cloth with each stroke

9. use 4th washcloth to rinse (no soap) from front to back using clean area of cloth with each stroke and pat dry

10. repositon client

11. empty, rinse, and dry basin and put in dirty area

12. dispose of dirty linens

13. trash gloves & wash hands

14. call light, bed locked and lowest positon, open curtain

TRANSFER FROM BED TO WHEELCHAIR USING TRANSFER BELFT

Knock_&_Wait-Wash hands-Provide Privacy, Introduce-Check_Wristband-Bed locked-Bed_At_Working_Level-Explain Supplies

Supplies: transfer belt & wheelchair

1. place wheelchair on side of bed at the head of the bed and facing the foot of the bed and make sure wheels are locked

2. place footrests up or remove

3. make sure bed is locked & in lowest position

4. assist client to sit, apply shoes & belt

5. provide instruction to stand (1,2, 3, on 3)

6. turn client so that their legs are against wheelchair

7. lower client into wheelchair

8. remove transfer belt

9. put feet on footrest

10. call light, wash hands, open curtain