Hartman's Nursing Assistant Care: The Basics

Beginning steps for client care

-Knock and wait for permission to enter

-Introduce yourself as Nurse Aide Student

-identify the patient by name

-wash your hands

-Explain procedure and ask for permission

-Provide privacy (cutain, screen, or door)

-Adjust bed to a safe level, usually waist high.

-Lock the bed wheels

Ending steps for client care

-Return to lowest position

-Remove privacy

-Place call light in reach

-wash your hands

-Report any changes in the client to the nurse

-Document procedure

Long Term Care (LTC)

care given in long-term care facilities for people who need 24-hour skilled care

skilled care

medically necessary care given by a skilled nurse or therapist, it is available 24 hours a day, and it is ordered by a doctor and involved a treatment plan

chronic condition

any disease or condition that lasts a long time (usually longer than six months). It usually can't be cured and therefore requires ongoing treatment and management. Examples include arthritis and asthma.

Example of chronic condition

Physical disabilities

terminal illness

a disease or condition that will eventually cause death

acute care

24-hour skilled care for short-term illnesses or injuries; generally given in hospitals and ambulatory surgical centers

subacute care

care for an illness or condition given to people who need less care than for an acute (sudden onset, short-term) illness or injury but more than for a chronic (long-term) illness

Example of chronic condition

Heart disease

Example of chronic condition

Dementia

outpatient care

Care given for less than 24 hours for people who have had treatments or surgery and need short-term skilled care. They do not require an overnight stay in a hospital or other care facility

Rehabilitation

Restore or improve function after an illness or injjury

hospice care

treatment of the terminally ill in their own homes, or in special hospital units or other facilities, with the goal of helping them to die comfortably, without pain. For people who have about 6 months or less to live

Medicare

A federal health insurance program for persons 65 years of age and older

Medicaid

A medical assistance program that pays for health care services for people who cannot afford them. For people who have low income, as well as for people with disabilities.

Nursing assistants are not allowed to

Insert or remove tubes, give tube feedings, or change sterile dressings

Nursing assistants are part of

A team of health professionals

assistive or adaptive devices

special equipment that helps a person who is ill or disabled perform activities of daily living (ex: occupational therapy)

occupational therapist

assess and plan for the client to regain ADLs, esp motor skills of the upper extremities; direct care of occupational therapy assistants

The chain of command protects employees from

Liability

chain of command

the line of authority that moves from the top of a hierarchy to the lowest level

In continence is

Not a normal part of aging

transmission-based precautions

CDC precautions used in patients known or suspected to be infected with pathogens that can be transmitted by airborne, droplet, or contact routes; used in addition to standard precautions

scope of practice

defines the tasks that healthcare providers are legally permitted to perform as allowed by state or federal law

care plan

is individualized for each resident. It lists the tasks that team members, including NAs, must preform.

policy

Is a course of action that should be taken every time a certain situation occurs

procedure

a method, or way of doing something

Omnibus Budget Reconciliation Act (OBRA)

Passed in 1987 in response to reports of poor care and aside in long-term care facilities.

OBRA requires that the Nursing Aide Training and Competency Evaluation Program (NATCEP)

Set minimum standards for nursing assistant training. NAs must complete at least 100 hours of training

To cite

Means to find a problem through a survey

Battery

The intentional touching of a person without his or her consent

False Imprisonment

unlawful restraint or restriction of a person's freedom of movement

active neglect

the purposeful failure to provide needed care, resulting in harm to a person

passive neglect

the unintentional failure to provide needed care, resulting in physical, mental, or emotional harm to a person

An Ombudsman

is assigned by law as the legal advocate for residents

OAA (Older Americans Act)

Federal law that requires all states to have an ombudsman program

Health Insurance Portability and Accountability Act (HIPAA)

A comprehensive set of standards and practices designed to give patients specific rights regarding their personal health information.

Protected Health Information (PHI)

Information that can be used to identify a person and relates to the patients condition, any health care that the person has had and payment for that health care

military time

To change the hours between 1:00 pm to 11:59 pm to military time, add 12 to the regular time

1600 as regular time

4 pm

2100 as regular time

9 pm

0900 as regular time

9 a.m.

0000 as regular time

12 am

1200 as regular time

12 pm

Minimum Data Set (MDS)

a detailed form with guidelines for assessing residents in long-term care facilities; also details what to do if resident problems are identified

Incident reporting guidelines

-tell what happened (state the time and the mental and physical condition of the person)

-describe the persons reaction to the incident

-state the facts; do not give opinions

-do not document that an incident report was completed on the medical record

-describe the action taken to give care

Anything the endangers the resident should be

Reporter immediately (ex: falls, chest pain, severe headache, trouble breathing)

Objective information

based on what a person sees, hears, touches, or smells

subjective information

something a person cannot or did not observe, but is based on something the resident reported that may or may not be true

"Mr Hartman says he has a headache"

Subjective information

"Mr Hartman is holding his head and rubbing his temples"

Objective information

brady-

slow

-pathy

disease

body mechanics

the way the parts of the body work together when a person moves

base of support

The foundation that supports an object

scalds

burns caused by hot liquids

Always check the water temperature with..

A water thermometer or on the inside of your wrist before using

Residents must always be identified before

Giving care or serving food

Anytime you are feeding a resident they should be

Sitting at a 75-90 degrees angle

OSHA (Occupational Safety and Health Administration)

a federal government agency that makes rules to protect workers from hazards on the job

Abrasion

an injury in which superficial layers of skin are scraped or rubbed away

P.A.S.S. (acronym for using fire extinguisher)

Pull the pin

Aim at the base of fire when spraying

Squeeze the handle

Sweep back and forth at the base of the fire

RACE acronym for fire

Remove anyone in danger if you are not in danger

Activate alarm or call 911

Contain 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.

cardiopulmonary resuscitation (CPR)

refers to medical procedures used when a person's heart or lungs have stopped working

choking

When something is blocking the tune through which air enters the lungs, the person has an obstructed airway

As long as the resident can speak, breath, or cough, the NA should

Encourage her to cough as forcefully as possible to get the object out

abdominal thrusts

a method of attempting to remove an object from the airway of someone who is choking

Cyanosis of the skin is caused by

decreased blood oxygen

cyanotic skin

Blue/gray, inadequate oxygenation or perfusion, inadequate respiration, heart attack

Shock can occur:

When organs and tissues in the body do not receive an adequate blood supply

Myocardial infraction (MI)

Heart Attack; Caused by partial or complete occlusion of one or more coronary arteries. Results in heart tissue death. Occurs when the heart muscle itself does not receive enough oxygen because blood vessels are blocked

Dyspnea

difficulty breathing

To treat a minor burn

Do not use ice or ice water, as ice may cause further skin damage. Dampen a clean cloth with cool water. Place it over the burn

Syncope

fainting

insulin reaction (hypoglycemia)

can result from either too much insulin or too little food

Diabetic Ketoacidosis (DKA)

Is caused by having too little insulin

Seizures

Involuntary, often violent, contractions of muscles

type 2 diabetes

Diabetes of a form that develops especially in adults and most often obese individuals and that is characterized by high blood glucose resulting from impaired insulin utilization coupled with the body's inability to compensate with increased insulin production. MOST COMMON

type 1 diabetes mellitus (juvenile onset)

diabetes caused by a total lack of insulin production; usually develops in childhood, and patients require insulin replacement therapy to control the disorder

cerebrovascular accident (CVA)

a.k.a. "Stroke". Lack of blood supply to the brain causing brain damage

Transient Ischemic Attack (TIA)

Aka "little stroke" the result of a temporary lack of oxygen in the brain

hemiplegia

paralysis of one side of the body

hemiparesis

Arm numbness or weakness on one side of the body

expressive aphasia

slurred speech or inability to speak

receptive aphasia

inability to understand spoken or written words

Emesis

vomiting

infection prevention

the set of methods practiced in healthcare facilities to prevent and control the spread of disease

Microorganism (MO)

a living thing or organism that is so small that it can be seen only through a microscope; also called microbe.

Microbe

another name for a microorganism

Infections occurs when harmful microorganisms, called pathogens

Invade the body and multiply

localized infection

an infection that is limited to a specific location in the body and has local symptoms

systemic infection

affects the entire body

Healthcare-associated infection (HAI)

an infection acquired within a healthcare setting during the delivery of medical care

chain of infection

a way of describing how disease is transmitted from one being to another

Link 1: causative agent

a pathogen, such as a bacterium or virus that can cause a disease

Link 2: reservoir

where the pathogen lives and grows

Link 3: portal of exit

any body opening on an infected person that allows pathogens to leave

Link 4: Mode of Transmission

How the pathogen travels; direct or indirect contact

Link 5: Portal of Entry

any body opening on an uninfected person that allows pathogens to enter; nose, mouth, eyes, and other mucous membranes