Chapter 10 - Nursing Assistant Care

body mechanics

Principles that focus on alignment, base of support, center of gravity, fulcrum and lever.

positioning

The act of helping people into positions that promote comfort and health.

supine

Body position in which a person lies flat on his back.

lateral

Body position in which a person is lying on either side.

prone

Body position in which a person is lying on his stomach, or front side of the body.

Fowler's

A semi-sitting body position, in which a person's head and shoulders are elevated 45 to 60 degrees.

Sims'

Body position in which a person is lying on his left side with the upper knee flexed and raised toward the chest.

draw sheet

An extra sheet placed on top of the bottom sheet; used for moving residents without causing shearing.

shearing

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

Moving a person as a unit, without disturbing the alignment of the body.

dangle

To sit up with the legs hanging over the side of the bed in order to regain balance and stabilize blood pressure.

Supine Position

Resident lying flat on back with pillows under head and shoulders, and under calves to elevate heels.

Lateral Position

Resident lying on either side with pillows supporting head, arm, and leg on upper side.

Prone Position

Resident lying on stomach with a small pillow under head and to keep feet off bed.

Fowler's Position

Semi-sitting, head and shoulders elevated with pillows at flexed knees, at flexed feet, and under head.

Sims' Position

Variation on lateral side position, left side-lying position with lower arm behind the back and upper knee flexed.

Moving a resident up in bed

Process involving identifying yourself, washing hands, explaining the procedure, and ensuring privacy.

Equipment for moving a resident

Draw sheet or other device.

Adjusting bed for moving a resident

Adjust bed to a safe level, usually waist high, and lock the bed wheels.

Lowering head of bed

Lower the head of bed to make it flat before moving the resident.

Raising side rails

If the bed has side rails, raise the rail on the far side of the bed.

Standing position for moving

Stand by the bed with feet shoulder-width apart, facing the resident.

Proper body mechanics

Using correct posture and movements to prevent injury while assisting a resident.

Count of three

A method used to coordinate movements when shifting a resident.

Comfortable positioning

Arranging the resident's pillows and blankets to ensure their comfort.

Lowest bed position

The bed height set to its lowest level for safety.

Call light

A device placed within the resident's reach to alert staff for assistance.

Hand hygiene

Washing hands to prevent infection before and after resident care.

Reporting changes

Informing the nurse about any noticeable changes in the resident's condition.

Privacy measures

Using curtains, screens, or doors to ensure the resident's privacy during care.

Shoulder-width apart stance

Standing with feet shoulder-width apart for stability while moving a resident.

Knee against the bed

Positioning one knee against the side of the bed for leverage while moving a resident.

Face-to-face contact

Maintaining direct eye contact with the resident to enhance communication.

Adjusting bed height

Setting the bed to a safe level, typically waist high, for ease of care.

Unrolling the draw sheet

Leaving the draw sheet in place after repositioning for future use.

Moving a resident to the side of the bed

The procedure of shifting a resident laterally using a draw sheet or hands.

Bending knees

A technique to maintain back safety while lifting or moving a resident.

Using another person for assistance

Modifying the procedure to include a helper for safer resident transfers.

Grasping the draw sheet

Holding the draw sheet securely to facilitate moving the resident.

Sliding hands under the resident

Gently positioning hands under different parts of the resident's body for movement.

Facility guidelines

The specific protocols to follow when documenting procedures in a care setting.

Lowering the head of the bed

Adjusting the bed's head section downwards to assist in resident positioning.

Maintaining back straight

Keeping the spine aligned to prevent injury while moving a resident.

Positioning a resident on his side

Gently slide your hands under her midsection and move it toward you.

Make the resident comfortable

Ensure the resident is in a comfortable position.

Return bed to lowest position

Adjust the bed to its lowest position for safety.

Remove privacy measures

Take down any curtains or screens used for privacy.

Place call light within resident's reach

Ensure the call light is accessible to the resident.

Wash your hands

Perform hand hygiene before and after the procedure.

Report any changes in resident to the nurse

Inform the nurse of any observed changes in the resident's condition.

Document procedure using facility guidelines

Record the procedure according to the established protocols.

Identify yourself by name

Introduce yourself to the resident clearly.

Identify the resident according to facility policy

Confirm the resident's identity as per the facility's procedures.

Explain procedure to the resident

Clearly and slowly explain what you will be doing.

Provide for the resident's privacy

Use a curtain, screen, or door to ensure privacy.

Adjust bed to a safe level

Set the bed height to a safe level, usually waist high.

Lock the bed wheels

Ensure the bed wheels are locked to prevent movement.

Lower the head of the bed

Adjust the head of the bed to a flat position.

Turning a resident away from you

Cross the resident's arms over his chest and cross the near leg over the far leg.

Turning a resident toward you

Cross the resident's far arm over his chest and move the arm on the side the resident is being turned to out of the way.

Position the resident properly and comfortably

Ensure the resident's head is supported by a pillow and the shoulder is adjusted.

Logrolling a resident

Use a draw sheet or other device with a coworker to move the resident.

Place a pillow under the resident's head

Support the neck during the move with a pillow.

Place the resident's arms across his chest

Position the resident's arms to facilitate movement.

Place a pillow between the knees

Use a pillow to support the resident's legs.

Stand with your feet shoulder-width apart

Maintain a stable stance while preparing to move the resident.

Grasp the draw sheet on the far side

Hold the draw sheet firmly to assist in the move.

Let the resident know you will be moving him

Inform the resident about the upcoming movement for awareness.

On three, gently roll the resident toward you

Count to three and roll the resident as a single unit.

Make resident comfortable

Adjust the resident's position for comfort after the move.

ergonomics

the science of designing equipment, areas, and work tasks to make them safer and to suit the worker's abilities.

transfer belt

a belt made of canvas or other heavy material that is used to help people who are weak, unsteady, or uncoordinated to transfer or walk.

slide board

a wooden board that helps transfer people who are unable to bear weight on their legs; also called transfer board.

nonskid shoes

footwear designed to prevent slipping, often used for residents getting out of bed.

vital signs

measurements of the body's basic functions, including pulse and respiration rates.

resident comfort

the state of being comfortable, often achieved by adjusting pillows and covers.

bed position

the height and angle at which a bed is set, important for resident safety and comfort.

care plan

a documented strategy for the care of a resident, outlining specific procedures and goals.

assistance

help provided to residents who are unable to perform tasks independently.

handwashing

the act of cleaning hands to prevent infection, required before and after resident care.

transfers

the process of moving a resident from one location to another, such as from bed to chair.

ambulation

the act of walking or moving about, often requiring assistance for residents.

sitting position

the posture of a resident when they are upright, often achieved by raising the head of the bed.

shoulder blades

the bony structures on the back that are important for support during transfers.

thighs

the upper part of the leg, which is supported during transfers.

counting pulse

the process of measuring the number of heartbeats per minute as part of vital signs assessment.

respiration rates

the number of breaths taken per minute, an important vital sign.

No-lift policy

A policy adopted by many facilities that prohibits lifting residents manually.

Affected side

The side of the resident's body that is weaker or has less mobility.

Nonskid footwear

Footwear designed to prevent slipping, required for residents during transfers.

Wheelchair guidelines

Instructions for safely using a wheelchair, including locking brakes and using armrests.

Transfer procedure

A series of steps to safely transfer a resident, including identifying the resident and washing hands.

Privacy during transfer

Providing privacy for the resident using curtains, screens, or doors during the transfer process.

Buckle adjustment

The transfer belt buckle should be tightened until snug, allowing room for flat fingers to fit underneath.

Repositioning residents

Moving residents at least every hour to promote comfort, muscle tone, and circulation.

Responding to a fall

Actions to take when a resident starts to fall, including widening stance and lowering the resident to the floor.

Stretcher guidelines

Instructions for safely using a stretcher, including locking wheels and keeping safety belts fastened.

Transferring with a stretcher

Moving a resident on a stretcher requires locking wheels and moving slowly and carefully.

Assisting resident in wheelchair

Ensure the wheelchair is close and locked before assisting the resident with transfers.

Safety rails on stretchers

Safety rails should be raised and safety belts fastened while the resident is on a stretcher.