INACE, CNA Practice Exam 4, CNA practice test 2, CNA Practice Test 1, Complete Verified Solution

INACE, CNA Practice Exam 4, CNA practice test 2, CNA Practice Test 1, Complete Verified Solution Reporting & Recording -Check current documentation of resident status & care. -Observe & report resident data (verbal). -Record objective & subjective resident data (written) Communicate need for changes in care plan. - Report unsafe conditions. -Place & receive phone calls Objective Data Things you can see, hear, feel, smell, or measure: Vital signs, weight, open sore on arm, reddened area on hip, swollen knee, wheezing, skin cold clammy, foul smelling urine, etc. -Subjective Data Things a resident tells you that cannot be observed through senses: Complaints of pain (headache, chest pain, stomach ache), nausea, numbness & tingling of fingers, no appetite, etc At the Nurse's Station: 1 st ring. • Identify unit, give name & title. • Take message. • Do NOT give confidential information. Refer caller to nurse The Resident's Personal Phone: Assist resident to answer. • Answer w/ consent. • If resident is unavailable, answer bedside phone (not cell phone) & take a message; do NOT provide any confidential info. Do NOT give your name or title, the name of the unit or facility Answer call signal: Used to signal for help. - Bed, bathroom. - Keep w/in reach. -Strong side. -Instruct on use. -Remind to use when help needed. - Answer promptly - Everyone responsible! Adaptations if limited mobility. 4. Reinforce instructions from other health professionals to resident & family - Not responsible for teaching but for knowing & reinforcing/assisting resident Inventory & label personal property Upon admission, as acquired. Instruct resident in use of body mechanics. Keep body in good alignment; have good posture. Have a wide base of support (feet shoulder-width apart). -Use strongest & largest muscles (shoulders, upper arms, hips, thighs). - Keep objects close to body. - Avoid unnecessary bending & reaching. - Bend knees & squat. Don't bend your back! -Get help from co-worker. -Use proper equipment. - Position feet & body in direction you are moving -Avoid sudden & jerky movements. Count 1-2-3. - Turn whole body when changing direction. Pivot, do NOT twist your back! Calculate, report, & record Food intake (solids): 0%, 25%, 50%, 75%, 100% Fluid intake: All oral fluids. -Foods that melt at room temp. - IV fluids & tube feedings. - CNA only responsible for fluids by mouth. Fluid output: Urine, vomit, diarrhea - CNA only responsible. - Wound drainage, hemorrhage - Nurse responsible. Intake & Output Intake: 1 oz = 30 ml Output: urinals, graduates, bedpans, specimen containers each line on urine container increases by 25 mL Communicate w/ limited English proficient resident. Utilize tools provided by facility Assist w/ unit discharge procedure Collect belongings, compare w/ personal belongings list. - Assist w/ packing. -Transport as indicated. -Wish well. - Return to room; strip bed, straighten, remove wastes & linens. If any additional equipment, take to soiled utility room Measure & Record VS & Weight All VS: Lying or sitting. -At rest for 10-20 min. -Obtain all VS of a resident (TPR & BP) before reporting any abnormal to nurse. Temperature: 98.6 + 1⁰ (97.6⁰ - 99.6⁰ ) Elderly on lower end of range ≈ 97.6⁰ - Do not eat, drink, smoke for 15 min Pulse 60 - 100 beats/min. - Tachycardia 100 - Bradycardia 60 -Count for 30 sec & multiply by 2. If irregular, must count for full min Respirations 12-20/min Do not let know you are counting. Dyspnea = difficulty breathing Blood pressure 90/60 - 120/80 Systolic - top # - Diastolic - bottom # - Hypertension - high BP Wait 1 min before retaking BP Weight SAME Scale - SAME Time of Day (does NOT matter when!) SAME Amount of Clothing (do NOT need to remove) Routine urine specimen anytime, earliest possible time 24-hour urine specimen Keep chilled. -Start w/ empty bladder. -Start over if urine missed or stool/tissue present Clean-catch urine specimen Testing for UTI. -Special cleansing wipes needed, sterile container. - Start to urinate, stop, start again & collect. Sputum specimen Secretions from respiratory system. -May rinse w/ clear water. -Take 2-3 deep breaths, cough, expel. stool specimen Collect about 2 tbsp. Include anything unusual. Collect specimens Assist in preparation of specimen for transfer to laboratory - Follow Standard Precautions! - Place in clear biohazard specimen bag. - Take to appropriate location according to facility policy: - Specimen refrigerator, lab, etc. standard percautions Apply to care of ALL residents. - Presume EVERYONE is INFECTED! Presume ALL may contain germs: Body fluids (blood, urine, saliva, wound drainage, vomit, etc.) Body substances (stool) Open skin Mucous membranes (mouth, eyes, nose, perineum) standard precautions guidelines Wash your hands! #1 in preventing spread of infection. Using FRICTION most important aspect of handwashing. Wear gloves whenever contact w/ body fluids, substances, open skin, mucous membranes is likely. (Wash hands before & after!) Placed all used linens in a LEAK-PROOF bag. Place all wastes in a container lined w/ PLASTIC bag. Clean & disinfect. Isolation Transmission-based Precautions INFECTION is present! COVID-19, MRSA, C Diff, Staph, E Coli, etc. No longer presuming! Doctor order required. All persons required to follow - staff, visitors, resident, etc. Used IN ADDITION to STANDARD PRECAUTIONS! Have taken on a whole new meaning & respect in the new world we are now living in Assist w/ the set-up & maintain supplies Sign on door. Isolation cart, cabinet, shelf OUTSIDE of room PPE - Place appropriate items on BEFORE entering the room. • Gloves • Gowns • Masks • Goggles/face shields • Shoe & hair covers Waste bags, linen bags, specimen bags, individual equipment. Contact precautions (isolation) Germs spread by touch: • Skin-to-skin contact • Contact w/ soiled linens, utensils, personal care items, etc Before entering room: Wash hands. • GLOVE. • Gown if providing direct care. • Single use equipment if possible. Droplet Precautions Respiratory germs spread thru air to mucous membranes of another person: • Nostrils, eyes, mouth. BEFORE entering room: • Wash hands. • Put on MASK. Keep door closed. Resident MUST wear mask if leaves room. Airborne Precautions Respiratory germs that remain infectious longer & travel farther. BEFORE entering room: • Wash hands. • Put on RESPIRATOR MASK. Keep door closed. Resident MUST wear mask if leaves room. Serve & remove diet tray in isolation Follow facility policy. Discard anything disposable (plastic, Styrofoam, napkins, packages, uneaten food, etc.) in the red biohazardous waste bag in the isolation room. Return re-usable dishes, drinking glasses/cups/mugs, eating utensils, & trays to the dietary cart or dietary department for cleaning & disinfecting. (Do not leave in room.) May include bagging, labeling as infectious. Collect a specimen in isolation Follow facility policy. Urine, stool, sputum. Label container & specimen biohazard bag. Put container in biohazard specimen bag & take to appropriate location. (Do not leave in room.) Dispose of soiled material in isolation -Biohazardous wastes (gloves, disposable gowns & masks, paper towels, briefs, disposable eating utensils & trays, leftover food, etc.) -Linens (bedding, towels, washcloths, clothing, etc.) -Leak-proof bags - Do NOT mix up the 2! -Do not overfill. - Tie securely. -Anything coming out of room is labeled as INFECTIOUS. Emergency Care Provide assistance to resident who has fallen - Prevention! Meet basic needs: • Fluid & elimination needs • Eye glasses, hearing aids • Items w/in reach • Call lights -Safety: • Bathroom, shower, floors, hallways, furniture, equipment, beds, side rails, call lights, alarms, footwear, clothing, lighting If fall occurring: -Do NOT try to prevent. -Ease to floor while protecting head. - Do NOT do this for bariatric resident; instead protect head, move furniture When a FALL occurs: Do NOT move resident! -Call nurse. -Attend to any emergency w/in your role (e.g., pressure to bleeding). -Follow nurse's instructions. -Obtain VS. Apply direct pressure to control BLEEDING Wear gloves! Place clean material over site. Apply direct pressure. Follow licensed staff's instructions for providing assistance to resident In SHOCK: Lie down Elevate legs. Open airway. Control bleeding, if occurs. Start CPR if cardiac arrest. Who has ingested a HAZARDOUS SUBSTANCE: Report immediately. Keep harmful products out of sight/reach. Store personal care items according to agency policy. Never leave unattended. Read labels carefully. Leave original labels on. Take to nurse for disposal. With BURNS: Prevention: • Check temperatures - foods, liquids, water. • Proper use of equipment. • No smoking. When occurs: • Call for help. • Stop the burning process. • Apply cold or cool water. • Remove hot clothing if it is NOT sticking to skin. • Cover w/ clean, MOIST cloth. Perform first aid for choking resident Airway obstructed. NO breathing, NO talking, NO coughing. If a person is coughing, able to talk, or is breathing, they are NOT choking! • Encourage to continue coughing. • Reposition as indicated. Universal sign NOT always present! Initiate CPR on resident Establish unresponsiveness. Check breathing, pulse. Check DNR status. Call for nurse & request AED. Position supine on flat, hard surface. Begin CPR: 30 compressions: 2 breaths 100-120 compressions/min 2 inches in depth Follow RACE guidelines to protect residents from fire rescue alarm confine extinguish Follow safety, emergency, & disaster procedures Confirm resident identity. Proper use of equipment: Know how to use, do not used damaged, know weight capacity of lifts & beds, remove broken, report to nurse. Wheels locked. Store appropriately. Fall prevention techniques. Facility disaster policies. Resident cares Prioritize order of care for residents w/ various needs Vital part of your role. Based on your knowledge & ability to apply to cares of residents Provide care for residents receiving oxygen treatment Oxygen is a MEDICATION Doctor orders, nurse administers, CNA assists w/care. Guidelines Do not remove unless instructed. Make sure secure, not too tight. Observe for irritation. Wipe nasal cannula/mask to keep clean. Do not shut off or adjust flow. Report if flow rate not correct or oxygen tank near empty. Report if humidifier not bubbling, water empty. Make sure tubing has no kinks/not laying on/not pulling. Oral hygiene q2h. No smoking! Assist w/ catheters & drainage tubing care Tube inserted thru urethra to bladder. HIGH RISK for UTIs! Things to check: Drainage bag below level of bladder. Drainage bag on bed frame, not side rail. Drainage bag positioned on side lying on. Drainage bag not touching the floor. Color of urine. If urine is clear (no particles in it). Amount of urine. Tubing not kinked, not pulling, resident not laying on. Extra tubing COILED on bed. Tubings connected. System not leaking. Any abnormal secretions or drainage at the urethra. Assist w/ catheters & drainage tubing care (cont.) Responsibilities: -Report if disconnected, leaking, not draining, abnormal urine. -Empty at end of shift or when full. -Maintain accurate measurements of u/o. If ordered, change to leg bag using sterile technique. Any time in bed, change back to drainage bag. -Provide catheter care whenever perineal care provided. #1 way to prevent UTIs! Change colostomy/ileostomy bag. Surgically created openings between colon/ileum & abdomen. Empty pouch 1/3rd to 1/2 full. Change pouch per facility policy. Provide skin care. Report abnormalities: • Skin breakdown, signs of infection • Color, amount, consistency • Pain, discomfort • Bleeding Provide assistance to hysterical or disoriented resident Remain calm. Use soothing voice, do not argue. Provide explanations. Reorient. Use touch, if appropriate. Maintain safety for resident & self. Call for help if needed. Identify triggers for future: Was it your approach? Were they misinterpreting what you were trying to do? Apply protective device. Restraints: -Used as a last resort; require doctor's order; must be dc'dASAP. -Once thought to protect, now known to cause life-threatening injuries. - 1 finger/flat hand fits between. - Never to side rail. -Strap out of reach. -Quick-release tie. -Check q15 min. -Remove, reposition, skin care q2h. -Report at once: • Increased confusion, agitation • Dyspnea, pain, numbness, tingling • Skin changes: o Redness, paleness, cyanosis / Cool, cold temp / Irritation, breakdown, swelling Adjust bed & side rails. Considered a restraint if restricts movement. -If to remain elevated, doctor's order required & previous restraint guidelines must be followed. -Always elevated on unprotected side when providing care to resident & bed is elevated. -Many LTCFs no longer have side rails. In this case, 2 CNAs required when performing cares, one on each side of bed. Clean & disinfect unit 1. Wear protective equipment. 2. Work from "clean" to "dirty". 3. Rinse any matter w/ cold water. 4. Wash w/ soap & hot water, scrub. 5. Rinse, Dry. 6. Disinfect.