Workbook - Chapter 1: The Nursing Assistant in Long Term Care

Another name for a long-term care facility is

skilled nursing facility

Assisted living facilites are initially for

People who need some help with daily care

Which of the following statements is true of adult day services?

This type of care is for people who need some help and supervision during certain hours

Care given by specialists to restore or improve function after an illness or injury is called

Rehabilitation

Care given to people who have about six months or less to live is called

Hospice care

People who live in long-term care facilities are usually called _______ because it is where they live for the duration of their day

Residents

Most conditions seen in long-term care facilities are chronic. What does this mean?

The conditions last a long time

True or False?

Long-term care facilities may offer assisted living, subacute care, or specialized care

True

True or False?

Facilities that offer specialized care must have specially trained employees.

True

True or False?

Nonprofit organizations cannot own long-term care facilities.

false

True or False?

Person-centered care means that staff should treat all residents exactly the same.

False

True or False?

Culture change means basing care on each individual's needs.

True

List two groups of people who qualify for Medicare.

-Those 65+

-Those with permanent kidney failure

-Those with certain disabilities

List the four parts of Medicare and what each helps pay for.

Part A: helps pay for care in a facility

Part B: Doctor services and other medical services and equipment

Part C: Allows private health insurance companies to provide Medicare benefits

Part D: Medications prescribed for treatment

How is eligibility for Medicaid classified?

Determined by income and special circumstances

What are three tasks that nursing assistants are not allowed to perform?

-Insert or remove tubes

-Give feeding tubes

-Change sterile dressings

What is one reason that observing and reporting changes ina. resident's condition is important?

Resident's care can be revised or updated as conditions change

If a nursing assistant (NA) sees a resident who is not on his assignment sheet but who need help, what should the NA do?

The NA should help the patient

Activites Director

Plan activities to help residents socialize and stay mentally and physically active

Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)

Licensed professional who has completed one to two years of education and is able to administer medications and give treatment

Medical Social Worker (MSW)

Helps residents get support services, such as counseling

Nursing Assistant (NA)

Preforms assigned tasks, such as measuring vital signs and providing personal care

Occupational Therapist (OT)

Helps residents learn to adapt to disabilities by training them to perform activities of daily life (ADLs) and other activities

Physical Therapist (Pt or DPT)

Gives therapy in the form of heat, cold, massage, ultrasound, electrical stimulation, and exercise to muscles, bones, and joints

Physician or Doctor (MD or DO)

Diagnoses disease or disability and prescribes treatment

Registered Dietitian (RD or RDN)

Evaluates residents nutritional statues and develops treatment plans, including creating special diets to meet residents' needs

Registered Nurse (RN)

Helps residents get support services such as counseling

Resident

Person whose condition, treatment, and progress are the focus of the care team

Speech-Language Pathologist (SLP)

identifies communication disorders and creates a care plan, as well as teaches exercises to help the resident improve or overcome speech problems

Which of the following statements is true of the chain of command?

It describes the line of authority

Liability is a legal term that means

Someone can be held responsible for harming someone else

Why should a nursing assistant not do tasks that are not assigned to him?

The NA may put himself or a resident in danger

What is one reason that other members of the care team will show great interest in the the work that a nursing assistant does?

Licensed healthcare providers assign the NA's tasks

True or False?

A policy is a course of action to be followed. For example, all health information must remain confidential

True

True or False?

Facilities will have procedures for reporting information about residents.

True

True or False?

It is alright to do tasks not listed in the job description if they are very simple.

False

True or False?

Changes in a resident's condition should be reported to the nurse.

True

True or False?

Each step in a procedure is important and must be strictly followed.

True

Compassionate

being caring, concerned, considerate, empathetic, and understanding

Conscientious

Being guided by a sense of right and wrong

Dependable

Getting to work on time and doing assigned tasks skillfully

Empathetic

Identifying with the feelings of others

Honest

Being truthful

Patient

Not losing one's temper easily, not acting irritated or annoyed, not rushing residents

Respectful

Valuing other people's individuality and treating others politely and kindly

Sympathetic

Identifying with the feelings of others

Tactful

Showing sensitivity and having a sense of what is appropriate when dealing with others

Tolerant

Respecting others' beliefs and practice and not judging others

Unprejudiced

Giving the same quality of care regardless of age, gender, sexual orientation, religion, race, ethnicity, or condition

Matt, a new nursing assistant, tells a resident that she has to wear the flowered shirt he picked out for her.

Which Residents' Right does this violate?

The right to make independent choices

Margaret, a nursing assistant, tells her best friend, "Ms. Picadilly's cancer is getting worse. I heard her moaning all night last night."

Which Residents' Right does this violate?

The right to privacy and confidentiality

Harry, a nursing assistant, is measuring a resident's vital signs when the resident's family arrives. He tells them, "You'll have to come back another day. I'm busy with her right now."

Which Residents' Right does this violate?

The right to visits

Yvonne, a nursing assistant, is going off duty. Leaving Ms. Scott's room, she notices a pretty necklace. She decides to borrow it for the night, promising to herself to return it tomorrow. She knows Ms. Scott has Alzheimer's disease and will not notice that it is gone anyway.

Which Residents' Right does this violate?

The right to security of possessions

Jane is explaining a care procedure to Mrs. Gonzalez in English. Mrs. Gonzalez only speaks Spanish. When she is finished, Jane asks Mrs. Gonzalez if she understands the procedure. Mrs. Gonzalez looks confused and doesn't respond. Jane begins to perform the care on Mrs. Gonzalez.

Which residents' right does this violate?

The right to participate in their own care

Mrs. Perkins is a resident who has a visual impairment. She has misplaced her eyeglasses many times. She gets upset during eye examinations, so the staff at her facility often allow her to go without glasses for a few weeks before having them replaced.

Which Residents' Right does this violate?

Services and activities to maintain a high level of wellness

Mr. Gallerano has a stomach ulcer that causes him minor pain. He has medication for it, but he says that it makes him nauseated and he does not want to take it. Lila, a nursing assistant, tells him that he may not have dinner until he takes the medication.

Which residents' right does this violate?

The right to participate in their own care

Amy is a nursing assistant at Sweetwater Retirement Home. Every night when she goes home, she tells her family touching stories about the residents with whom she is working.

Which Residents' rights is being violated?

The right to privacy and confidentiality

Laura, a nursing assistant at Great Oak Extended Care Facility, is running behind with her work for the evening. She is helping Mr. Young, a resident with Alzheimer's disease, with his dinner. She is getting frustrated with him because he keeps taking the fork out of her hand and dropping it on the floor. Finally she slaps his hand to get him to stop.

Which Residents' Right is being violated?

The right to dignity, respect, and freedom

Ms. Land, an elderly resident, gets into a loud argument with another resident during a card game. When her daughter comes to see her later that day, Anne, an NA, tells her that Ms. Land is in a bad mood and cannot see anyone.

Which residents' right does this violate?

The right to visits

During Dinner, Pete, a nursing assistant, spills hot soup on a resident's arm. He tells her that she better not tell anyone about it or her will be very angry at her.

Which Residents' Right is being violated?

The right to complain

Abuse

Purposeful mistreatment that causes physical, mental, or emotional pain or injury to someone

Active Neglect

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

Assault

A threat resulting in a person feeling fearful that he will be harmed

Battery

The intentional touching of a person without his or her consent

Domestic Violence

Physical, sexual, or emotional abuse by spouses, intimate partners, or family members

False Imprisonment

Unlawful restraint that affects a person's freedom of movement

Financial Abuse

The improper or illegal use of a person's money, possessions, property, or other assets

Involuntary Seclusion

The separation of a person from others against the person's will

Malpractice

Injury caused by a professional misconduct through negligence, carelessness, or lack of skill

Negligence

Actions, or the failure to act or provide proper care, resulting in unintended injury to a person

Passive Neglect

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

Psychological Abuse

Emotional harm caused by threatening, scaring, humiliating, intimidating, isolating, or insulting a person, or by treating him as a child

Sexual Abuse

Forcing a person to perform or participate in sexual acts against his or her will

Substance Abuse

The repeated use of legal or illegal drugs, cigarettes, or alcohol ina. way that harms oneself or others

Verbal Abuse

The use of spoken or written words, pictures, or gestures that threaten, embarrass, or insult a person

Workplace Violence

Verbal, physical, or sexual abuse of staff by other staff members or residents

If a Resident wants to make a complaint of abuse, what must a nursing assistant do?

The NA must help in every way; this includes telling the resident about the process and their rights; they must never retaliate against residents complaining of abuse

One task of an ombudsman is to

Investigate and resolve resident complaints

What is the purpose of the Health Insurance Portability and Accountability Act (HIPAA)?

To protect and secure the privacy of health information

What is included under protected health information (PHI)?

Patient's social security number

What is the correct response by a NA is someone who is not directly involved with a resident's PHI?

Tell the person the the information is confidential and cannot be given out

Which of the following is one way to keep private health information confidential?

Using confidential rooms for reporting on residents

Which of the following is true of a resident's medical chart?

A medical chart is the legal record of a resident's care

When should care be documented?

Immediately after care is given

How does a nursing assistant's reporting affect the MDS?

They may "trigger" a needed assessment

How soon after a resident is admitted does an MDS need to be completed by a nurse?

Within 14 days of admission

An incident is

An accident or unexpected event in the course of care

Which of the following would be considered an incident?

A resident on a low-sodium diet recieves and eats, a regular, non-restricted meal

Incidents should be reported to

The charge nurse

True or False?

Documentation of incidents helps protect the resident, the employer, and individual staff members.

True

True or False?

The information in an incident report is confidential.

True

True or False?

If an NA does not actually see an incident but arrives after it has already occurred, he should document what he thinks happen

False

True or False?

The documentation of an incident should include who the NA thinks could be responsible for the incident.

False

True or False?

Incident reports should be factual.

True

True or False?

If a resident falls but is okay after the fall, an incident report does not need to be completed.

False

True or False?

If an NA receives an injury on the job, he should file an incident report.

True