CNA study guide 2024

Long Term Care Centers answers - Designed for persons who cannot care for themselves: Medical, nursing, dietary, recreational, rehabilitative, and social services are provided Residents answers - Persons in long-term care centers; Center is their permanent or temporary home; Most residents are older and have chronic diseases, poor nurtrition, or poor health; Some residents are disabled from birth defects, accidents, or diseases; Alert, oriented residents answers - Resident knows who & where they are, the year, and time of day. They have physical problems. Disability level affects the amount of care required. Some require complete care, others need help with daily activities Confused & disoriented residents answers - Resident is mildly to severely confused & disoriented. Some simply have trouble remembering where the dining room is, the month, or year. Others are more confused & disoriented--they do not know who or where they are. Sometimes the problem is short term. For others it is permanent and becomes worse Complete care residents answers - Residents who are disabled, confused, and disoriented. They cannot meet their own needs or tell you what they need. They need to be kept clean, safe, and comfortable Short-term residents/Respite Care answers - Residents who need to recover from surgery, fractures, or illnesses and regain strength & mobility to return to their former living situations. Home care-giver is given a rest. Life-long Residents answers - Residents with birth defects & childhood injuries & diseases can cause disabilities such as mental retardation & Down syndrome. Person has limited function in at least 3 ares: self-care, understanding, or expressing language, learning, mobility, self-direction, independent living, & financial support. Person needs lifelong assistance, support and special services. Developmental Disability answers - A disability occurring before 22 years of age; May be a physical impairment, intellectual impairment, or both Mentally ill residents answers - Residents with problems coping or adjusting to stress affecting behavioral and function. Terminally ill residents answers - Residents who are going to die from terminal illness (cancer, AIDS, liver/heart/kidney/respiratory disease. Nursing Team answers - RN's, LPN's (LVN's), & Nursing Assistant's Nursing Process answers - 1) Assessment - Collects information. 2) Nursing Diagnosis - Describes health problems. 3) Planning - Setting priorities and goals. 4) Implementation - Carries out the plan (goals). 5) Evaluation - Measures if the goals of the planning step were met. Medicare answers - A federal health insurance program for persons 65 yrs of age or older Medicaid answers - A health care payment program sponsored by federal & state governments OBRA-Residents Rights answers - Right to all his or her information records; Right to refuse treatment; Right to privacy & confidentiality; Right to personal choice; Right to voice concerns, questions, & complaints about care; Right to not have to work for care, care items, or other things or privileges; Right to form & take part in resident & family groups; Right to keep and use personal items; Right to be free from all abuse, mistreatment, & neglect; Right to be free of restraint; Right to a quality of life that promotes dignity & self esteem; Promotes physical, psychological, and mental well-being for quality of life Quality of Life Activities answers - Nursing center provides activity programs that allow personal choice. They must promote physical, intellectual, social, spiritual, & emotional well being. Religious services promote spirtual health Quality of Life Environment answers - Nursing centers environment must promote quality of life by being clean, safe & as home-like as possible. OBRA Requirements for Dignity & Privacy answers - 1. Courteous & Dignified Interactions (right tone of voice, good eye contact, stand or sit close, use proper name & title, gain attention before interacting with resident, use touch IF person approves, respect social status, listen with interest, DO NOT yell, scold, or embarrass resident) 2. Courteous & Dignified Care (grooming, dressing, clothing is personal choice, promote independence & dignity in dining, respect private space & property, assist with walking, transfers, bathing & hygiene preferences) 3. Privacy & Self-Determination (avoid exposure & embarrassment, keep person properly draped at all times, use curtains & screens during all care & procedures, knock before entering, close bathroom door when person uses it) 4. Maintain Personal Choice & Independence (Person smokes in allowed areas, takes part in activities according to interests, involved in scheduling activities & care, gives input to care plan about preferences & independence, involved in room or roommate change) OBRA Requirements (all 50 states) answers - Nursing Assistant training and competency evaluation program must be completed to work in nursing centers and hospital long-term care units. OBRA Training Program answers - Requires at least 75 hours of instruction (16 hrs are supervised practical training); includes knowledge & skills needed to give basic nursing care; takes place in a laboratory or clinical setting OBRA Competency Evaluation answers - After training program you take a written test that has multiple-choice questions and a skills test that is performing certain skills learned in training program. OBRA allows at least 3 attempts to successfully complete the evaluation OBRA Nursing Assistant Registry answers - An official record or listing of persons who have successfully completed a competency evaluation; Each state must have a nursing assistant registry; all information stays in registry for at least 5 years OBRA other requirements & provisions answers - Retraining & new competency evaluation program are required for NA who have not worked for 2 consecutive years. It does not matter how long you worked, it is how long you did NOT work: Requires new competency evaluation OR Both retraining & new competency evaluation; Nursing agencies must provide 12 hrs of educational programs to NA's every year Delegation answers - RN's can delegate tasks to LPNs/LVNs, & NA's (Right Task, Right Circumstances, Right Person, Right Directions & Communication, Right Supervision) Refusing a Task answers - Have the right to refuse when: Task is beyond legal limits of your role, Is not in your job description, You were not prepared to perform the task, Task could harm the person, Person's condition has changed, You do not know how to use the supplies or equipment, directions are unethical, illegal, or against agency policy, directions are unclear or incomplete, nurse is not available for supervision Ethical Aspects answers - Knowing difference between right & wrong conduct; behaves and acts in the right way and does not harm anyone; not being prejudiced or biased Good Work Ethics answers - Caring, Dependable, Considerate, Cheerful, Empathetic, Trustworthy, Respectful, Courteous, Conscientious, Honest, Cooperative, Enthusiastic, Self-aware 5 Steps of Nursing Process answers - Assessment, Nursing diagnosis, Planning, Implementation, & Evalualtion Assessment answers - Involves collecting information about the person; Nursing history is taken from family's health history, info from doctor, test results, & past medical records Signs answers - Objective data that is seen, heard, felt, or smelled (you can feel a pulse, see urine) Symptoms answers - Subjective data is things a person tells you about that you cannot observe through your senses (you cannot see pain, fear, or nausea) Nursing Evaluation answers - Involves measuring if goals in planning step were met: progress is evaluated; changes in nursing diagnoses, goals & care plan may result; NA has keep role as NA's observations are used for this step Safety & Security Needs answers - Feeling safe from harm, danger, & fear; People feel safe and more secure if they know told what is or going to happen (Tell them - Why it is needed, who will do it, how it will be done, what sensations or feelings to expect) Dealing with Behavior Issues answers - Recognize frustrating & frightening situations; Treat person with dignity & respect; Answer questions clearly and thoroughly and have nurse answer questions you cannot answer; Keep person informed about what you are going to do and when; Do NOT keep person waiting, answer signal lights promptly; explain reason for long waits and ask if you can get or do something to increase person's comfort; Stay calm & professional if person is angry or hostile (usually angry at another person or situation); Listen & use silence as person may feel better if able to express feelings); Report person's behavior to the nurse and discuss how you should deal with the person Family & Visitors answers - Family & friends help meet safety, security, love, belonging, self-esteem, support, & comfort needs. Presence or absence of family or friends can affect recovery & quality of life; Person has the right to visit with family & friends in private and without unnecessary interruptions; If visitor upsets person, report observations to the nurse Accident Risk Factors answers - Age (decreased strength, move slowly & less steady); Awareness of surroundings (person in coma); Impaired vision (may not see toys, rugs, furniture or cords and may have problems reading labels on cleaners, drugs, and other containers); Impaired hearing (may not hear warning signals, fire alarms, approaching meals cards, drug carts, stretchers, or persons in wheelchair; Impaired smell & touch (senses may be dulled and they cannot detect smoke or gas odors, burns are a risk because of decreased pain sensation; Impaired mobility (cannot move quickly or safely away from danger; Drugs (side effects could include loss of balance, drowsiness, lack or coordination, reduced awareness, confusion, & disorientation) Preventing Burns answers - Smoking in bed, spilling hot liquids, electrical devices and and very hot bath water are common causes of burns. Do following for prevention: Person smokes only in smoking areas; NO smoking in bed; NO smoking near oxygen equipment: Supervise persons smoking who cannot protect themselves; DO NOT use heating pads or electric blankets; Turn cold water on first, then hot - - turn hot water off first, then cold; Measure bath water temperature (110-115 degrees F) and check it before person gets in; Check for "hot spots" in water moving hand back and forth; Follow measures to prevent equipment accidents Wheelchair Safety answers - Check wheel locks; Check for flat or loose tires; Check wheel spokes; Be sure casters point forward for balance and stability; Be sure person's feet are on footplates before pushing or repositioning (feet cannot touch or drag on floor); Push chair forward when transporting person, going backward ONLY through a doorway; Lock both wheels before you transfer person to or from the wheelchair; Follow care plan for keeping wheels locked when not mving wheelchair (locking would keep person from moving or getting out of chair is so desired); DO NOT let person stand on footplates; DO NOT let footplates fall back onto person's legs; Make sure person has needed safety belt, pouch, tray, lapboard or cushions; Remove armrests (if able) when transferring person to bed, toilet, commode, tub, or car; Swing front rigging out of way to transfer to & from wheelchair (some detach); Clean wheelchair according to agency policy; Ask nurse or PT to show you how to propel wheelchair up steps, ramps, and over curbs; Follow measure to prevent equipment accidents Stretcher Safety answers - Ask 2 co-workers to help with transfer; Lock stretcher wheels before transfer; Fasten safety straps when person is properly positioned on stretcher; Ask co-worker to help with transport; Raise side rails and keep up during transport; Be sure person's arms, hands, legs, and feet stay on stretcher; Stand at head of stretcher and co-worker stands at foot; Move stretcher FEET FIRST; DO NOT leave person alone; Follow measure to prevent equipment accidents Restorative Nursing/Rehabilitation answers - Involves promoting: Self-care, Elimination, Positioning, Mobility, Communication, Cognitive function; Focus's on the whole person Whole Person answers - Has physical, social, psychological, and spiritual parts Self-Help Devices answers - Often needed when the hands, wrists, & arms are affected. Equipment is changed, made, or bought to meet person's needs; Includes - Eating devices, Electric toothbrushes, Longer handles attached to combs, brushes, & sponges; Self-help devices for cooking, dressing, writing, phone calls Rehab & Restorative Focus on PERSON answers - 1. Provide Comfort - Practice good communication skills - just be there to listen, often you do not need to say anything 2. Ethical behavior: Personal choice is important but do not let person control you; Letting person control you is wrong and problems must be reported to nurse. 3. Remaining Independent: Focus on what the person CAN do: Independence to the greatest extent possible is goal of rehab & restorative care. 4. Speaking Up: Use the nurse or therapist words, guides and directions as this helps the person learn & remember what to do. 5. OBRA and other laws: Requires centers to provide services required by person's comprehensive care plan. 6. Nursing Teamwork: Rehab process can frustrate person, you, and other nursing team members. Help each other with care and emotional support Restraint Use answers - Restraints are used ONLY as a LAST RESORT to protect persons from harming themselves or others: DO NOT use for discipline or convenience Restraint Risks answers - Agitation, Anger, Cuts & Bruises, Constipation, Dehydration, Depression,