Test 1 Study Guide

What is the purpose of OBRA?

The purpose of OBRA (Omnibus Budget Reconciliation Act) is to improve the quality and safety of healthcare

What is the act of delegation and how many parts does it have?

Delegation is the act of assigning a task to another person while still being responsible for the outcome.

• Right task

• Right circumstance

• Right person

• Right direction/communication

• Right supervision/evaluation

Professionalism

Personal grooming: Bathing, oral care, hair care, shaving, nail care, dressing, and maintaining personal hygiene.

Dependable: Being reliable, responsible, and trustworthy; doing what you are expected to do.

Valuable NA characteristics: Caring, respectful, honest, dependable, patient, compassionate, and a good communicator.

NA Scope of Practice: Tasks such as basic patient care, hygiene, nutrition, mobility, vital signs, and reporting changes to the nurse.

Effective team qualities: Good communication, cooperation, respect, trust, shared goals, and teamwork.

Tasks delegated to an NA: Bathing, dressing, feeding, toileting, taking vital signs, assisting with mobility, making beds, and documenting care.

Tachycardia

Fast Heart Rate

bradycardia

slow heart rate

tachypnea

Fast reseparation

hypotensive

low blood pressure

hypertensive

high blood pressure

febrile

having or showing the symptoms of a fever.

afebrile

not feverish.

Measurements for Vital Signs

• Temperature (T)

• Pulse (P)

• Respirations (R)

• Blood pressure (BP)

• Oxygen saturation (SpO₂)

Oral Temp Value

Baseline 98.6 F

Normal Range 97.6 to 99.6 F

Rectal Temp Value (1 degree higher from Oral)

Baseline 99.6 F

Normal Range 98.6 F to 100.6f

Axillary Temp Value ( 1 degree less than Oral)

Baseline 97.6 F

Normal 96.6 F to 98.6 F

Tympanic Membrane & Temporal temp values

Same as Oral temp values

TEMPORAL IS NONINVASIVE

When NOT to Take an Oral Temperature

Unconscious

Recent facial/mouth surgery

Recent injury to face

Sores/redness/mouth pain

Confused/agitated

History of seizure

Using oxygen

Mouth-breather

Feeding tube

#1 way to prevent the spread

Wash Hands!!!

Indirect Contact

Spread through contaminated objects/surfaces

Direct Contact

Person-to-person contact

Susceptible host

A person who can become infected.

Chain of Infection

How to break the Chain of Infection

Hand hygiene, PPE, cleaning/disinfection, covering coughs, safe sharps disposal, and isolation precautions.

When is a sharps container full?

Only fill ¾ of container

Spill On floor

Put on gloves

Absorb spill

Clean area

Discard waste in appropriate container

Apply disinfectant to area

Place a warning cone or sign in area

PPE order

• Putting on: Gown → Mask → Goggles/face shield → Gloves

• Removing: Gloves → Goggles/face shield → Gown → Mask

Localized Infection

One body part with limited symptoms

Painful

Red

Hot to touch

Puffy

Drainage

Systemic Infection

Entire body part or system

−Fever

−Chills

−Fatigue

−Nausea

-Vomiting

Caring for a patient with Norovirus

Use Contact Precautions, wear gloves and gown, practice excellent hand hygiene, and clean contaminated surfaces.

Three most common bloodborne pathogens:

• Hepatitis B (HBV)

• Hepatitis C (HCV)

• HIV

How to remove gloves

Pinch the outside of one glove near the wrist → peel it away from your hand → hold the removed glove in the gloved hand → slide an ungloved finger under the remaining glove → peel it off inside-out, containing the first glove.

Standard Precautions

basic infection control practices used during the care of all patients, regardless of their diagnosis or infection status

Transmission-Based Precautions

Used for every patient, regardless of diagnosis.

extra infection control steps used alongside standard precautions for patients who may have dangerous or easily spread germs

Transmission-Based Precautions

Extra precautions used when a patient has a known or suspected infection spread by contact, droplets, or airborne transmission.

Normal Pulse Value

60-100 beats per minute

Eupnea

Normal Breathing

12-20 normal range for respirations

Norovirus

A highly contagious virus that causes vomiting and diarrhea

Leads to dehydration and MUST replace fluids
Affects GI Tract

HAI

Healthcare Associated Infection

Infection acquired while in a hospital

ADC

the average number of residents/patients in a facility each day.

North Carolina Board of Nursing.

It regulates nursing practice in North Carolina, including LPNs, RNs, and nursing assistants (NAs).

UAP

Unlicensed Assistive Personnel

DHSR

North Carolina Division of Health Service Regulation

It regulates and oversees healthcare facilities and services in North Carolina, including nursing homes and adult care homes.

Where is stethoscope placed?

Over a artery

What sounds do you hear in the stethoscope?

Korotkoff Sounds

Oxygen saturation (SpO₂)

usually finger using a pulse oximeter

Systolic

top number

• Pressure when the heart contracts/pumps blood out.

• Example: 120/80 mmHg → 120 is systolic.

Diastolic

• Pressure when the heart relaxes between beats.

• Example: 120/80 mmHg → 80 is diastolic.

Edema

swelling caused by excess fluid collecting in body tissues.

• Commonly seen in feet, ankles, legs, hands

Erythema

redness of the skin.

• Can indicate irritation, inflammation, pressure, or infection.

NPO

Nothing by mouth

• Patient should not eat or drink unless specifically allowed.

BID

Twice a day

QID

Four times a day

AC

Before meals (ante cibum)

hs

At bedtime (hora somni)

ac/hs

Before meals and at bedtime

Spills

Gloves, Absorb spill, clean area, discard, disinfectant, wet floor sign

Orthostatic Hypotension

BP is low when resident suddenly stands up

Normal Range of Systolic BP

90-119 normal

Normal Range of Diastolic BP

60-79 normal

Orthostatic blood pressure order

lying down (supine), sitting, and standing

1 oz

30 mL

Order of the chain

Infectious agent → Reservoir → Portal of exit → Mode of transmission → Portal of entry → Susceptible host

Airborne Precautions

Tiny particles remain in the air and can travel farther

N95/respirator

Tuberculosis, measles, chickenpox

Droplet Precautions

Respiratory droplets from coughing, sneezing, talking

Flu, pertussis

Surgical mask

Contact Precautions

Touching the person or contaminated objects

C. diff, MRSA

Gloves + gown

NCBON

North Carolina Board of Nursing

lists tasks that are included in nurse aid 1

How to check orthostatic blood pressure?

Check BP while laying down. Have resident sit up, wait 2 mins then check. Tell resident to stand up, wait 2mins then check BP

Measurement of Graduated Specimen Container

Short line: 25 cc/mL or 75cc/mL

Long Line: 50 cc/mL

How many mL in a teaspoon?

5mL

2/3

Top tells the number of parts the resident drank

Bottom tells the number of parts that were originally in the container

1 ounce equals what?

30mL

ALWAYS ROUND UP IF IN BETWEEN

ALWAYS ROUND UP IF IN BETWEEN