Hartman's Nursing Assistant Care Chapter 5, 6, & 7 Exam Questions With Correct Answers

Confusion - Answers The inability to think clearly or make decisions Delirium - Answers Severe confusion which occurs suddenly - usually temporary- Drugs and alcohol usually involved but could also be due to disease, illness, fluid imbalance, poor nutrition Causes of Confusion - Answers UTI, Low Blood Sugar, Dehydration, Fever, Lack of Oxygen, Infections, Brain Tumor Guidelines of Care for Residents experiencing Confusion - Answers Do NOT leave resident alone, provide a quiet environment, introduce self each time you see the resident and use their name, Keep a routine and talk to residents about plan for the day, use calendars - remind them of date, time, place Signs of Delirium - Answers Agitation, Irritability, Anger, Depression, Diorientation, Trouble focusing, Aphasia, Changes in Perspective & Sensations, Changes in Consciousness, STM loss Goal of Treatment for Delirium - Answers Control or Reverse the cause Cognition - Answers The ability to think logically and clearly & make decisions Cognitive Impairment - Answers Inability to think logically & clearly (Not rational) Dementia - Answers Symptom not a diagnosis. Loss of thinking, reasoning, remembering, & communicating. No recovery. Difficulty to perform ADL's. Cause Dementia - Answers Alzheimer's, Multi-Infarc/Vascular Dementia (series of CVAs causes damage to the brain, Lewy Body Dementia, Parkinson's, Huntington's. Lewy Body Dementia - Answers Most common type of dementia. It involves fluctuations between alertness and attention, meaning that one moment resident may seem completely fine and the next he is staring into space and drowsy. It also involves frequent hallucinations and gradual loss of motor skills. Huntington's Disease - Answers Caused by a faulty gene on chromosome 4. The faulty gene leads to a damage of the nerve cells in areas of the brain, including the the basal ganglia and cerebral cortex. This leads to gradual physical, mental and emotional changes. It is a dominant hereditary disease. The hallmark symptom is uncontrolled movement of the arms, legs, head, face and upper body. Also causes a decline in thinking and reasoning skills, including memory, concentration, judgment and ability to plan and organize. Other symptoms include alterations in mood, especially depression, anxiety, and uncharacteristic anger and irritability, obsessive-compulsive behavior, leading a person to repeat the same question or activity over and over. Alzheimer's Disease - Answers Most common cause of dementia in the "elderly". Women are more prone to the disease (possibly hormone imbalances). Causes "tangled nerve fibers (tangles)" and protein deposits to form in the brain. No known cause or cure. Only sure way to "diagnose is by autopsy". Skills a person has used over a lifetime (playing instruments) are usually kept longer. Alzheimer's Care Guidelines - Answers Encourage independence to keep mind and body active as possible. Problem solving, socializing , reading, working/projects all help slow the disease. CNA's attitude when dealing with Alzheimer's should be: - Answers Empathetic, DON"T take things personally, "Let's..." Team Effort Approach Strategies for better communication with Alzheimer's patients - Answers Approach from front (so as not to startle) Determine patient's "space bubble" comfort zone Reduce distractions Always identify yourself and address resident by name Lower tone of voice Use same words and phrases & repeat yourself Use signs, pictures & gestures Break complex tasks into smaller, simpler ones Give simple step by step instructions (treat as an adult but use toddler logic...limited choice etc.) Strategies for helping frightened or agitated Alzheimer's patients - Answers Get rid of noise & distractions Keep them calm Always describe what you are going to do Toddler logic while treating patient as an adult (Don't say don't, limited choice, distractions work well) Watch for non-verbal cues Touch & Smiles reassure them Place pictures on cabinets/bathroom doors/resident's door "Let's..." get dressed now, bathe, walk etc. "Team effort" Strategies for helping depressed or lonely Alzheimer's patients - Answers Take one on one time to listen Involve resident in activities Report signs of depression to the nurse When Alzheimer's resident wants to go home - Answers "Tell me about your home" Redirect conversation to activities or other interests Be patient and gentle ALWAYS When Alzheimer's resident has lost verbal skills - Answers Use nonverbal skills such as smiles, laughter, & touch (if ok with resident) Show affection Use signs, labels & gestures often Validation Therapy - Answers To go along with what a patient says to avoid causing trauma or undue stress. Keep 'em happy. Usually used with patients who are delusional or having hallucinations that are harmless Perseveration - Answers To repeat words, phrases, questions or actions in a soothing manner Guidelines for problems with ADL's in patients with AD or experiencing dementia - Answers 1. Develop a routine and stick with it 2. Promote Self-Care 3. Take Good Care of YOURSELF. You don't want to be on the next episode of Snapped. Guidelines for problems with BATHING in patients with Dementia - Answers Schedule bathing when resident is least agitated & after bowel movement Be sensitive, calm & quiet Be organized so bath is quick Sponge bath instead Prepare the resident by handing the supplies B4 hand (washcloths, etc) & walking them to the shower bath b4 DO NOT LEAVE RESIDENT ALONE PROVIDE PRIVACY Bathroom well lit? Water comfortable temp? Non-slip mats, tub seats and hand holds Guidelines for problems with GROOMING in patients with AD - Answers Help residents to feel attractive Show resident what they are going to wear/provide choice b4 hand Lay out clothes in order that they are put on (Toddler logic while respecting resident is an adult) Avoid delays Dress resident in their room, provide privacy Clothing Order - Answers Underwear, Tee Shirt, Socks, Pants, Shoes - Jacket/Pullover last Guidelines for problems with TOILETING in patients with Dementia - Answers Encourage Fluids - advise nurse if not drinking enuff Mark bathroom with picture Check lighting Remember residents respond to physical needs however they can