CNA Fundamentals: Delegation, Scope of Practice & Care Settings

These flashcards review delegation rules, CNA scope of practice, patient settings, resident rights, pressure injury prevention, HIPAA principles, and documentation essentials.

What state document legally defines the nursing profession and allowable CNA tasks?

The State Nurse Practice Act.

Delegation allows an RN to assign additional nursing tasks to whom?

Unlicensed personnel such as CNAs, after verifying training and competence.

Which licensed professional always retains liability for a delegated task?

The Registered Nurse (RN).

List the five RN steps in the delegation process.

1) Assess the patient, 2) Establish a goal, 3) Verify delegate’s skill level, 4) Communicate what/how/when & what to report, 5) Monitor and evaluate the outcome.

Before accepting a delegated task, what must a CNA ensure?

They have been properly trained, understand what/how/when, have needed supplies, and know what to report to the RN.

Define ADLs that CNAs commonly assist with.

Bathing, dressing, grooming, shaving, hair care, oral hygiene, skin & perineal care, bed making, maintaining a clean environment.

Give three mobility-related tasks CNAs perform.

Ambulating, transferring, positioning/turning/lifting (including ROM exercises).

Name three nutrition/hydration tasks a CNA may do.

Feeding or assisting with eating, meal setup, encouraging or thickening fluids.

What elimination-related duties can CNAs perform?

Toileting, bedpan/urinal assistance, catheter care, specimen collection, emptying ostomy bags, bowel & bladder retraining.

List four assistive devices a CNA should be prepared to manage.

Dentures, eyeglasses, hearing aids, prosthetic or orthotic devices (e.g., braces, anti-embolus stockings).

Give four basic nursing skills within CNA scope after training.

Vital signs, height & weight, measuring intake/output, reporting abnormal findings.

Which emergency and end-of-life tasks may CNAs assist with?

CPR, first aid, comfort measures, post-mortem care.

Why must CNAs promote resident rights and socialization?

Because patient needs extend beyond medical care, encompassing dignity and quality of life.

Differentiate Companion, Home Health Aide (HHA), and CNA roles in home care.

Companion: no hands-on care; HHA: personal care without nursing skills; CNA: personal plus advanced nursing tasks under RN.

State two advantages of adult day-care programs.

Provides supervision/socialization during the day and is less expensive than one-on-one home care.

Why do most Assisted Living Facilities (ALFs) not require on-site nurses?

Because the majority of care is non-medical personal assistance.

Who pays for most ALF services?

Residents out-of-pocket; insurance rarely covers ALF costs.

Describe the hospital environment for CNAs in two words.

Fast-paced and constantly changing.

Match the hospital unit with its focus: Ortho, Neuro, Telemetry, Oncology, Obstetrics.

Ortho: joint surgery care; Neuro: brain/spinal injuries; Telemetry: heart patients; Oncology: cancer; Obstetrics: mother-baby.

Primary goal of a Rehabilitation Center.

Restore patients to the highest level of function possible through nursing care and therapies.

Why might a patient be placed in a Nursing Home instead of Rehab?

They need long-term nursing care for conditions not expected to improve.

What special skill set benefits CNAs working with dementia residents?

Patience, behavioral management, and additional dementia-specific training.

Name two patient types treated in Mental Health Centers where CNAs assist.

Patients in psychiatric crisis and patients undergoing detox from addiction.

Give three examples of outpatient settings that may hire CNAs.

Doctor’s offices, dialysis clinics, same-day surgery centers.

According to the chain of command, list at least four professionals who may legally direct a CNA.

RNs, LPN/LVNs, Physical Therapists, Occupational Therapists, Speech-Language Pathologists.

What fundamental resident right can never be ignored even if inconvenient for staff?

The right to refuse treatment or care.

Define abuse related to pressure injuries.

Failing to reposition or keep a patient clean, resulting in skin breakdown.

How often must a bed-bound patient be repositioned to prevent pressure injuries?

At least every 2 hours.

What is the wheelchair repositioning rule stated in the lecture?

Shift weight or reposition at least every 1 hour.

How many staff members and what equipment are required when using a Hoyer (mechanical) lift?

Two trained staff members and an intact, appropriate sling.

What federal law protects patient health information and sets privacy standards?

HIPAA – Health Insurance Portability and Accountability Act.

List three examples of Protected Health Information (PHI) under HIPAA.

Patient name, medical record numbers, test results (any data that can identify the individual).

Provide two common HIPAA violations to avoid.

Discussing cases in public areas; leaving medical records visible to unauthorized persons.

When should a CNA document a patient’s fluid intake or urine output?

Immediately after the event, then total amounts are recorded at the end of the shift.

Why must CNAs understand military (24-hour) time for charting?

It prevents confusion about AM/PM times and is the healthcare documentation standard.

What is the primary purpose of documenting care promptly and accurately?

To ensure clear communication among the healthcare team and provide a legal record of care.