Nursing Fundamentals Review
Exam and Scope After Class
Exam Timing: Students must take the exam within 2 years after finishing the class.
Responsibilities and Reporting Procedures
Care for Patients: If asked about taking care of someone with hip dressing, it is out of the CNA's scope of practice.
Medication Inquiry: If a patient's family member asks about their medications, refer to the charge nurse.
Subjective vs. Objective Information
Subjective Information: Includes feelings, reported symptoms, e.g., a patient not feeling well and complaining of a headache.
Objective Information: Measurable and observable data, e.g., odor, bruise.
Signs of Intoxication
Slurred Speech and Alcohol Breath: If someone relieving a CNA exhibits these signs, it should be documented as objective.
Patient's Own Report of Alcohol Use: If the patient claims to have had a few drinks and appears slightly intoxicated, report to the charge nurse.
Escalating Issues
If the nurse does not address a concern, escalate it to the director of nursing, then to the administrator.
Activities of Daily Living (ADL)
Refers to essential tasks necessary for self-care that are part of daily life.
Nursing Procedures and Policies
Procedure: Steps on how to perform tasks.
Policy: Explains the rationale behind procedures.
Empathy and Scope of Practice
Empathy: Understanding another's experience and emotional state.
Scope of Practice: Legal boundaries defining tasks a nursing assistant can perform.
Reporting Potential Abuse
Signs of Abuse: If a CNA notices bruises during care, it must be reported to the nurse as potential physical abuse.
Confidentiality and Social Media
Privacy Violations: Taking photos of bruises and sharing on social media breaches privacy and confidentiality.
Patient Observations and Responses
Patient Movements: Observations like moaning or grooming when trying to move should be documented as objective,
Complaints of leg pain should be categorized as subjective information.
Infection Control Practices
Hand Hygiene: Essential for breaking the chain of infection, especially after specific tasks.
Vaccination Understanding
Giving an MMR shot breaks the link of infection by ensuring the individual is no longer a susceptible host.
Ethical Considerations
Ethics in Nursing: Questions of right and wrong affect decision-making processes.
Communication Disorders
Receptive Aphasia: Severely affects the ability to understand language despite fluent speech that may be nonsensical.
Expressive Aphasia: Patients struggle to express themselves verbally despite understanding what they want to say.
Cardiac Issues and Responses
Angina Pectoris: Pain characterized by chest discomfort due to inadequate oxygenation of the heart muscle, primarily caused by blockages in coronary arteries.
Definition: Chest pain or discomfort resulting from the heart not receiving enough oxygen-rich blood.
Patient Mobility Assistance
Gait Belts: Devices used for supporting patients during ambulation or transfer.
Mechanical Lift Aid: Required for transferring patients who cannot bear weight.
Understanding Human Anatomy
Urinary System Components: Includes kidneys, ureters, bladder, and urethra.
Circulatory System: Composed of the heart, blood vessels, and blood.
Digestive Process
Digestion Begins: At the mouth.
Recognizing Cardiovascular Events
Signs of Myocardial Infarction (MI): Severe chest pain radiating from back to arms may indicate a heart attack.
Patient Refusal: Patients can refuse to go to the emergency room even if symptoms suggest need for immediate care.
Neurological Conditions
Multiple Sclerosis (MS): A chronic disease affecting the central nervous system.
Symptoms may include muscle weakness and fatigue.
Urination and Patient Experiences
Enlarged Prostate: Symptoms include difficulty starting urination, straining, and increased frequency.
Recognizing Strokes
Stroke Signs: Sudden weakness and confusion in a patient could indicate a stroke.
Nutritional Considerations
Diminished Appetite: Often caused by a decrease in the senses of taste and smell.
Aspiration Precautions
Coughing During Meals: Encourage patients to cough to ensure airway safety.
Diabetes Types Overview
Type 1 and Type 2 Diabetes: Chronic conditions impacting the endocrine system, primarily insulin production and usage.
Identifying Developing Disabilities
Developing Disabilities: Not all conditions, e.g., paraplegia, are classified as developing disabilities.
Environmental Safety
Removing Hazards: If a patient has care supplies that could pose risk (e.g., rubbing alcohol), it should be immediately removed.
Physical Restraints and Hospital Protocol
If a patient placed in a chair cannot sit or stand due to restraints that prevent movement, this qualifies as improper restraint.
Managing Agitation in Patients
Restless Behavior: When a patient is yelling for assistance, consider basic needs (e.g., toileting).
Aging Considerations
Normal Aging Changes: Include thinner skin, brittle bones, slower reflexes, diminished appetite, and weakened immune system.
Incontinence: Is not a normal change of aging and should be addressed properly.
Patient Needs and Prioritization
Maslow’s Hierarchy of Needs: Physical needs must be prioritized before psychological and social needs can be addressed.
Fire and Safety Protocol
Fire Requirements: Oxygen, fuel, and heat must be present for fire to occur or continue burning.
Homeostatic Balance
Homeostasis: The term used for maintaining a stable internal environment in the body.
Diabetes and Insulin Use
Type 2 Diabetes: Occurs when the body cannot effectively utilize insulin.
Communication and Response Procedures
Assisting New Residents: Individuals should be shown essential controls like the call light for safety and comfort.
Evidence of Infection and Response
Signs of Infection: Such as changes in patient behavior, odor, or discoloration must be promptly reported.
Essential Measurements and Monitoring
Vital Signs Ranges:
Temperature:
Respiration: per minute
Pulse: beats per minute
Blood Pressure:
Nutrition and Dietary Considerations
Fluid Restrictions: If a patient has restricted fluid intake, it is crucial to monitor signs of dehydration.
Common Symptoms: Include excessive thirst and dry mucous membranes.
Administering Care
Using Proper Techniques for Patient Care: Practices like ensuring hand hygiene and correctly assisted feeding techniques are essential for safe care.
Communication Principles in Nursing
Effective communication techniques: Involve speaking directly, using short sentences, and non-verbal cues when interacting with hard-of-hearing residents.
Recognizing End of Life Care Needs
Hospice Care: Focuses on providing comfort for patients with limited life expectancy.