Ch 2

Foundations of Resident Care

Objective Information

is based on what a person see, hears, touches, or smells. Obtained using senses or signs - One kind of factual info used in reports

Subjective Information

is something a person cannot or did not observe, based on something the resident reported that may or may not be true, symptoms - Another kind of factual info used in reports

Incontinence

is the inability to control the bladder or bowels

Talking to Patients

• do not use medical terminology, slang, or profanities when talking to residents or resident family

• Avoid asking “Why?” as it can lead to defensiveness

• Avoid using Cliches or asking yes/no answer questions

• NA should not offer their advice or opinion

Defense Mechanisms

unconcious behaviors used to cope/avoid the uncomfortable

• denial, projection, displacement, rationalization, repression, regression

Impairment

is a loss of function or ability, partial or complete

Body Mechanics

the way the parts of the bosy work together when a person moves, important to avoid strain as a NA - alignment, posture, base of support, center of gravity

Scalds

burns caused by hot liquid

abrasion

an injury that rubs off the surface of the skin

PASS Acronym

for fire safety and how to use a fire extinguisher

• Pull the pin

• Aim at the base of the fire when spraying

• Squeeze the handle

• Sweep back and forth at the base of the fire

RACE acronym

In case of fire:

• Remove anyone in danger if you are not in danger

• Alert by activating the fire alarm system of calling 911

• Contain the fire if possible by closing all doors and windows

• Extinguish the fire, or the fire department will extinguish it. Evacuate the area if instructed to do so

Occupational Safety and Health Administration (OSHA)

makes rules to protect workers at their jobs, have a Safety Data Sheet (SDS)

Myocardial Infraction (MI)

heart attack, when heart muscles dont recieve enough oxygen

syncope

fainting, decreased blood flow to brain

Hypoglycemia

Insulin Reaction, too much insulin or too little food - give patient a glass of milk, fruit juice, water with dissolved sugar in it, a glucose tablet

Diabetic Ketoacidosis (DKA)

caused by having too little insulin in the body, can result from undiagnosed diabetes, infection, eating too much, stress - signs are increased hunger thirst or urination, abdonimal pain, deep or labored breathing, breath that smells sweat or fruity

Cerebrovascular Accident (CVA)

stroke/brain attack, occurs when blood supply to a part of the brain is blocked or a blood vessel leaks or ruptures within the brain

Transient Ischemic Attack (TIA)

a warning sign of CVA, it is a result of a temporary lack of blood supply to the brain, symptoms can last up to 24 hours

hemiplegia

Paralysis on one side of the body

Hemiparesis

Numbness or weakness, especially on one side

Expressive Aphasia

Slurred speech or inability to speak

Receptive Aphasia

Inablility to understand spoken or written words

FAST acronym

Used to remember sudden signs of stroke

(F)ace - Is one side of the face drooping? Is it numb? Ask the person to smile. Is the smile uneven?

(A)rms - Is one arm numb or weak? Ask the person to raise both arms. Check to see if one arm drifts downwards.

(S)peech - Is the person’s speech slurred? Is the person unable to speak? Can the person be understood? Ask the person to repeat a simple sentence and see if the sentence is repeated correctly.

(T)ime - Time is of the upmost importance when responding to a stroke. If the person shows any of the symptoms listed above, report to the nurse immediately.

emesis

vomitting, ejecting stomach contents out of the mouth and or nose

Infection Prevention

a set of methods practiced in healthcare facilities to prevent and control the spread of disease, facilities are required to employ an infection preventionist.

Microorganism (MO) / microbe

is a living thing that is so small that is can be seen only under a microscope, always present in the environment, infections occur when harmful MO, called pathogens invade the body and multiply

Pathogens

Harmful microoganisms that cause infencion by invading body an multiplying

Localized Infection

is limited to a specific location in the body, has local symptoms (symptoms are near site of infection), red, swollen, warm, painful

Systemic Infection

affects the entire body, travels through the bloodstream and spreads to the entire body, fever, chills, metal confusion, lower than normal blood pressure

Healthcare associated Infection (HAI)

can be localized or systemic, infection acquired in healthcare setting during the delivery of medical care

Chain of Infection

1. Causative agent - pathogen MO that causes disease (bacteria, viruses, fungi, parasites) normally do not cause harm to a healthy person as long as the flora remain in that particular area

2. Reservoir - is where a pathogen lives and multiplies (human, animal, plant, soil, substance, lungs, intestine) warm dark and moist places are ideal, some need oxygen

3. Portal of Exit - is any body opening on an infected person that allows pathogens to leave (nose, mouth, cut)

4. Mode of Transmission - describes how the pathogen travels (contact, droplet, airborne) (direct contact - touching person or secretions) (indirect contact - touching object that is contaminated)

5. Portal of Entry - any body opening of an uninfected person that allows pathogens to enter (nose, mouth, eyes, other mucus membranes - line the cavities of the body open to the outside of the body)

6. Susceptible Host - an uninfected person who could get sick

Medical Asepsis

measures used to reduce and prevent the spread of pathogens

Surgical Asepsis

“sterile technique” makes an object or area free of all MO

Centers for Disease Control and Prevention (CDC)

a federal government agency that issues guidelines to protect and improve the health of individuals and communities

Standard Precautions

treating blood and other bodily fluids, nonintact skin, and mucus membranes as if they were infected (not including sweat)

Sputum

mucus coughed up

Hand Hygiene according to CDC

Washing hands with soap or alcohol based hand soap

Personal Protective Equipment (PPE)

helps protect employees from serious injury or illness resulting from contact with workplace hazards (gowns, face shields, gloves, goggles)

don

put on (gown,gloves, etc)

doff

remove (gown, gloves , etc)

perineal care

care of genital and anal area

clean

has not been contacted with pathogens

dirty

has been in contact with pathogens

sterillization

cleaning process that destroys all MO , uses steam under pressure, dry heat, or liquid or gas chemicals to sterilize

Disinfection

process that destroys most pathogens, use pasteurization or chemical germicides

Transmission Based Precautions

used for people who are infected or may be infected, used in addition to standard precautions - airborne (facemask), droplet (facemask +limited contact), contact (gloves, gown, isolation)

bloodborne pathogens

MO found in human blood, can cause infection

Hepatitis

Inflammation of the liver caused by certain viruses and other factors (alcohol, meds, trauma) Liver function can be permanently damaged, A B C - B and C are bloodborne diseases that can cause death

Hepatitis B (HBV)

is spread through sexual contact, sharing infected needles, mother to baby during delivery, has vaccine typically 3 shots

Hepatitis C (HCV)

transmitted through blood/ bodily fluids, can lead to cirrhosis and liver cancer, no vaccine

Tuberculosis (TB)

highly contagious disease, caused by bacterium that is carried on mucus droplets suspended in the air, usually affects lungs “pulmonary Tuberculosis”, can usually be cured by taking meds, if not treated can cause death

COVID-19/coronavirus

droplet and airborne, particles can linger, symptoms appear 3-5 days after exposure - long covid /post covid conditions (PCC) where symptoms last 3 months+

MRSA

staphylococcus aureus is common type of bacteria can cause infection, methicillin is powerful antibiotic - MRSA has developed a resisitence to Methicillin, spread through direct or indirect contact - CA=community-associated , HA=Hospital-associated

VRE/ Vancomycin-resitant Enterococcus

Enterococci are bacteria that live in digestive + genital tracts, safe for healthy ppl but can lead to infection - Vancomycin is its antibiotic, if bacteria becomes resistant, it is called VRE - spread through direct + indirect contact

Clostridioides Difficile (CDI) “C. Diff”

spore-forming bacterium which can be a part of normal intestinal flora, can cause infection - too many/overuse of antibiotics can cause this, can cause colitis and more serious intestinal conditions - spread through direct + indirect contact

Physiological Needs

• food +water

• protection+shelter

• activity

• sleep+rest

• comfort/freedom from pain

Psychosocial Needs

• love+affection

• acceptance by others

• safety+security

• self-reliance + independence in daily living

• contact with others

• success + self-esteem

Holistic care

considering a whole system/whole person ( mind+body)

Developmental disabilities

present at birth or emerge during childhood, up to age 22 - chronic condition

Intellectual Disability

the most common developmental disability - ppl develop at below average rate (not a disease or mental disorder)