CNA modules 3&4 Test

Vital Signs

· Vital signs reflect the function______ of three body processes essential for life:

1. Regulation of body temperature_______

2. breathing________

3. heart____ function

· The four vital signs are:

1. temperature________

2. Pulse______

3. Respirations

4. Blood______ Pressure______

· Some agencies also consider “____pain______” as a vital sign.

Measuring and Reporting Vital Signs

· Vital signs are measured to detect changes in normal body functions______.

· They help tell about the response to treatment______.

· They often signal ___life_______-____threatening______ events.

· Vital signs are part of the assessment______ step in the nursing process.

· Factors affecting vital signs include activity, anger______, ____anxiety______, eating, exercise, ___fear_______, ____noise______, pain, sleep, and weather.

When to Measure Vital Signs

· Vital signs are measured during physical exams.

· When a person is admitted__ to a health__ care__agency.

· As often as the person’s ___condition_______ requires.

· Before and after surgery, complex procedures, and diagnostic tests.

· After some care measures______, such as ambulation (walking).

· After a ____fall______ or other injury______.

· When drugs affect the ___respiratory_______ or ___circulatory_______ system.

· When the person complains______ of pain, dizziness, light-headedness, feeling faint, shortness______ of breath, a rapid heart rate, or not feeling well______.

· As stated______ on the care plan (daily, bid, q shift).

· Report any vital signs that change from a ___prior_______ measurement, are above the normal range, or are below the normal______ range.

· Vital signs show even minor __________in the person’s ________.

o Accuracy______ is essential when you measure, record, and report vital signs

o If you are ___unsure_______ ask a nurse to ___verify_______.

· Take vital signs with the person at rest______ -lying or sitting with feet flat on the floor—unless otherwise ordered

· Report the following at once:

o Any vital sign that is changed______ from a prior measurement

o Vital signs above______ the normal range

o Vital signs ____below______ the normal range

Body Temperature

· Body temperature is a balance______ between the amount of ___heat_______ produced and lost by the body.

· Heat is produced by cells using food______ for energy.

· Heat is lost through the skin______, breathing, ___urine_______, and feces.

· Temperature is measured using thermometers, and scales include ___farenheit_______ and centigrade______.

· Temperature sites include the mouth, rectum______, axilla, __________ membrane, and ___temporal_____ artery.

· Each site has a normal range______.

· ___Febrile_______ means with a ___fever_______ (over 100.4°F), and ___Afebrile_______ means without a ___fever_______.

· Always report temperatures that are ______above____ or ___below_______ the normal range.

Factors Influencing Temperature

· Factors that increase temperature include exercise, digestion______ of food, environmental temperature, illness, infection, ___excitement_______, ___anxiety_______, and time of day______.

· Factors that decrease temperature include sleeping________, fasting, exposure to ___cold_______, decreased muscle activity, ___mouth_______ breathing, depression, time of day, and menstrual cycle______.

Types of thermometers used:

o glass____ thermometers

o Standard electronic____ thermometers

• tympanic____ membrane thermometers

• ___temporal_____ artery thermometers

· digital____ thermometers

· Disposable____ oral thermometers

· Temperature-__sensitive______ tape

· ___pacifier_____ thermometers

Taking temperatures

· The ___nurse_______ and ___care plan_______ tell you when to take the person’s temperature, what ___site_______ to use, and what ____thermometer______ to use.

Contraindications for Temperature Sites

· Do not take a rectal temperature if the person:

· has ___diarrhea_______

· has a rectal disorder or ___injury_______

· has a heart______ disease

· has had rectal________ surgery

· is confused______ or agitated______

· For an oral temperature, if a person has had anything to eat______, drink, or has ___Naso-gastric tube_______ in the

· Electronic thermometers are commonly____ used.

o Some have Batteries____.

o Others are kept in ___battery_____ chargers____ when not in use.

o Standard electronic thermometers

• Measure temperature____ in a few seconds

• They have oral______ (blue) and rectal____ (red) probes.

· tympanic______ membrane thermometers

• Measure temperature in 1 to 3 seconds

• Risk of spreading infection is reduced.

· temporal____ artery thermometers

• Measure temperature in 3 to 4 seconds____

• Measure the temperature of the blood in the temporal______ artery____ which is the same temperature of the blood coming from the heart

Pulse

· A pulse is felt every time the heart ___beats_______.

· The pulse___ ___rate_____ is the number of heartbeats in one______ minute.

· The radial______ pulse is commonly used, and the ___radial_______ pulse is felt over the ___radius_______.

· The normal adult pulse rate is between ___60_______ and 100______ beats per minute.

Factors Affecting Pulse Rate

· Factors affecting pulse rate include age, fever, blood______loss, physical shape, ___exercise_______, medication, _____illness_____, sleep, emotions, ___heat______, ___position_______, and ____pain______.

Respirations

· Respiration involves breathing air into (inhalation) and out of (exhalation) the ___lungs_______.

· The normal respiratory rate for a healthy adult is ___12_______ to 20______ respirations per minute.

· Respiration should be quiet, ___effortless_______, and ___regular_______.

Blood Pressure

· Blood pressure (BP) is the amount of force exerted against the walls of an artery by the ___blood_______.

· Systole______ is the period of heart muscle contraction______, and ___diastole_______ is the period of heart muscle ___relaxation_______.

· Systolic pressure is the pressure in the arteries when the heart ___contracts_______, and diastolic pressure is the pressure when the heart is at rest_____.

· Normal ranges for blood pressure:

· Systolic: ___90_______ mm Hg or higher but lower than ___120_______ mm Hg.

· Diastolic: ____60______ mm Hg or higher but lower than ___80_______ mm Hg.

Hypertension and Hypotension

· Hypertension is when the systolic BP is 140______ mm Hg or higher, or diastolic BP is ____80______ mm Hg or higher.

· Hypotension is when the systolic BP is below ____90______ mm Hg, or diastolic BP is below ___60_______ mm Hg.

Pain

· Pain is a warning___ sign from the body.

o Pain can signal tissue__ damage.

o Many agencies consider pain to be a vital__ sign___.

Pulse Oximetry

· Pulse oximetry measures the oxygen concentration in ___arterial_______ blood.

· The normal range is ____95______% to ____100______%.

· The sensor is attached to a ___finger_______, toe, earlobe, ____nose______, or forehead.

Introduction to The Person’s Rights

· People want information about their ____health______ problems and treatment.

· They seek better care at ____lower___ costs.

· They want to understand and be involved in ____treatment______ decisions.

· They do not accept the doctor’s advice without ___question______.

· As patients and residents, they have certain ___rights_______.

The Patient Care Partnership

· This document explains the person’s ___rights______ and ____expectations____during hospital stays.

· The relationship between the ___doctor____, the ___health______ ____team_____, and the ____patient______ is stressed.

· Adopted in ___April____ by the American Hospital Association (AHA).

· Explains the person’s rights and expectations during ____hospital___ stays.

· Focuses on the relationship between the ___doctor_____, health team, and patient.

· During their hospital stay a patient can expect:

____high_____ ____quality______ hospital care.
A ___clean____ and safe___ environment.
____involvement______ in their care.
_____protection______ of their privacy.
Help when ___leaving____ the hospital.
Help with billing____ questions.

Resident Rights

· Passed in 1987, applies to all ___50___ states.

· Requires nursing centers to provide care in a manner and a setting that maintains or

improves each person’s quality__ of life, ___health____ and ___safety____.

· Residents’ rights are a ___major___ part of OBRA.

· Rights are protected by federal___ and state law.

· Residents have rights relating to their ___everyday____ lives and care in a nursing center___.

· If incompetent, a representatives___ may act on the resident's behalf.

· Nursing centers must ___inform_____ residents of their rights, which are posted throughout

the center___.

Right to Information

· Access to all records____ about the person including medical records, ____contracts____, incident____

reports, and financial records___. The request for information may be either oral__ or

____written_______.

· Information is given in a language and in words the person can understand.

· The person has the right to be fully informed of his/her health condition___.

· The person must also have information about his or her ___doctor________. Information includes the doctor’s ___name___, specialty____ and contact information.

Refusing Treatment

Treatment is the care provided to ___maintain_____ or restore___ health, improve ___function___ or relieve ___symptoms_____.

· The person has the right to refuse treatment___.

· Advance directives are part of the right to refuse treatment___.

o ____living_____ wills.

o Instructions about life__ support___.

· Report treatment refusal the ___nurse____.

· If a resident refuses treatment the facility must find out the reason__ for refusal, ___educate___ the person about the ___problems____ that can result _from the refusal, offer other treatment___ options___, and continue to provide all other services.

Privacy and Confidentiality

· Residents have the right to personal ___privacy____.

· Staff must provide care in a manner that maintains privacy of the person’s body___.

o Expose the person’s body only as ___necessary___. Protect privacy by closing_ ___privacy___ curtains_, ___doors___, and ___window______ ___coverings_____; removing residents from ___public___ view_, providing ___clothes___ or ___draping___ the person to prevent unnecessary____ exposure of body parts.

· The resident has the right to visit____ with others in private.

· Residents have the right to make ___phone____ calls___ in private.

· The person has the right to send and receive mail_ without others interfering_.

o Mail must be given to the person within__24___ hours of the facility receiving the mail.

o If the person wishes to send mail, it is delivered to the postal service with 24 hours of regular delivery or pick-up service.

Personal Choice

· Residents have the right to make their own ___choices____ regarding doctors____, ____planning ____ and deciding care/treatment____ as well as choosing activities___, ___schedules__, and care based on their preferences___.

· Personal choice promotes quality___ of life, dignity___, and self___-__respect____.

Grievances

· The right to voice concerns___ , questions__, and ___complaints____ about treatment or care.

o The problem may involve another person___.

o The problem may be about care given__ or ___not___ given.

· The center must promptly try to ___correct____ the matter.

· No one can punish___ the person in any way for ___voicing___ the grievance.

Work and Services

· Residents can work or perform services if they ___want to____.

· Not required to work for ___care___, care items_, or ___other things____ or ___privileges___.

· Other people need work for rehabilitation__ or ___activity___ reasons.

· The person is not required to perform ___services____ for the center.

Participation in Resident Groups

· The right to form and take part in resident ____groups___. They can discuss ___concerns___ and suggest ___center improvements______. Residents ____support__ each other, plan activities__, and take part in ___educational______ activities.

· Families have the right to meet with other families___.

Personal Items

· Right to keep and use personal ___items____.

· Treat the person’s property with care_ and respect__.

o The center must investigate reports of ___lost___, ___stolen___, or damaged ___items____.

· The person’s property is protected.

o Do not go through the persons property without his or her ___knowledge____ or ___consent___.

Abuse, Mistreatment, and Neglect

· Residents have the right to be free from ___verbal____, ___sexual____, physical__, and ___mental___ abuse.

· They also have the right to be free from ____involuntary__ seclusion__.

· No one can abuse_, neglect_, or mistreat a resident.

Nursing centers must ___investigate___ suspected or reported cases of abuse_.

· Centers cannot employ persons guilty of abuse___ or mistreatment.

Freedom from Restraint

· Residents have the right not to have body movements ___restricted____.

· Restraints may be used if required to treat the person’s medical_ symptoms_. A doctor’s ____order___ is required.

Quality of Life

· Residents have the right to ___quality____ of life. Protecting this right promotes__ quality of life_ and shows respect_ for the person.

· Residents must be cared for in a manner and setting that promote ___physical___, mental_, and__ social well___-__being___.

Activities

· Right to activities that enhance ___person’s_ physical__, mental, and psychosocial__ well-being.

· Activities must be related___ and reflect the person’s ___needs____, interests, culture__, and background.

· The CNA assists with taking residents to__ and ___from___ activity programs.

Environment

· Right to a safe, clean, ___comfortable___, and home_- ___like____ environment.

· Promote the person’s independence, dignity, and well-being.

The Older Americans Act (Ombudsman Program)

· The law requires a long-term care ombudsman (someone who supports the rights of a person)___ program in every state.

· Residents have the right to voice grievances and ___disputes____.

Slide 1: Introduction

The following serve to protect patients and residents from harm:
- Nurse practice acts
- Your training and job ___description_______
- Safe ___delegation_______
- A complex set of rules and standards of ___conduct_______.

Slide 2: Ethical Aspects

Ethics is the knowledge of what is right ___ conduct_______ and wrong conduct.
____morals______ are involved.
It deals with choices or judgments about what should or should not be ____done______.
Ethical behavior involves not being prejudiced or ___biased_______.
Professional groups have codes of ___ethics_______.

Slide 3: Ethical Aspects (Cont.)

Professional boundaries separate helpful behaviors from behaviors that are not ____helpful______.
Boundary ____crossing______: A brief act or behavior of being overinvolved with the person.
Boundary ____violation______: An act or behavior that meets your needs, not the person’s needs.

Slide 4: Legal Aspects

The U.S. and state legislatures make ____laws______.
An act that violates a criminal law is called a ___crime_______.
Civil laws involve ___contracts_______ and nursing practice.

Slide 5: Legal Aspects (Cont.)

Torts: A wrong committed against a person or the person’s ____property______.
Unintentional—harm was not ____intended______.
Intentional—harm was ____intended______.

Slide 6: Legal Aspects (Cont.)

Informed consent is consent when the person clearly understands the ___reason_______ for treatment, procedure, or care measure.
Other treatment, procedure, or care options______.
Risk factors related to the treatment, procedure, or care ___measure_______.

Slide 7: Reporting Abuse

Abuse is the intentional mistreatment or harm of another ___person_______.
Forms of elder abuse include physical abuse, neglect, verbal abuse, and ___financial exploitation_______.
Child abuse may involve physical abuse, emotional neglect, sexual abuse, and ___abandonment_______.

Slide 8: Reporting Abuse (Cont.)

Domestic abuse occurs in relationships where one partner has power and control over the other through ____abuse______.
Abuse may be physical, sexual, verbal, economic, or ___social_______.
State laws vary about reporting domestic ____abuse______.