CNA

Admission Pack

personal care items supplied upon a resident's admission.

Baseline

initial value that can be compared to future measurements.

Bedridden

confined to bed.

Dorsal Recumbant

position in which a person is flat on her back with knees flexed and slightly separated and her feet flat on the bed.

Kilogram

a unit of mass equal to 1000 grams; one kilogram equals 2.2 pounds.

Knee-Chest

position in which a person is lying on his abdomen with knees pulled up towards the abdomen and with legs separated; arms are pulled up and flexed and the head is turned to one side.

Lithotomy

position in which a person is on her back with her hips at the edge of the exam table; legs are flexed and feet are in padded stirrups.

Metric

system of weights and measures based upon the meter.

Pound

a unit of weight equal to 16 ounces.

1. What are two resources that families may use to help them choose a care facility for a loved one?

1. Review information from federal agencies, such as, the Centers for Medicare & Medicaid Services

2. Recommendations from family and friends

2. Why is it a good idea for nursing assistants to ask family members questions about residents upon admission?

So that the NA will know more about the resident's routines and personal preferences and family history and rituals.

3. Why might a transfer to a new room be difficult for a resident?

To some residents, change maybe hard for them.

4. During discharge of a resident, when does a nursing assistant's responsibility for the resident end?

When the resident is safely in their vehicle and the doors are closed.

5. If a nursing assistant makes a mistake with resident care, he can demonstrate that he is responsible by

D. Reporting the mistake to the nurse immediately.

6. Which of the following would be the best response by the nursing assistant if a new resident says that he does not want to attend a facility activity?

A. "That's okay. I'll ask you again some other time."

7. What should the scale be balanced at before measuring a resident's weight?

A. 0

8. How many inches are there in five feet?

C. 60

9. In which position is a resident who is lying flat on her back with her knees flexed and her feet flat on the bed?

C. Dorsal recumbent position

10. In which position is a resident who is lying on her abdomen with her knees pulled toward the abdomen and her legs separated?

D. Knee-chest position

11. In which position is a resident who is lying on her back with her feet in padded stirrups?

A. Lithotomy position

Bony Prominences

areas of the body where the bone lies close to the skin.

Bruise

a purple, black, or blue discoloration on the skin caused by the leakage of blood from broken blood vessels into the surrounding tissues; also called contusion.

Celluitis

a skin infection caused by bacteria moving into the tissues due to a break in the skin.

Closed Wound

a type of wound in which the skin's surface is not broken.

Dermatitis

inflammation of the skin.

Dermis

the inner layer of the two main layers of tissue that make up the skin.

Epidermis

the outer layer of the two main layers of tissue that make up the skin.

Gangrene

death of tissue caused by infection or lack of blood flow.

Integument

natural protective covering.

Lesion

an area of abnormal tissue or an injury or wound.

Melanin

the pigment that gives skin its color.

Melanocyte

cell in the skin that produces and contains the pigment called melanin.

Necrosis

the death of living cells or tissues caused by disease or injury.

Open Wound

a type of wound in which the skin's surface is not intact.

Pressure Ulcer

a serious wound resulting from skin breakdown; also known as pressure sore, decubitus ulcer, or bed sore.

Psoriasis

a chronic skin condition caused by skin cells growing too quickly when results in red, white, or silver patches, itching, and discomfort.

Scabies

a contagious skin infection caused by mites burrowing into the skin that results in pimple-like irritations, rashes, intense itching, and sores.

Shingles

a viral infection caused by the same virus that causes chickenpox; results in pain, itching, and rashes.

Sitz Bath

a warm soak of the perineal area to clean perineal wounds and reduce inflammation and pain.

Skin Cancer

the growth of abnormal skin cells.

Tinea

a fungal infection that causes red, scaly patches to appear in a ring shape, generally on the upper body, or on the hands and feet.

Wart

contagious hard bump caused by a virus.

1. List four functions of the integumentary system.

1. "Protect internal organs from injury."

2. "Protect the body against bacteria and other pathogens."

3. "Prevent the loss of too much water."

4. "Regulate body temperature."

2. List eight normal age-related changes of the integumentary system.

1. "Amount of fat and collagen decreases, causing skin to sag."

2. "Elastic fibers lose elasticity, causing wrinkles."

3. "Hair and nail growth slows."

4. "Skin becomes drier due to decreased production of perspiration and oil."

5. "Skin becomes thinner and more fragile, causing more frequent skin injuries, tearing, and infections."

6. "Protective fatty tissue layer thins, so person feels colder."

7. "Hair thins and turns gray, due to a decrease in the melanocyte activity."

8. Brown spots on the skin may appear due to an increase in the production of certain melanocytes in the areas exposed to the sun."

3. Briefly describe the damage and/or symptoms caused by first-, second-, and third- degree burns.

First-degree burns (superficial):

With a first-degree burn the layer of skin that is affected is the outer layer which is called the epidermis. The damage caused is usually redness and pain in the area.

Second-degree burns (partial-thickness):

With a second-degree burn the layer of skin that is affected is the deeper layer or the dermis. The damage that is usually caused is some skin damage; redness, pain, swelling, and blistering.

Third-degree burns (full-thickness):

With a third-degree burn the layers of skin that are affected are the epidermis, dermis, and underlying tissue. The damage that is caused is serious scarring; muscle and bone may be affected; white or charred skin; pain; swelling; and peeling skin.

4. How is scabies usually transmitted?

By direct person-to person contact, using an infected person's towel, washcloth, clothing, or bedding. "The elderly and others with weakened immune systems are at a higher risk of acquiring scabies."

5. Under what circumstances are non-sterile dressings usually used? When are sterile dressings used?

Non-sterile dressings are applied to dry wounds that have a less chance of infections. Sterile dressings are required when the wound is new, open, or draining.

6. What happens when skin first begins to break down?

A. The skin becomes discolored.

7. How often should a resident change positions when he is in a wheelchair in order to help prevent pressure ulcers?

A. Every 15 minutes.

8. Generally speaking, for how long should warm or cold applications be applied?

D. 20 minutes

Additive

a substance added to another substance, changing its effect.

Axilla

underarm or armpit area.

Bridge

a type of dental appliance that replaces missing or pulled teeth.

Dandruff

excessive shedding of dead skin cells from the scalp.

Edema

swelling in body tissues caused by excess fluid.

Edentulous

lacking teeth; toothless.

Gingivitis

an inflammation of the gums.

Grooming

practices to care for oneself, such as caring for fingernails and hair.

Halitosis

bad breath.

Hygiene

practices to keep the body clean.

Partial Bath

bath that includes washing the face, underarms, hands, and perineal are.

Pediculosis

an infestation of lice.

Plaque

a substance that accumulates on the teeth from food and bacteria.

Tartar

hard deposits on the teeth that are filled with bacteria; may cause gum disease and loose teeth if not removed.

1. Define the terms hygiene and grooming.

Hygiene is practices to keep the body clean.

Grooming is practices to care for oneself, such as caring for fingernails and hair.

2. List three ways nursing assistants can help promote residents' dignity when performing personal care.

1. Allow the residents enough time to use the bathroom without rushing or interrupting them.

2. Assist with dressing as needed, but allow as much independence as possible.

3. Be patient while they perform care tasks.

3. Which serious skin wound can nursing assistants help prevent by observing residents' skin closely?

Pressure ulcers.

4. In general, what should the water temperature be for bathing residents?

105°F

5. Why should residents be involved in choosing a comfortable water temperature?

So that the temperature is comfortable for them.

6. Why should the use of bath oils, gels, and powders be avoided when bathing residents?

This can cause the bath tub/shower to be slippery and can increase the risk of falls.

7. How often should the perineal area be bathed?

Every day

8. What are two benefits of back rubs?

1. Helps relax tired, tense muscles.

2. Improves circulation

9. What is the best way to prevent aspiration when performing oral care on unconscious residents?

Using as little liquid as possible.

10. Why should nursing assistants explain what they are doing when working with unconscious residents?

They may be able to still hear you and they deserve the same respect as any other resident.

11. Should nursing assistants wear gloves when shaving residents? Why or why not?

Yes, because it is a part of Standard Precautions due to the risk of the exposure of blood.

12. Under what circumstances should an electric razor not be used?

If the resident uses oxygen.

13. Why should nursing assistants not cut residents' toenails?

"Problems with circulation can lead to a serious infection if skin is accidentally cut while caring for the nails."

14. When dressing and undressing residents, how should nursing assistants refer to the weaker side?

The Affected side

15. Which of the following should be washed before the axillae (underarms)?

B. Face

16. When bathing a resident, which body part should be washed first?

A. Eyes

17. At a minimum, how often should oral care be performed?

B. Two times a day

18. How should dentures be stored after they are cleaned if the resident does not want to wear them?

D. Dentures should be stored in a denture cup filled with cool water.

19. When dressing a resident, on which side should a nursing assistant start?

A. On the resident's weaker side