CNA Basic Nursing Skills: In-Depth Notes

Spills and Safety Precautions

  • If a client spills water in the hallway:
    • DO NOT ignore the spill; it poses a fall hazard, especially for elderly or ill clients.
    • Actions:
    • Call the nurse.
    • Clean up the spill if safe to do so.
    • Call housekeeping if needed.
    • Important Note: If the spill is blood or body fluids, follow decontamination protocols and wear Personal Protective Equipment (PPE).

Client Transfers

  • During client transfers:
    • Most of the client’s weight should be supported using legs, not the back.
    • Key techniques:
    • Keep back straight and locked.
    • Avoid twisting; bend at the hips only.
    • Assess the level of assistance the client can provide before transfer.
    • If unsure, ask a co-worker for help.

Handling Malfunctioning Equipment

  • If an electric shaver sparks while in use:
    • FIRST STEP: Unplug the shaver to stop sparks.
    • Keep client safety paramount; if on oxygen, move them away from the area immediately.
    • Notify the nurse after ensuring safety.
    • Do not use items from other clients due to infection risks.

Unconscious Oral Care

  • Equipment needed for unconscious oral care:
    • Toothpaste
    • Toothbrush or toothette/mouth swab
    • Precautions:
    • Positioning: Client’s head turned to the side to prevent choking.
    • Gently clean teeth and gums with separate moistened swabs.
    • Raise the client’s head after cleaning.

Fire Safety Protocols

  • In case of a fire alarm:
    • Lock the client’s wheelchair.
    • Check surroundings for smoke and comfort the client while evacuating to safety.
    • Follow the R.A.C.E. protocol:
    • Rescue: Remove those who cannot help themselves.
    • Alarm: Ensure the alarm is triggered.
    • Confine: Close doors to contain smoke/fire.
    • Extinguish: Attempt to put out small fires only if safe.

Handling Difficult Transfers

  • For clients who are agitated and need a mechanical lift:
    • DO NOT attempt to transfer alone; get assistance.
    • Follow the care plan and ensure safety at all times.

Taking Temperature

  • When taking oral temperature:
    • Ensure client hasn’t eaten/drunk anything for 15 minutes prior.
    • Proper placement: Under the tongue.
    • Definitions of fever:
    • Adults: > 38 °C (100.4 °F)
    • Children: > 37.5 °C (99.5 °F)

Converting Units

  • Conversion from ounces to milliliters:
    • 30 ml = 1 ounce; thus, for 4 ounces, multiply by 30 ml.

Electrical Safety

  • If a radio's cord poses a hazard:
    • First, determine a safer way for the client to use the radio without causing tripping hazards.

Apical Pulse Measurement

  • Counting for an apical pulse:
    • Should be taken for one full minute, especially important for irregular or slow rates.

Rheumatoid Arthritis

  • Characteristics:
    • Autoimmune disease causing severe joint pain, swelling, and possible deformities.
    • Can have periods of remission but has no cure.

Home Health Care Management

  • Managed by:
    • Registered Nurses (RNs) oversee home health care, ensuring compliance with care standards.

Bed Making Protocols

  • For making an occupied bed:
    • Always raise the side rail on the opposite side to prevent falls.
    • Use a privacy sheet for the client's comfort.

Signs of Decubitus Ulcers

  • First sign:
    • Redness and warmth in skin; inspect frequently for breakdown.

Activities of Daily Living (ADLs)

  • ADLs include:
    • Eating, bathing, dressing, personal hygiene, mobility, using the toilet.
    • A mnemonic to remember: “DEATH” → D=Dress, E=Eat, A=Ambulate, T=Transfer/Toilet, H=Hygiene.

Heart Function Terms

  • Systole is the period of heart muscle contraction, responsible for pumping blood and identifying systolic pressure during blood pressure measurement.

If a client spills water in the hallway:

  • DO NOT ignore the spill; it poses a fall hazard, especially for elderly or ill clients. Prompt response can prevent injuries.

Actions:

  1. Call the nurse without delay to report the spill and seek assistance.
  2. If safe to do so, clean up the spill using appropriate materials (e.g., absorbent towels or mops).
  3. If necessary, call housekeeping to ensure a thorough cleaning follows safety protocols.

Important Note: If the spill is blood or body fluids, follow strict decontamination protocols. Always wear Personal Protective Equipment (PPE) such as gloves and masks to safeguard against potential infections.

Client Transfers

During client transfers:

  • Most of the client’s weight should be supported using your legs, rather than straining your back. This not only protects the caregiver from injury but also ensures safe transfer practices for the client.

Key Techniques:

  1. Body Mechanics: Keep your back straight and locked in position. Avoid twisting your torso during transfers; bend only at the hips.
  2. Assessment: Before lifting or transferring, assess the level of assistance the client can provide. This helps in determining the safest method for transfer.
  3. Collaboration: If unsure about how to proceed or if the client is uncooperative, ask a co-worker for help. Teamwork ensures safety for both the client and caregiver.

Handling Malfunctioning Equipment

If an electric shaver sparks while in use:

  1. Immediate Action: FIRST STEP: Unplug the shaver to stop any further sparks and prevent accidental fire hazards.
  2. Client Safety: Prioritize client safety; if the client is using oxygen, swiftly move them away from the area to avoid possible ignition sources.
  3. Notification: Notify the nurse after ensuring client safety to take further actions regarding the malfunctioning equipment.
  4. Infection Control: Avoid using items from other clients due to infection risks. Ensure that shared equipment is properly cleaned and maintained.

Unconscious Oral Care

Equipment needed for unconscious oral care includes:

  • Toothpaste
  • Toothbrush or toothette/mouth swab

Precautions:

  1. Positioning: Position the client’s head turned to the side to prevent choking and to facilitate the cleaning.
  2. Gentle Cleaning: Gently clean teeth and gums with separate, moistened swabs, avoiding harsh movements.
  3. Aftercare: After cleaning, raise the client’s head carefully to ensure comfort and safety.

Fire Safety Protocols

In case of a fire alarm:

  1. Client Management: Lock the client’s wheelchair to secure them during evacuation.
  2. Environmental Check: Check the surroundings for smoke or hazards while comforting and preparing the client for evacuation to safety.
  3. Follow the R.A.C.E. protocol:
    • Rescue: Remove individuals who cannot help themselves first.
    • Alarm: Ensure the fire alarm has been triggered to alert emergency services.
    • Confine: Close all doors to contain smoke and fire spread.
    • Extinguish: Attempt to put out small fires only if it is safe to do so. Prioritize personal safety.

Handling Difficult Transfers

For clients who are agitated and require a mechanical lift:

  • DO NOT attempt to transfer alone; always get assistance from colleagues.
  • Thoroughly follow the care plan and ensure safety at all times, maintaining clear communication among the team.

Taking Temperature

When taking oral temperature:

  1. Preparation: Ensure the client hasn’t eaten or drunk anything for at least 15 minutes prior to taking their temperature for an accurate reading.
  2. Placement: Properly place the thermometer under the client’s tongue and instruct them to close their lips around it.

Definitions of fever:

  • Adults: > 38 °C (100.4 °F)
  • Children: > 37.5 °C (99.5 °F)

Converting Units

Conversion from ounces to milliliters:

  • 30 ml = 1 ounce; thus, for 4 ounces, multiply by 30 ml, leading to:
    4 ext{ ounces} imes 30 ext{ ml/ounce} = 120 ext{ ml}.

Electrical Safety

If a radio's cord poses a hazard:

  1. Precautionary Measures: First, determine a safer way for the client to use the radio without causing tripping hazards.

Apical Pulse Measurement

When counting for an apical pulse:

  • Should be taken for one full minute, especially important for identifying irregular or slow rates.

Rheumatoid Arthritis

Characteristics:

  • An autoimmune disease that causes severe joint pain, swelling, and possible deformities.
  • Episodes may include periods of remission, but it currently has no cure available.

Home Health Care Management

Managed by:

  • Registered Nurses (RNs) oversee home health care practices, ensuring compliance with care standards and protocols.

Bed Making Protocols

For making an occupied bed:

  • Always raise the side rail on the opposite side to prevent falls when adjusting bedding.
  • Use a privacy sheet for the client's comfort and dignity during the process.

Signs of Decubitus Ulcers

First sign:

  • Redness and warmth in the skin; it is crucial to inspect frequently for breakdown to prevent further complications.

Activities of Daily Living (ADLs)

ADLs include:

  • Eating, bathing, dressing, personal hygiene, mobility, and using the toilet.

A mnemonic to remember: “DEATH” → D=Dress, E=Eat, A=Ambulate, T=Transfer/Toilet, H=Hygiene.

Heart Function Terms

Systole:

  • The period of heart muscle contraction, crucial for pumping blood throughout the body and identifying systolic pressure during blood pressure measurement