CNA: quiz 2 preparation: C7-C13

CH7

Poisoning may be suspected when a resident

vomits, has heavy, difficult breathing, is very drowsy, is confused, or has burns or red areas around the mouth

BURNS

first degree, second degree, third degree

1. First-Degree (Superficial) Burns

• Depth: Affects only the outer layer of the skin (epidermis).

• Symptoms: Redness, pain, and mild swelling, similar to a typical sunburn. There are no blisters.

• Healing & Care: Usually heals on its own in 3 to 5 days. Care includes cold compresses and over-the-counter pain relievers. [1, 2, 3, 4, 5]

2. Second-Degree (Partial-Thickness) Burns

• Depth: Affects both the outer layer and the second layer of skin (dermis).

• Symptoms: Severe pain, redness, swelling, and fluid-filled blisters. The skin may look splotchy or wet.

• Healing & Care: Superficial second-degree burns typically heal in a few weeks with proper wound care, while deeper burns may require surgery. Small burns (under 3 inches) can be treated at home with cool water and antibiotic ointment. [1, 2, 3, 4, 5]

3. Third-Degree (Full-Thickness) Burns

• Depth: Destroys all layers of the skin (epidermis and dermis) and can penetrate into the fat, muscle, and even bone.

• Symptoms: The skin appears stiff, dry, and has a leathery, charred, or pearly white appearance. Because the nerve endings are completely destroyed, the burn area is often painless.

• Healing & Care: These require immediate emergency medical attention and often necessitate surgical treatments like skin grafts

First-Degree (Superficial) Burns

• Depth: Affects only the outer layer of the skin (epidermis).

• Symptoms: Redness, pain, and mild swelling, similar to a typical sunburn. There are no blisters.

• Healing & Care: Usually heals on its own in 3 to 5 days. Care includes cold compresses and over-the-counter pain relievers. [1, 2, 3, 4, 5]

2. Second-Degree (Partial-Thickness) Burns

• Depth: Affects both the outer layer and the second layer of skin (dermis).

• Symptoms: Severe pain, redness, swelling, and fluid-filled blisters. The skin may look splotchy or wet.

• Healing & Care: Superficial second-degree burns typically heal in a few weeks with proper wound care, while deeper burns may require surgery. Small burns (under 3 inches) can be treated at home with cool water and antibiotic ointment. [1, 2, 3, 4, 5]

3. Third-Degree (Full-Thickness) Burns

• Depth: Destroys all layers of the skin (epidermis and dermis) and can penetrate into the fat, muscle, and even bone.

• Symptoms: The skin appears stiff, dry, and has a leathery, charred, or pearly white appearance. Because the nerve endings are completely destroyed, the burn area is often painless.

• Healing & Care: These require immediate emergency medical attention and often necessitate surgical treatments like skin grafts

Diabetic Ketoacidosis (DKA)

is caused by having too little insulin in the body. WHICH MEANS HIGH BLOOD SUGAR

is caused by having too little insulin in the body. WHICH MEANS HIGH BLOOD SUGAR

Diabetic Ketoacidosis (DKA)

Insulin reaction or hypoglycemia

MEANS LOW BLOOD SUGAR

MEANS LOW BLOOD SUGAR

Insulin reaction or hypoglycemia

CH8

Anorexia

is when a person does not eat

Bulimia

binges eats a lot of food and then purges it by exercising or vomitting: SO ITS LIKE A MORE EXTREME VERSION OF ANOREXIA

WHAT ARE NORMAL SIGNS OF AGING?

• SKIN IS THINNER, DRIER, MORE FRAGILE, AND LESS ELASTIC. IT IS MORE EASILY DAMAGED.

• MUSCLES WEAKEN AND LOSE TONE

• BONES LOST DENSITY AND BECOME MORE BRITTLE.

• SENSNITIVITY OF NERVE ENDINGS IN THE SKIN DECREASES

• RESPONSES AND REFLEXES SLOW

• SHORT-TERM MEMORY LOSS OCCURS

• SENSES OF VISION, HEARING, TASTE, AND SMELL WEAKEN

• HEART PUMPS LESS EFFIECENTLY

• LUNG STRENGTH AND LUNG CAPACITY DECREASE

• OXYGEN IN THE BLOOD DECREASES

• URINARY ELIMINATION IS MORE FREQUENT - bladder muscles arent as strong

• APPETITE DECREASES (due to loss of senses)

• DIGESTION TSAKES LONGER AND IS LESS EFFICIENT

• LEVELS OF HORMONES DECREASED

• IMMUNITY WEAKENS

• LIFESTYLE CHANGES OCCUR

what are NOT normal changes of aging?

• Signs of depression

• Suicidal thoughts

• Loss of ability to think logically

• Poor nutrition

• Shortness of breath

• Incontinence

Signs of depression

ARE NOT NORMAL SIGNS OF AGING

Suicidal thoughts

ARE NOT NORMAL SIGNS OF AGING

Loss of ability to think logically

ARE NOT NORMAL SIGNS OF AGING

Poor nutrition

ARE NOT NORMAL SIGNS OF AGING

Shortness of breath

ARE NOT NORMAL SIGNS OF AGING

Incontinence

ARE NOT NORMAL SIGNS OF AGING

CH9

• SPECIFIC IMMUNITY

• NONSPECIFIC IMMUNITY

• SPECIFIC IMMUNITY is protection that the body developed from a vaccine or antibodies

• NONSPECIFIC immunity is the body’s general defense system

Homeostasis

is the name for the condition in which all the body’s systems are balanced and are working together to maintain internal stability: EQUALLIBRIUM

WHAT IS THE CONDITION IN WHICH ALL THE BODY’S SYSTEMS ARE BALANCED AND MAINTAING AN INTERNAL STABILITY OF EQUALLIBRIUM?

Homeostasis

To be in homeostasis the body’s….

the body’s metabolism or physical and chemical process must be working at a steady level: EQUALIBRIUM

• What is metabolism?

Let’s use this analogy..

What does your stomach metabolize?

What does your pancreas metabolize?

METABOLISM IS THE SET OF CHEMICAL PROCESSES IN YOUR BODY THAT CONVERTS FOOD TO ENERGY. It is the complex network of life-sustaining chemical processes your body uses to convert food into energy. It fuels everything you do—from breathing and thinking to repairing cells and digesting—and is primarily driven by two main processes

Your stomach metabolizes food - it breaks down the food in your stomach and turns it into energy.

Your pancreas metabolize sugar - it uses insulin to regulate your sugar at a steady rate, and feeds it into your cells for energy

What does your stomach metabolize?

What does your pancreas metabolize?

METABOLISM IS THE SET OF CHEMICAL PROCESSES IN YOUR BODY THAT CONVERTS FOOD TO ENERGY. It is the complex network of life-sustaining chemical processes your body uses to convert food into energy. It fuels everything you do—from breathing and thinking to repairing cells and digesting—and is primarily driven by two main processes

An organ

has a specific function

Tissues

are made up of groups of cells

Cells

are the building blocks of the body. Living cells divide, grow, and die renewing the tissues and organs of the body.

WHAT IS THE PURPOSE OF THE INTUGEMENTARY SYSTEM (SKIN)?

to protect internal organs from injury, protect the body against bacteria, and prevent the loss of too much water. It also responds to heat, cold, pain, touch and pressure, and it regulates body temperature.

Normal changes of aging include the following:

• Skin is thinner, drier, and more fragile. It is more easily damaged.

• Skin is less elastic.

• Protective fatty tissue is lost, so the person may feel colder.

• Hair thins and may turn gray.

• Wrinkles and brown spots, or liver spots appear.

• Nails are harder and more brittle

• Dry, itchy skin may result from lack of oil from the sebaceous glands.

Skin being thinner and dryer

Is a normal part of aging

Skin being less elastic and stretchy

Is a normal part of aging

Protective fatty tissue in skin being lost

Is a normal part of aging

What should you report when it comes to the skin? (Integumentary system)

• Broken skin

• Redness or broken skin between the toes or around toenails

• Skin that appears different from normal or that has changed

Describe the musculoskeletal system

Muscles, bones, ligaments, tendons and cartilage give the body shape and structure.They work together to move the body. The skeleton or framework of the human body has 206 bones.  

How many bones does the human body have?

206

Atrophy

Is when the muscle wastes away, decreases in size, and becomes weak

IT LOSES SIZE

Contracture

develops, the muscle or tendon shortens becomes inflexible and freezes in position. This causes permanent disability of the limb.

IT LOSES FLEXIBILITY

What is the difference between atrophy and contracture?

Atrophy refers to a decrease in size

Contracture refers to a decrease in flexibility

Atrophy refers to a…

Decrease in size

Contracture refers to

Decrease in flexibility

Muscle decreasing in size is..

Atrophy

Muscle decreasing in flexibility is..

Contracture

The functions of the musculoskeletal system

are to give the body shape and structure to low the body to move, to protect, to maintain posture, and to produce heat.

Normal changes of aging include the following:

• Muscles weaken to lose tone.

• Body movement slows.

• Bones lose density. They become more brittle, making them more susceptible to break.

• Joints may stiffen and become painful.

• Height is gradually lost.

central nervous system (CNS)

Is the mastermind that controls the singals in the peripheral nervous system (PNS)

peripheral nervous system (PNS)

Extends throughout the whole body. It receives signals from the CNS (the mastermind) to make the body move

Normal changes of aging include the following:

 Responses and reflexes slow.

 Sensitivity of nerve endings in skin decreases

 Some short-term memory loss may occur. Long-term memory, or

memory of past events, usually remains sharp.

Some short-term memory loss may occur. Long-term memory, or

memory of past events, usually remains sharp.

is a normal part of aging

Responses and reflexes slow

is a normal part of aging

Observing and Reporting: Nervous System

Disturbance ort changes in vision or hearing

 Difficulty swallowing

 Bowel and bladder changes

 Depression or mood changes

 Memory loss or confusion

 Violent behavior

 Decreased ability to perform ADLs

Describe the circulatory system

The circulatory or cardiovascular system is made up of the heart, blood

vessels and blood. The heart pumps blood through the blood vessels to

the cells. The blood carries food, oxygen and other substance cells need

to function properly. The heart is the pump of the circulatory system. The heart is a muscle. It

is located in the middle lower chest, on the left side. The heart muscle is

made up of three layers: The pericardium, the mayocardium and the

endocardium.

Normal changes of aging include the following:

 The heart pumps less efficiently.

 Blood flow decreases.

 Blood vessels narrow.

Respiration

the body taking in oxygen and removing carbon dioxide, involves breathing in, or inspiration, and breathing out or expiration. The lungs accomplish this process.

NORMAL SIGNS OF AGING WHEN IT COMES TO THE LUNGS:

• Lung capacity decreases

• Lung strength decreases

• Oxygen in the blood decreases

• Voice weakens

OBSERVING AND REPORTING WHEN IT COMES TO THE RESPIRATORY SYSTEM:

• CHANGE IN RESPIRATORY RATE

• SHALLOW BREATHING OR BREATHING THROUGH PURSED LIPS

• COUGHING OR WHEEZING

• NASAL CONGESTION AND DISCHARGE

• SORE THROAT

NORMAL SIGNS OF AGING WHEN IT COMES TO THE ENDOCRINE SYSTEM

• levels of hormones such as estrogen and progesterne decrease

• insulin production lessens

• the body is less able to handle stress

OBSERVING AND REPORTING: ENDOCRINE SYSTEM

• headache

• weakness

• blurry vision

• irriatibility….

OK ITS ALL SELF EXPLANATORY. MOVE ON

CH10

Principle of Body Mechanics

• Assess the load. Before lifting, assess the weight of the load.

Determine whether you can safely move the resident or object

without help. Know the lift policies at your facility. Never

attempt to lift someone or something you are not sure you can

lift.

• Think ahead, plan and communicate the move. Check for any

object in you path. Look for any potential risks, such as a wet

floor.

• Check you base of support and be sure you have firm footing.

Use a wide but balanced stance to increase support.

• Face what you are lifting. Your feet should always be the direction you are moving.

• Keep your back straight

• Begin in squatting position and lift with your legs

• Tighten your stomach muscles

• Keep the object close to your stomach

• Push object when possible rather than lifting.

Positioning

means: helping residents into positions that promote

comfort and health. Bed bound residents should be repositioned at

least every two hours.

A draw sheet

is an extra sheet placed on top of the bottom sheet when the bed is made

Shearing

is rubbing or friction that results from the skin moving one way and the bone underneath it remaining fixed or moving in the opposite direction

Logrolling

means moving a resident as a unit, without disturbing

the alignment of the body.

To dangle means to sit up on the side of the bed with the legs

hanging over the side.

A quad

with four rubber-tipped feet and a rectangular base is designed to bear more weight than the other canes.

CH11

OBRA requires that at admission…

RESIDENTS BE TOLD OF THEIR LEGAL RIGHTS

HOW DO YOU USE THE WEIGHING SCALE?

Before the resident steps on the scale, ensure that it is balanced at 0

• To determine the resident’s weight: You will move both the small and large weight indicators until the bar balances

Then once the bar balances, you need to read the two numbers on the small and large weight indicators

LARGE WEIGHT INDICATOR + LARGE SMALL INDICATOR = WEIGHT

WHEN WEIGHING A RESIDENT IN A WHEEL CHAIR…

YOU ROLL THE WHEELCHAIR ON THE WEIGHER. TAKE THE WEIGHT OF THE WHEELCHAIR.

THEN ROLL THE WHEELCHAIR ON THE WEIGTHER WITH THE RESIDENT.

THEN SUBTRACT THE WEIGHT OF THE WHEELCHAIR FROM THE TOTAL WEIGHT, TO GET THE WEIGHT OF THE RESIDENT

HOW DO YOU WEIGH A RESIDENT WHO CAN’T GET UP OR IS BEDRIDDEN?

MAKE MARKS ON THE SHEET AT THE RESIDENT’S HEAD AND HEEL

AND USE A MEASURING TAPE

Baseline

signs are initial values that can then be compared to future measurements.

CH12

Guidelines: Promoting Comfort

Promptly answer ringing telephones and call lights.

 Odors may be caused by urine, feces, vomit, certain

diseases, and wound drainage. Body and breath odors

may be offensive too. Help control odors by doing the

following:

 Temperature can affect comfort. OBRA requires that

long-term care facilities maintain comfortable and safe

environment with a temperature range of 71-81`F. As

people age and lose protective fatty tissues, they may

feel cold often. Illness can also cause a person to feel

cold. Help residents stay comfortable by doing the

following:

 Layer clothing and bed covers for warmth.

 Keep residents away from drafty areas, such as areas near

doors and windows.

 Offer blankets to residents in wheelchairs

 Keep residents covered while giving personal care.

 If residents control the heat and air conditioning in their

room, do not change the temperature for your comfort.

WHAT TEMPERATURE DOES OBRA SAY THAT THE TEMPERATURE IN LONG-TERM CARE FACILITIES MUST BE?

71-81F’

71-81F

IS THE TEMPERATURE THAT LONG TERM CARE FACILITIES MUST BE

Circadian rhythm

is the 24-hour day – night cycle. It also affects body temperature and hormone production, among other things.

Sleep

is a natural period of rest for the mind and body. As a person sleeps, the mind and body’s energy is restored.

Insomnia

is the inability to fall asleep or remain asleep

An occupied bed

is a bed made while the resident is still in the bed

A closed bed

is a bed completely made with the bedspread and blankets

in place.

an open bed

opposite of closed bed

A surgical bed

is made to accept residents who are returning to bed onstretchers or gurneys.

CH13

Guidelines: Basic Skin Care [IMPORTANT]

 Report any changes you observe in a resident’s skin. When

documenting changes, use the terms left or right in reference to the

left or right side of the resident’s body (not your own left or right).

 Reposition immobile residents often (at least every two hours).

 Elderly residents may have very fragile, thin skin. This makes the

skin more susceptible to injury. Be gentle during transfers. Avoid

pulling or tearing fragile skin.

 Residents who are overweight may have poor circulation and extra

folds of skin. The skin under the folds may be difficult to clean and

to keep dry. Pay careful attention to these areas and give regular

skin care. Report signs of skin irritation.

—

• Give frequent skin care as often as needed for residents who are incontinent

• Massage the skin often. Use light, circular strokes to increase circulation.

• The care plan may include special instructions for particularly dry skin or closed wounds. The skin may need a special soap. Follow the care plan’s instructions.

BASIC SKIN CARE FOR RESIDENTS WHO CANNOT MOVE EASILY

• Keep the bottom sheet tight and free from wrinkles.

• Do not pull the resident across sheets during transfers or repositioning. This causes shearing which can lead to skin breakdown.

• Place an absorbent pad under the back and buttocks to absorb moisture or perspiration that may build up

• Relieve pressure under bony prominences. Use pillows and other positioning devices to keep elbows and heels from resting on the surface of the bed.

• Special matttresses such as an alternating pressure or low air loss mattress may be used to prevent pressure injuries

• A bred or chair can be made softer with flotation cushions or special foam overlays

• Use a bed cradle to keep top sheets from rubbing the resident’s skin

• Residents seated in chairs or wheelchairs need to be respositioned often. REPOSITION AT LEAST EVERY HOUR IF THEY ARE IN A WHEELCHAIR OR CHAIR AND CANNOT MOVE EASILY

Guidelines: Positioning Devices

 Backrests provide support and comfort for the back. They can be

regular pillows or special wedge- shaped foam pillows.

 Bed cradles or foot cradles are used to keep the bed covers from

resting on residents’ legs and feet. Sometimes even the light

pressure of a sheet draped over the toes can eventually lead to

pressure injuries.

 Draw sheets may be placed under residents to assist with turning,

lifting or moving residents up in bed. Draw sheets also help

prevent skin damage that can be caused by shearing A regular bed

sheet folded in half can be used as a draw sheet.

 Footboards are padded boards placed against the feet to keep them

properly aligned. They help prevent foot drop.

 Hand rolls are cloth – covered or rubber items that keep the hand

and/ or fingers in a normal, natural position.

 An orthotic device or orthosis, is a device that helps support and

align a limb and improve its functioning.

An electric razor

is the safest and easiest type of razor to use

WHY IS AN ELECTRIC RAZOR THE EASIEST TO USE?

Because the oscillating or rotary blades are shielded behind a protective guard, you can achieve a fast, nick-free shave without having to worry about angle, pressure, or cutting your skin.

People with diabetes should use what kind of razors?

electric razors primarily because they minimize the risk of accidental nicks, cuts, and abrasions.

Pediculosis

is the infestation of lice

Edentulous

means having no teeth. For a resident who has no teeth, the NA will clean the mouth, tongue, and gums using mouth wash or other solution on sponge swabs

HOW DO YOU GIVE ORAL CARE TO AN UNCONSCIOUS RESIDENT?

• Identify yourself by name. Identify the resident according to facility policy.

• WASH YOUR HANDS

• Explain the procedure to the resident

• Provide privacy for the resident

• Adjust the bed to a safe level, usually waist high. Lock the bed wheels

• Put on gloves

• Turn the resident onto his side. Place a towel under his cheek and chin. Place an emesis basin next to the cheek and chin so that excess fluid flows into the basin.

• Hold the mouth open with the tongue depressor

• Dip the sponge swab in the cleaning solution. Squeeze excess solution to prevent aspiration. Wipe the innter, outer, and chewing surfaces of the upper and lower teeth, gums, tongue, and inside surfaces of the mouth.

• Rinse with a clean swab dipped in water. Squeeze the swab first to remove excess water.

• Remove the towel and basin. Pat the lips or fry the face if needed. Appy mostirerizer. Turn the resident onto his back

• Empty, rinse, and the dry basin. Place the basin in designated dirty supply area or return to storage, depending on the facility policy

• Place the soiled linens in proper container

• Remove and discard gloves. Wash your hands.

• Return the bed to its lowest position. Remove privacy measures

• Place the call light within the resident’s reach

• Wash your hands

• Report any problems with the teeth, mouth, tongue, or lips to the nurse, including odor, cracking, sores, bleeding, and discoloration

• Document the procedure using facility guidelines

WHEN GIVING ORAL CARE TO AN UNCONSCIOUS RESIDENT, YOU MUST…

TURN THEM ONTO THEIR SIDES

YOU A TURN AN UNCONSCIOUS RESIDENT TO..

THEIR SIDE WHEN GIVING ORAL CARE

Pulmonary

means lung

GROOMING VS HYGEINE

Hygiene is the term used to describe practices that keep bodies clean

and healthy. Bathing and brushing teeth are two examples. 

Grooming refers to practices like caring for fingernails, hair, shaving and applying

makeup.

Hygiene

is the term used to describe practices that keep bodies clean

and healthy. Bathing and brushing teeth are two examples. 

Grooming

refers to practices like caring for fingernails, hair, shaving and applying

makeup.

is the term used to describe practices that keep bodies clean

and healthy. Bathing and brushing teeth are two examples. 

Hygiene

refers to practices like caring for fingernails, hair, shaving and applying

makeup.

Grooming

AN AUTOCLAVE

IS THIS STERLIZATION THING. IT STERILIZES EQUIPMENT

Partial Bath vs Complete Bath

Partial Bath

• What it is: Washing only the parts of the body that cause discomfort, odor, or infection if left unwashed.

• Key areas cleaned: Face, hands, underarms (axilla), and the perineal area.

Complete Bath

• What it is: A thorough, head-to-toe cleansing of the entire body.

• Key areas cleaned: Face, hair, neck, chest, arms, abdomen, legs, back, and the perineal area.

Partial Bath

• What it is: Washing only the parts of the body that cause discomfort, odor, or infection if left unwashed.

• Key areas cleaned: Face, hands, underarms (axilla), and the perineal area.

Complete Bath

• What it is: A thorough, head-to-toe cleansing of the entire body.

• Key areas cleaned: Face, hair, neck, chest, arms, abdomen, legs, back, and the perineal area.