Chapters 1& 2 Flashcards
(374 cards)
1
Q
Infection prevention
A
The way you prevent diseases from spreading
2
Q
Infection preventionist
A
Required Professional that oversees infection prevention programs.
3
Q
Who is responsible for preventing infections
A
All employees, including NAs
4
Q
Microorganism
A
Microbe. Small living thing you can only see with microscope
5
Q
Infections
A
Bad microorganisms (pathogens) invade body and multiply
6
Q
Localized infection
A
Infection in one part of body
7
Q
Systemic infection
A
Infection that affects entire body. Travels through blood.
8
Q
What can a systemic infection cause?
A
Fever, chills, mental confusion, low BP
9
Q
Healthcare-associated infection (HAI)
A
Infection acquired in a healthcare setting within 36 hours while patient was under care. Insurance doesn’t have to pay for it.
10
Q
Describe the chain of infection
A
- Causative agent
- Reservoir
- Portal of exit
- Mode of transmission
- Portal of entry
- Susceptible host
11
Q
Causative agent
A
Pathogen or microbe that causes disease
12
Q
Reservoir
A
Where pathogen lives & multiplies
13
Q
Portal of exit
A
Body opening that let’s pathogen leave. Nose, mouth, eyes or cuts
14
Q
Mode of transmission
A
How pathogen travels, contact, droplet and airborne
15
Q
Direct contact
A
Touching infected person and their secretions
16
Q
Indirect contact
A
Touching something that was contaminated by infected person. Needle, dressing or tissue.
17
Q
Primary route of disease transmission in healthcare settings
A
Hands of healthcare workers
18
Q
Portal of entry
A
Body opening that lets pathogens in. Nose, mouth, eyes, mucous membranes, cuts and cracked skin.
19
Q
Mucous membranes
A
Membranes that line cavities. Linings of mouth, nose, eyes, rectum and genitals
20
Q
Susceptible host
A
Uninfected person who could get sick.
21
Q
Immunizations
A
Reduce a person’s chances of getting sick from things like hep b and influenza
22
Q
Transmission
A
Passage of infectious diseases
23
Q
Most important way to stop infection
A
Hand washing
24
Q
Medical asepsis
A
Measures used to prevent the spread of pathogens
25
Surgical asepsis
Sterile technique
Makes an area free of all microorganisms. Used in many procedures, like changing catheters.
26
CDC centers for disease control and preventions
Issues guidelines to protect and improve health of individuals and communities.
Control disease, injury and disability, promote public health.
27
Standard precautions and transmission based precautions
Levels of infection prevention system
28
Standard precautions
Treat blood, body fluids, non intact skin as if they're infected. Blood, saliva, sputum, urine, feces, semen, vaginal secretions, pus, wound drainage and vomit. Not sweat. Abrasions: pimples, open sores)
29
When must standard precautions be used?
With every resident
30
Sputum
Phlegm coughed up
31
Can you tell when residents have infectious diseases?
No. NA can't tell by looking at residents or reading charts.
32
Common infectious diseases
Tuberculosis, hepatitis, influenza
33
True or false: diseases can spread before infected person has been diagnosed or shows signs
True
34
These two affect the mode of transmission
Standard precautions and transmission based precautions. They don't stop the infected person from giving off pathogens
35
How do transmission based precautions vary?
Vary based on how an infection is transmitted.
36
Guidelines for standard precautions
1. *Wash hands* before & after putting on gloves
2. *Wear gloves* when you may touch something infectious.
3. Remove gloves immediately after and wash hands
4. Wash all contaminated skin surfaces
5. Wear a disposable gown
6. Wear a mask, goggles and face shield
7. Careful with sharps. Don't re Open and dig in biohazard containers
8. Never recap needles
9. Bag all contaminated supplies. Put bag over them if needed.
10. Clearly label body fluids that are being saved for a specimen
11. Dispose of contaminated waste according to policy.
37
Should you wear gloves out of room?
No! Always use new gloves
38
When are gloves particularly important
Mouth care
Toilet and Peri care
Helping with bedpan
Ostomy care
Cleaning spills, basins, urinals, bedpans
Handling containers with body fluids. Disposing of waste
39
T/F: you should wear a gown even if a resident has a contagious illness, even if you're unlikely to come into contact with bodily fluids
True
40
Should you put fluids in biohazard containers?
No.
41
Hand hygiene
Washing hands with soap and water or using an alcohol based rub.
Wash after using sanitizer 3-5 times
42
When should NAs wash their hands?
-arriving to work
- when hands are visibly soiled
- before, between and after all contact with residents
- before putting gloves on and after removing gloves
- after contact with all bodily fluids, mucous membranes, non intact skin or wound dressings.
handling contaminated items
Handling anything in resident's room
Before and after touching meal trays
Before and after helping with meals
Before getting clean linen
Before and after using toilet
After touching garbage
After picking up anything from floor
After blowing, sneezing or coughing into hands
Before and after eating
After smoking
After touching areas of the body
Before and after applying makeup
After any contact with pets
Before leaving facility
43
PPE
Helps protect workers from injuries and illnesses
Gowns, goggles, face shields and face masks
44
Don
Putting on
45
Doff
Taking off
46
How many times can you wear a gown
Once
47
When should you change a soiled mask
Immediately
48
Change masks between moving between residents?
True
49
Eyeglasses provide proper eye protection
False
50
Order for donning ppe
1. Wash hands
2. Put on gown
3. Put on mask
4. Put on goggles or face shield
5. Put on gloves
51
Order for doffing ppe
1. Remove and discard gloves
2. Remove goggles and face shield
3. Remove and discard the gown.
4. Remove and discard mask
4. Wash your hands..always final step after removing and discarding ppe
52
Clean object
Has not been contaminated with pathogens
53
Dirty
Has been contaminated with pathogens
54
How should you handle equipment, linens and clothing
1. Prevent skin/mucous contact
2. Contamination of your clothes
3. Transfer of disease to other residents or areas
4. Don't use reusable equipment until it has been properly sterilized.
5. Dispose properly of single use equipment
6. Clean and disinfect
7. Handle soiled items preventing skin and mucous membrane exposure, transfer of disease to other residents, or contamination of your clothing. Do not shake linens or clothes.
8. Bag soiled linens at point of origin
9. Sort soiled linens away from resident care areas.
10. Place wet linens in leak proof bags.
55
Sterilization
Destroying all microorganisms including those that form spores
56
Disinfection
Destroys most, but not all pathogens. Reduces pathogen count to non infectious levels
57
T/F: you should disinfect commonly touched surfaces
True
58
How to clean spills
1. Don gloves, preferably heavy duty
2. Absorb spill with absorbing product.
3. Scoop up absorbed spill and throw out in designated container.
4. Apply disinfectant to spill area and let it stand wet for 10 mins minimum. (Follow label)
5. Clean spills with proper cleaning solution
6. Don't pick up broken glass with hands. Use dustpan, broom or other tools.
7. Place waste containing body fluids, broken glass in biohazard bag. Follow policy.
59
Transmission based precautions
Precautions used for infected people or those who may be infected.
Airborne, droplet and contact
60
Airborne precautions
Transmitted through air. Pathogen can stay floating in the air.
(Tuberculosis)
1. Wear special masks or respirators.
2. Keep door closed
3. Wash hands before and after leaving. Dietary can't enter.
61
Droplet precautions
Droplets in air. Usually don't travel more than 6 ft. Coughing, laughing singing, talking or suctioning can cause droplets.
(FLU)
1. Wear a mask
2. Restrict visits from uninfected people.
3. Cover noses and mouth when sneezing. Wash hands if they're soiled.
4. Residents should wear masks from room to room
4. Don't save tissues.
62
Contact precautions
C Diff and pink eye. Touching resident or contaminated object
1. Hand hygiene before and after entering
2. Wear gloves and gown.
3. Use single use equipment and disinfect what's not single use.
63
Isolation guidelines
1. Wear and remove PPE properly
2. Remove ppe and put it in proper container before leaving resident's room.
3. PPE can't be worn outside room except for respirator. Removed after leaving the room and closing door.
4. Wash hands after taking PPE off and after closing door once left.
5. Don't share equipment between residents
6. Wear proper PPE when feeding residents. Remove meal tray and take to proper area when done
7. Follow standard precautions when dealing with body waste.
8. Wear PPE when taking specimens.
9. Listen to what residents are saying.
6.
64
Bloodborne pathogens
Pathogens found in human blood and bodily fluids
65
Most common way to be infected with Bloodborne disease
Contact with blood or body fluids
66
Majors Bloodborne diseases in US
AIDS HEPATITIS
67
Hepatitis
Inflammation of the liver caused by certain viruses and other things such as: alcohol abuse, medication, trauma. Damages liver function
Can cause other chronic illnesses.
Hep A, B &C. Can cause death.
68
Hep B
Spread through:
-Sex
-Infected needles
-Mother to baby during delivery
-blood splashes
69
Should you take the vaccine for hep B if you're contaminated on the job?
Yes. And make sure to follow through with the 3 parts
70
Is there a vaccine for hep c?
No. It can cause cirrhosis, liver cancer and death. Be very very careful with fluids
71
Tuberculosis TB
Highly contagious.
Bacteria carried by mucous. Airborne disease.
72
Symptoms of tuberculosis
Coughing
Trouble breathing
Weight loss
Fatigue
Chest pain
Coughing up blood
Loss of appetite
Slight fever
Chills
Night sweats
73
Why is it important that doors remain closed with airborne pathogens
Rooms are under different pressure to help control spread.
Do not open or close quickly.
Help resident remember to take TB medication prescribed.
74
COVID 19
Droplet and airborne disease
Inhalation can occur at distances Greater than 6 ft. Enclosed spaces with poor ventilation increase the risk of infection
75
Signs and symptoms of COVID 19
Fever
Cough
Chills
Fatigue
Shortness of breath
Muscle aches
Sore throat
Loss of taste or smell
Nausea
Vomiting,
diarrhea
Headache
Can be infected from 2-14 days by can be infected longer and not show symptoms
76
COVID 19 precautions
1. Monitor residents daily
2. Wear PPE
3. Residents will quarantine in room. Keep doors closed. Don't open or close doors quickly
4. Use disposable supplies
5. Don't share personal items
6. Wash hands often
7. Residents should wear face masks.
8. Clean frequently touched surfaces
9. Encourage residents to drink lots of fluids.
10. Don't touch eyes, nose or mouth
11. Don't go to work if you have a fever or feel sick.
12.Report more serious symptoms
77
More serious symptoms of COVID 19
1. Difficulty breathing
2. Persistent pain or pressure in chest
3. Confusion
4. Difficulty waking or remaining alert
5. Prolonged elevated temperature
6. Bluish, gray or unusually light lips or face.
78
Staphylococcus aureus
Common bacteria that causes infection.
79
MRSA or HA-MRSA
Strain of staph that's resistant to methicillin
80
CA-MRSA
Community associated MRSA
MRSA infection that happens in people that haven't been admitted to a facility and haven't had MRSA before.
Shows up as skin boils and pimples. Increasingly more common.
81
How is MRSA spread?
Skin to skin contact
Or indirect contact
82
Signs and symptoms of MRSA
Drainage
Fever
Chills
Redness
83
Best way to prevent against MRSA
Hand washing using soap and water
84
VRE
Vancomycin resistant enterococci
Spread through direct and indirect contact. Live in digestive and genital tracts. Can sometimes cause infections.
85
Symptoms of VRE
Fever
Fatigue
Chills
Drainage
86
When is VRE life threatening?
1.Weak immune systems
2. Very young/old
3. Very I'll
87
How is VRE spread?
Direct and indirect contact
88
C diff /CDI
Spore forming bacteria
Formed when normal GI flora is altered.
Produces toxin that causes watery diarrhea.
Transferred through direct and indirect contact
Can cause colitis
89
What increases the chances of cdiff
1.Enema
2. Nano gastric tube insertion
3. GI tract surgery
4. Elderly
5. Overuse of antibiotics
90
Will alcohol sanitizer kill cdiff?
No. Use soap and water each time. Bleach can help too
91
Symptoms of Cdiff
1. Foul, watery stools
2. Diarrhea that contains blood and mucus,
3. Nausea
4. Lack of appetite
5. Abdominal cramps
6.
92
Employer responsibilities for preventing infection
1. Establish infection prevention procedures and exposure plan
2. In service infection prevention education. Including airborne and Bloodborne pathogens. Be up to date with new safety standards
3. Have written procedures to follow, including medical treatment and plans to prevent similar exposures.
4. Provide PPE and teach employees how to use it.
5. Provide free heb p vaccines for all employees
93
Employee responsibilities for infection prevention
1. Follow standard precautions.
2. Follow facility policies and procedures
3. Follow care plans and assignments
4. Use PPE as indicated or as appropriate
5. Take free hep b vaccine
6. Report exposures to infection, blood or body fluids immediately
7. Participate in annual education programs
94
Long term care (LTC)
People who need 24 hr skilled care. Given in long term care facilities
95
Skilled care
Medically necessary care given by skilled nurse or therapist.
Ordered by doctor.
Involves treatment plan
96
Synonyms for nursing homes
Long term care facilities
Skilled nursing facilities
Rehabilitation centers
Extended care facilities
97
Length of stay
Days a person stays in a facility
98
Terminal illness
Illness eventually causes death
99
Chronic
Condition lasts a long time
100
Diagnoses
Medical conditions determined by doctor
101
Home health care
Care in someone's home.
Older and chronically Ill.
Can also be when a person is weak after a hospital stay.
102
Assisted living
Residences. Need some help with daily tasks and medications. Don't need 24 hr skilled care. Independent living homelike environment
103
Adult day services
Need help during certain hours, but don't live where care is provided.
Not seriously I'll or disabled.
104
Acute care
(er) 24 hr skilled care given in hospital or ambulatory center. People require short term immediate care.
Short stays for surgery.
105
Subacute care
Hospitals or long term facilities. Less cost & care than acute but more care than long term illness.
Ends when condition has stabilized or after time for treatment has been completed.
106
Outpatient care
Short term, skilled care. Don't require hospital or other care facility. People who had treatments, procedures or surgeries.
107
Rehabilitation
Improve function after illness or injury
108
Hospice
People who are terminally Ill and won't get better. Usually have 6 months to live. Give physical and emotional care. Support families during process.
109
Describe long term care facilities
Businesses
Care 24 hrs a day.
Can have specialized care
Helps with ADLs
-physical, occupational and speech therapy
-wound care
-tube care (like catheters)
-nutrition therapy
-management of chronic diseases
110
T/f special units require specialized workers
True
111
Who can own long term care facilities
Non profit or for profit facilities
112
Person centered care
Care revolves around resident, their preferences, choices, dignity and interests.
113
Trauma Informed care
Considering patient's trauma when providing care.
114
What is Medicare? Who does it cover?
Federal health insurance program
65+ and permanent kidney failure or certain disabilities
115
What does Medicare cover?
Only what is medically necessary.
80% of costs. Not free, we pay for it
116
Medicare part A
Inpatient care,
Hospitals, home health, nursing facilities
117
Medicare Part B
Doctor's visits, medical services and equipment
118
Medicare Part C
Private insurance Provide Medicare benefits
119
Medicare part D
Medications
120
What is Medicaid and who qualifies for it?
Free (uses other's money)
Medical assistance program for people with low income and people with disabilities. Funded by government and state
1. Low income and special circumstances
121
How much do Medicare and Medicaid pay?
Fixed amount based upon needs of person and stay
122
What do nursing assistants do?
Assigned nursing tasks like temp or vital signs and helping with ADLs
Bathing, assisting with meals, elimination, etc.
123
What can't CNAs do?
1. No sterile dressings
2. No inserting or removing Catheters
3. No giving medications?
124
Charting
Documenting and reporting changes in resident's condition.
125
Who is part of care team?
Family
Residents
NAs
Medical staff
126
NA
Does minor nursing tasks and gives personal care.
Must have at least 75 hrs of training and be evaluated
127
RN
Coordinates, manages and provides skilled nursing care. Gives special treatment and medication prescribed by doctor. Assigns tasks and supervised daily care.
128
LPN/LVN
Gives medications and treatment. Completed one to 2 years of education . Passed exam
129
APRN
Nurse with advanced degree like nurse practitioner
130
Physician or Doctor (MD or DO)
Diagnoses disease or disability. Prescribes treatment and medication bachelor's+ med school
131
Physician assistant
Diagnoses disease, disability, develops treatment plan, gives medication under MD supervision
132
PT
Helps recover mobility has doctorate degree
133
Occupational therapist
Helps residents adapt to disabilities and trains residents to do ADLs
134
Speech language pathologist
Communication disorders and problems swallowing. Helps them overcome speech issues.
135
Registered Dietitian or Nutritionist
Assesses resident's nutritional status. Develops treatment plan to improve health and manage illness
136
Medical Social Worker
Helps determine resident's needs and helps them find support services. Counseling or financial assistance. Clothing or personal items. Book appointments and transportation.
137
Activities director
Plans activities for residents to help them socialize and stay active
138
Resident and residents family
Resident should make their own choices and do as much as they can for themselves. Family has information about resident.
139
Who gives na instructions?
OT, PT or nurse
140
Liability
Held responsible for harming someone else.
141
Chain of command
Line of authority. Ensures proper resident care. Protects employer and employees
142
Describe chain of command
CNA>staff nurse>charge nurse>nursing supervisor>MDS coordinator>
143
Scope of practice
What you're legally allowed to do professionally
144
Care plan
Individualized plan for taking care of patient. Updated daily. Tells you how to take care of residents
145
Who's involved in making the care plan?
Family , resident, NAs, nurse
146
Policy
Course of action to take.
What to do in case of X
147
Procedure
Steps for appropriately carrying out policy
148
Common policies
1. Resident info is confidential
2. Care plan must always be followed
3. NAs shouldn't do things outside of their job description
4. Report events and changes to nurse.
5. Don't discuss personal problems with residents
6. NAs can't accept money or gifts
7. NAs must be on time and dependable
149
When in doubt about a task.....
Have it approved by the nurse
150
Compassionate
Caring concerned empathetic
151
Empathy
Identifying with feelings of others
152
Sympathy
Sharing in the feelings and difficulties of others
153
Tactful
Showing sensitivity, knowing when things are appropriate
154
Conscientious
Try to do your best. Having sense of right and wrong
155
Ethics
Knowledge of right and wrong
156
Laws
Rules set by government
157
OBRA
Omnibus Budget Reconciliation act
1987
Try to improve poor care and prevent abuse
158
_ minimum hours of in service education required to keep your license
12
159
What does OBRA require in regards to resident assessments?
Complete assessments must be done on every resident. Assessment forms are the same in every facility
160
What are OBRA surveys?
Periodic inspections to see of guidelines are being followed
161
Cite
Document problem through survey
162
T/F results from surveys are available to public and posted in facility?
True
163
What are Residents' rights?
Rights of residents. Code of conduct for employees. Residents are given a list of these rights and are made aware of them.
164
List the residents' rights
1. Quality of life
2. Services and activities to maintain wellness
3. Right to be fully informed about rights and services
4. Right to participate in their own care
5. Right to make independent choices
6. Right to privacy and confidentiality
7. Right to dignity, respect and freedom
8. Right to security of possessions.
9. Rights during transfers and discharges. (Right to stay unless transfer or discharge is needed)
10. Right to complain
11. Right to visits
12. Rights with regards to social services: counseling, legal and financial professionals
165
Informed consent
Making decisions about healthcare with the help of a doctor. Their body their choice.
166
What should you do if a resident asks you to call them by a nickname?
Document it.
167
Abuse
Purposeful mistreatment that causes physical, mental, emotional pain, injury
168
Physical abuse
Treatment that causes harm to a person's body.
169
Psychological abuse
Emotional harm caused by threatening, scaring or treating as a child
170
Verbal abuse
Speaking, written words, pictures used to hurt or embarrass.
171
Sexual abuse
Nonconsensual sexual contact of any type.
172
Financial abuse
Improper, illegal use of person's boundaries or possessions.
173
Assault
Threat to harm an person
174
Battery
Intentionally touching someone without consent
175
Domestic violence
Abuse by intimate partners or family
176
False imprisonment
Unlawful restraint of mobility. Threat of being restrained counts too. Not allowing resident to leave facility
177
Involuntary seclusion
Separation from others against will. NA confining resident to their room.
178
Workplace violence
Abuse from other staff
179
Sexual Harassment
Unwelcome sexual advance or behavior that creates offensive working environment
180
Substance abuse
Uses illegal drugs or legal drugs incorrectly
181
Neglect
Failure to provide needed care that results in physical, mental or emotional harm
182
Negligence
Actions. Failure to act and provide proper care. Aka forgetting to lock a wheelchair before transferring
183
Malpractice
Someone is injured due to professional misconduct, negligence, carelessness or lack of skill
184
Signs of abuse
1.Poisoning
2. Traumatic injuries
3. Teeth marks
4. Bruises scars
5. Burns, missing hair
6. Yelling obscenities
7. Fear of being alone
8. Constant pain
9. Threatening to hurt others
10. Withdrawal
11. Private convos not allowed
185
Signs of neglect
1. Body lice
2. Unclean body
3. Unanswered call lights
4. Briefs not being changed
5. No glasses or hearing aids
6. Poorly fitting clothing
7. Uneaten food
8. Dehydration
9. Not receiving medication
186
What should you do if resident wants to make a complaint of neglect
Help them every step. Tell them how and their rights.
187
Ombudsman
Legal advocate for residents. Visits facility and works with agency to solve complaints
188
Which act requires all states to have an ombudsman program
Older Americans Act
189
HIPAA
Health insurance portability and accountability act.
Patient health information must be kept private
190
Protected health information
Information that can be used to identify a person and relates to the patient's condition,
Any healthcare they've had
And payment for healthcare
Name address
SSN, email, medical record number
191
What do you say when someone asks you how a patient is doing
"I'm sorry, but I cannot share that information."
192
Guidelines for protecting privacy
1. Speak in private area
2. Know who you're speaking to on the phone. If you aren't sure get name and number
3. Be careful when greeting family and residents in public
4. Don't bring family and friends to meet residents
5. Make sure no one can see phi
6. Don't give confidential info in emails.
7. Don't share resident info, photos or videos on social media
8. Make sure fax numbers are correct
9. Don't leave documents where others can see them
10. Destroy documents according to policy
193
Medical chart
Legal document, cannot be altered. If it's not in chart it didn't happen.
194
Why is careful charting important
1. Guarantees clear complete communication
2. Can be used as legal evidence
3. Helps protect against liability
4. Up to date record of each resident
195
Main rule of documenting
Don't record care before it is done! Ever !
196
Guidelines for careful documentation
1. Document care immediately after
2. Be brief and clear
3. Facts
4. Don't share login info
5. Don't let anyone enter info for you
6. Make sure You're logged into the right resident. Log out and close resident info when done.
7. Check before exiting a resident's chart.
8. Don't browse personal accounts at work
9. Use black ink when documenting by hand. Try to write neatly
197
In what kind of ink should you document by hand?
Black ink
198
What should you do if you make a mistake while documenting by hand?
Draw one line through it. Write the correct information. Put your initials and the date. Don't erase or use correction fluid
199
What should you do if you make a mistake documenting on computer
Make another entry. It is timestamped.
200
How should you sign charts?
Full name, and title
Write correct date
201
What should you follow when documenting?
The care plan
202
What is the minimum data set
Resident assessment system. Form with guidelines for assessing residents. Completed for each resident within 14 days of admission and every year.
203
How often does the MDS have to be reviewed?
Every 3 months or when there is a major change in resident's condition.
204
What does MDS mean?
Minimum Data Set
205
Incident
Accident, problem or unexpected event during care.
Must be documented
206
Are incident reports confidential?
Yes
207
Common incidents
1.Resident Falls
2.Broken things by na or resident
3.NA mistake
4.Requests outside of NAs scope of practice
5. Resident or family makes sexual remarks
6. Anything that makes NA feel unsafe
7. NA gets injured on job
8. NA is exposed to blood or bodily fluids
208
How should you document something you didn't see?
State only what you know.
"Mr. Grant says he fell".
"Found Mr. Grant on the floor."
209
Should you place blame or liability in incident report?
No
210
Guidelines for incident reporting
1. Tell what happened stating only the facts
2. State time, mental and physical condition of person
3. Describe person's reaction to the incident
4. State facts, don't give opinions
5. Do not document on medical record that incident report was completed.
6. Describe action taken to give care.
211
Should you document on the medical record that an incident report was completed?
No, do not document on the medical record that an incident report was completed
212
Communication
Exchanging info, giving and receiving messages
213
Verbal communication
Spoken or written words. Oral reports
214
Nonverbal communication
Not using words. Body language
215
How should you treat a resident that speaks a different language
Always have an interpreter present when speaking to them or speaking with staff in front of them
216
What should be reported immediately?
Falls
Chest pain
Severe headaches
Trouble breathing
Abnormal pulse, respiratory rates
Change in mental status
Sudden weakness
Fever
Change or Loss of consciousness
Bleeding
Swelling of body parts
Change in condition
Signs of abuse
217
What kind of questions should NA ask?
Open ended
218
How should NA communicate with residents
1. Address them by their preferred name
2. Identify myself
3. Focus on topic
4. Face resident while speaking and talk directly to them
5. Listen and respond to them
6.use positive language and smile often
7. Encourage residents to interact with you and staff
8. Tell resident when you leave room.
219
Objective information
What you saw through senses
220
Subjective information
What resident tells you
221
Signs
What is observed
222
Symptoms
What is reported
223
How can you use your sense of smell
Body and breath odors
Foul smells coming from room
224
Sight
Changes in resident's appearance
225
How can you use Hearing
Residents words, tone and breathing
226
Touch
Resident's skin and pulse
227
Incontinence
Inability to control bowels or bladder
228
Why do you need notes for oral reports?
So info is not forgotten when reporting
229
What do you have to document after giving oral reports?
When
Why
About What
To whom was the report given
230
What can I do to make sure I understand oral reports?
Repeat them back in my own words and ask questions
231
Prefix
Word part that comes before word
232
Root
Main word part
233
Suffix
Word part added to the end of root
234
How should you communicate on phone
1. Identify yourself, position and facility
2. Ask to place caller on hold if you need to find person.
3. Write down messages and ask for proper spellings
4. Get name, #, patients name, repeat it back
5. Don't give info about staff or residents
6. Thank person for calling
235
What do you do if someone is calling to give doctor's order for resident?
Find the nurse, or take a message for the nurse
236
Where should call lights always be?
Within reach of a resident's stronger hand
237
Why shouldn't NAs give medical advice
Not within scope of practice. It could be dangerous
238
Why shouldn't you ask why questions?
It makes residents defensive
239
Why shouldn't you use Clichés?
Meaningless phrases that could make resident feel ignored
240
Why should you watch your nonverbal communication
It can change the message you send out
241
Defense mechanism
Unconscious behavior used to relieve tension or cope with stress
242
Denial
Completely rejecting thoughts or feelings
243
Projection
Seeing things in others that are one's own
244
Displacement
Transferring feelings to another situation. Unhappy husband at work later yells at his wife
245
Repression
Blocking painful thoughts to memories
246
Culture
System of learned beliefs and behaviors that's practiced by group of people
247
Impairment
Loss of function or ability. Can be partial or complete loss.
248
How should you approach a patient that's hard or hearing
Get their attention first
249
How should you clean hearing aids
Follow manufacturer:s instructions. Wipe with proper cleaning solution and cloth. Always store in case . Turn it off when not in use. Take them out before showering or washing hair.
250
Should you put light on resident's face?
No, put it on your own
251
Why shouldn't you chew gum when speaking to a resident?
They may be hard or hearing and read lips.
252
Why shouldn't you pretend to understand a resident?
This leads to miscommunication
253
When should you wash glasses?
As needed! In the morning and at night and whenever they get dirty
254
Why should you report any issues with glasses to the nurse?
Residents have a right to their well-being
255
Why should you preferably leave contact lens care to resident
Care for contact lenses varies.
256
Why should you not touch a resident that's visually impaired before identifying yourself
You could startle them
257
What should you do when entering a new room with a visually impaired resident?
Let them know where things are. You can use the clock. Give specific instructions
258
Why should you never leave doors partially open for visually impaired residents?
They could hurt themselves or not get the privacy they desire
259
When should you give assistance cutting food?
When residents are visually impaired. Open all containers
260
How can you help visually impaired residents keep track of time
Use clocks that chime or radio
261
What should you not do to a guide dog
Feed it
Play with it
Or distract it
262
Mental health
Normal function of emotional and intellectual abilities
263
Things a mentally healthy person can do
1.Get along with others
2. Adapt to change
3. Care for himself and others
4. Give and accept love
5. Deal with situations that cause anxiety, disappointment and frustration
6. Take responsibility for their actions
7. Control and fulfill desires and impulses appropriately
264
Mental health disorder
Disorder that affects mental health
265
Signs and symptoms of mental health disorders
Confusion
Disorientation
Agitation
Anxiety
266
How should you treat residents with mental health disorders
1. Don't speak to them like children
2. Show respect.
3. Be simple, honest and clear in communication.
4. Avoid arguments
5. Sit or stand at normal distance
267
Combative behavior
Violent, hostile behavior.
Hitting, pushing verbal attacks.
Must always be reported even if NA doesn't find it upsetting.
268
How do you deal with combative behavior?
1.Block physical blows or step out of way but never hit back! Or threaten!
2. Let resident calm down. Give space. Stay arm's length away, closer to hallway.
3. Lower tone of voice
4. Be flexible and patient
5. Stay neutral don't respond to verbal attacks. Don't accuse resident of wrongdoing
6. Don't make residents that frighten or startle resident.
7. Keep hands open and in front of you.
8. Consider what provoked resident.
9. Report inappropriate behavior to nurse
10. Listen to what angered resident
269
How should you deal with inappropriate behavior?
1. Try to distract resident
2. Try to take them to a private area.
3. Notify nurse. Report behavior even if you think its harmless
270
How can you deal with inappropriate behavior from residents
Say " that makes me uncomfortable"
"I can't talk about my personal life on the job."
271
Who is responsible for safety in a facility?
Everyone. NAs must report any hazards they see
272
How should furniture be before leaving?
In same place it was! Bed in lowest position!
Walkways to bathroom and around room should be clear
273
Body mechanics
Way body parts work together when moving
274
Alignment
Good posture. Both sides mirror each other
275
Posture
Way person holds and positions their body. Must be maintained when lifting or carrying objects.
276
How can someone keep proper body alignment when lifting or carrying objects
Keeping item close to their body. Feet should face in the direction he is moving
277
What should you do instead of twisting at the waist?
Turn entire body or pivot feet
278
Base of support
Foundation that supports an object.. feet.
Keep them shoulder width apart
279
Center of gravity
Point in body where most weight is concentrated. Pelvis. Bend knees and lower pelvis
280
What should you do before lifting anything?
Clear obstacles
281
Should you lift with one or both arms?
Both
282
How should you raise heavy objects
Lower your pelvis, bend your knees. Hold it close and lift together
283
Whenever possible you should ___ or ____ objects instead of lifting
Push or slide
284
How should you adjust a bed to make it?
Waist high. Avoid bending at waist
285
Why should you coordinate with residents before moving them?
So they can help.
Count 1-2-3 and move on 3
286
How should you help someone stand?
Put one foot in front of other and bend knees. Stand with feet shoulder width apart.
287
Why shouldn't you try to catch a falling resident?
You could injure yourself or the resident. Instead, you can guide them down
288
What should you do when there's a task you can't do safely?
Report it to the nurse
289
___ make up most of the accidents in care facilities
Falls
290
Fracture
Broken bone
291
These increase the risk of falls
Throw rugs
Exposed cords
Slippery or wet floors
Uneven floors or stairs
Poor lighting
Call lights that are out of reach or not answered
292
Disorientation
Confusion about person, place or time
293
How do you prevent falls during wheelchair transfers?
Lock wheels and move leg rests out of way.
294
How do you prevent falls during bed transfers?
Lock bed wheels before helping resident in and out of bed. Return beds to lowest position after giving care.
295
Scalds
Burns cause by hot liquids
296
Where should you place hot drinks?
Away from edges
297
Why should you offer help with elimination often?
So residents don't try to go alone and fall
298
Why should you know which residents are at greater risk of falling?
So you can pay special attention to them and try to keep them from falling.
299
How long does it take for serious burns to occur at a temp if 140 ºF ?
5 seconds or less
300
At what temperature at hot drinks served?
160-180ºF
Can cause instant burns
301
Why should you pour hot drinks away from residents and put lids on them
So residents don't get burned
302
Before giving any care you should
Identify the resident
Identify yourself
wash hands
303
The _____ ______ should always be compared with Id before feeding a resident
Diet card should always be compared with identification before feeding a resident
304
The room number ____ be used to identify a resident
Cannot
305
Who can choke on their own saliva
The weak, Ill or unconscious
306
In what position should resident's eat?
Upright
307
Patients with ____ may hide food in their rooms
Dementia. Always check for odors
308
Abrasion
Injury. Rubs off surface of skin
309
After using sharp objects like clippers, you should,
Put them away
310
Wheelchairs should not
Be pulled from behind
311
Before entering elevators, wheelchairs should be pushed to face
Forward. Front of elevator
312
How do you prevent smoking fires?
Empty ashtrays often
Look for hot ashes
Make sure smoking aprons are properly fastened
Never leave smokers unattended
313
When charging e cigs you should
Only use the correct charger
Know if batteries must be removed manually and turned off after charging
Report damaged cords
314
When fire alarms and exits are blocked, you should
Report to the nurse
315
PASS
How to use fire extinguisher
1. Pull pin
2. Aim at base of fire
3. Squeeze handle
4. Sweep back and forth base of fire
316
RACE
1.Remove anyone in danger
2. Activate alarm or call 911
3. Contain fire if possible by closing all doors and windows
4. Extinguish fire or fire dpt will extinguish it. Evacuate area if instructed to do so
317
How do you safely help residents exit the building safely
1. Know which residents need extra help..blind, deaf, disoriented, wheelchair
2. Remove things blocking exits
3. Don't get in elevator unless told to by fire dpt
4. Feel doors for heat and plug doorways if needed
5. Use damp cloth to cover mouth and nose
6. Stay low in a room to escape fire
318
Can blankets be used as stretchers?
Yes
319
OSHA
Occupational
Safety and
Health administration
Makes safety guidelines to protect workers from hazards
320
Safety Data sheet / material safety Data sheet
List of all hazardous chemicals in a workplace. Has instructions on what to do if you come into contact. Tells you how to dispose of things
Staff needs to know where it is and how to read it
321
Disaster guidelines
1. Remain calm
2. Know where stairways, exits, fire alarms and extinguishers are located
Know what to do in case of emergencies.
Use Internet to stay informed
Assess situation and assess victim
322
How do you properly assess the situation?
Find out what happened?
Look at time
Make sure You're not in danger
323
Conscious
Mental alertness having awareness of surroundings, sensations and thoughts
324
How do you properly assess a victim?
1. Ask them what happened.
2. Speak to them by name. See if they know it.
3. Ask for consent to take their vital signs.
325
Implied consent
Assume consent for
Children without parents present.
Unconscious or seriously injured people
326
What should you look for when checking someone
1.serious bleeds
2.change in consciousness
3. Breathing
4. Color or feel of their skin
5. Swelling on body
6. Medical alert tags
7. Pain
Get help!
Nurse!
Listen to person and tell them what's being done
327
First aid
Emergency care given by first responders
328
CPR
Medical procedures to get lungs and heart working again
329
Brain damage can occur between _-_ minutes after heart stops beating and breathing
Person can die within _ minutes
4-6
Can die within 10 minutes
330
T/f some employers don't let NAs start CPR without direction of nurse
True
331
Obstructed airway
Something blocks breathing tube
332
NA should stay with resident until resident cannot
Speak
Breathe or cough
She should get help immediately using call light or emergency cord
333
When resident can still cough, speak or breathe NA should
Encourage them to cough forcefully
334
Abdominal thrusts
Method of attempting to remove an object from obstructed airway
335
Resident must show signs of severely obstructed airway before giving abdominal thrusts
Poor air exchange
Increase in trouble breathing
Silent coughing
Blue tinged skin
Inability to speak, breathe or cough
336
What should NA do when signs of severe airway obstructions occur?
Are you choking? I know what to do. Can I help you? .
If yes, start performing abdominal thrusts
Help them to floor gently and perform CPR if allowed to do so
337
Cyanotic skin
Blue tinged
338
Shock
Organs and tissues don't have adequate blood supply.
339
Causes of shock
Bleeding, heart attack,
Severe infection, falling blood pressure.
Becomes worse when person is scared or in pain.
340
Signs of shock
1. Pale, gray bluish, discolored skin
2. Staring
3. Increases pulse and respiration rates, low blood pressure, extreme thirst.
341
How to respond to shock?
1. Notify nurse immediately
2. Put on gloves before trying to control bleeding
3. Have person lie down on back.
4. Turn them on side if no injuries.
5. Elevate legs 8-12 inches unless person has head neck, spinal, abdominal or back injuries.
4. Check pulse and respiration if possible give CPR
5. Keep person calm and comfortable as possible
6. Maintain a normal body temperature. Place blanket around person if they're cold. If it's hot, give them shade.
7. Don't give food or fluids
8. Report and document
342
Myocardial infarction (MI) heart attack
Heart doesn't get enough oxygen because blood vessels are blocked.
343
Signs of MI
1.Sudden pain/pressure in chest, usually in left side or center. Elephant on chest
2. Pain or discomfort in other areas. One or both arms, back, neck, jaw or stomach.
3. Indigestion or heartburn.
4. Shortness of breath
5. Dizziness
6. Pale, cyanotic color of skin, or mucous membranes (lack of oxygen)
7.perspiration. cold clammy skin
8. Weak irregular pulse rate
9. Low blood pressure
10. Anxiety and sense of doom
11. Denying heart problems
344
Signs of MI in women
Can have heart attacks without chest pressure
More likely to have:
Shortness of breath
Dizziness, nausea vomiting,
Lightheadedness,
Fainting,
Stomach pain,
Sweating,
Fatigue,
Back,
Neck,
Jaw pain,
More flu like
More likely to deny heart problems
345
How do you respond to a myocardial infarction
1. Notify nurse immediately
2.Place person in comfortable position. Encourage them to rest. Reassure that you won't leave
3.Loosen clothing around their neck
4. Don't give food or liquids
5. Monitor breathing and pulse. Begin CPR if they're not breathing, have no pulse and you are allowed to do so.
6. Stay with person until help arrives
7. Report and document
346
Bleeding: can cause death quickly
1. Call nurse immediately
2. Put on gloves. Tell resident to hold hand over wound
3. Hold a thick sterile pad, clean cloth or clean towel against the wound.
4. Press down hard directly, don't remove pressure, don't remove pads. Add additional pads if blood seeps through
5. Raise wound above level of heart. If no injuries
6. Secure dressing when bleeding is under control
7. Check for symptoms of shock.
8. Stay with person until help arrives
9. Remove and discard gloves. Wash hands thoroughly.
10. Report and document
347
Treating minor burns
1. Notify nurse immediately. Put on gloves.
2. Use cool clean water to decrease temperature. Don't use ice, it can cause skin damage. Dampen clean cloth
3. Cover area with dry clean dressing or non adhesive sterile bandage.
4. Remove and discard gloves. Wash your hands.
5. Never use ointment
348
Treating serious burns
1. Remove person from source of fire. Stop drop and roll. Smother fire with blanket to put out. Protect yourself
2. Notify nurse immediately. Put on gloves
3. Check for breathing, pulse and severe bleeding. Start CPR if needed and allowed
4. Don't use ointment
5. Do not try to pull clothes away from burned areas. Cover burn with sterile gauze or clean sheet.
6. Don't rub burned area.
7. Don't give food or liquids
8. Monitor vital signs and wait for help
9. Remove and discard your gloves.
10. Report and document
349
Syncope
Fainting. Decreased blood flow to brain.
350
Causes of syncope
Low blood sugar
Abnormal heart rhythm
Hunger
Dehydration
Fear
Pain
Fatigue
Standing a long time
Poor ventilation
Pregnancy or overheating
351
Signs and symptoms of syncope
Dizziness
Lightheadedness
Nausea
Perspiration
Pale skin
Weak pulse
Shallow respiration
Black vision
352
Responding to fainting
1. Notify nurse immediately
2. Have person lie down or sit down before fainting occurs
3. Place head below knees or raise legs about 12 inches
4. Loosen tight clothing
5. Have person stay in position for at least 5 minutes after symptoms disappear
6. Help person get up slowly. Continue to observe for symptoms of fainting. Stay until they feel better.
7. Lower person to floor gently if they do faint. Position on back and raise legs. Check breathing. Report to nurse immediately
8. Report and document
353
Insulin reaction
Hypoglycemia.
Low sugar presence in blood.
Too much insulin, too little food.
Person gets insulin and skips meal. Or they excercise a lot. Vomiting and diarrhea
354
First signs of insulin reaction
Nervousness
Dizziness
Perspiration
Feeling weak or different
355
Signs and symptoms of insulin reaction
Hunger
Headache
Rapid pulse
Low BP
Cold clammy skin
Confusion
Trembling
Blurred vision
Numbness of lips and tongue
Unconsciousness
356
DKA
Too little insulin.
Undiagnosed diabetics. Low excercise. Physical or emotional stress
357
Signs and symptoms DKA and Insulin reaction
Headache
Weakness
Rapid weak pulse
Low BP
Dry skin
Flushed cheeks
Drowsiness
Flushed cheeks
Nausea and vomiting
Shortness of breath or gasping for air
Unconsciousness
358
Seizures
Involuntary violent contractions. Small area or entire body
359
Responding to seizures
1. Note the time. Put on gloves. Remove eyeglasses if person is wearing them.
2. If person is walking or standing, lower them to floor. Cradle and protect their head. Place pillow under head. Loosen clothing and turn on side.
3. Have someone call nurse immediately or use call light. Don't leave unless you need to to get help.
4. Move furniture away to prevent injury
5. Don't restrain or put things in their mouth.
6. Don't give food or liquids
7. Note time when seizure is over. Turn them on their side if possible. Check pulse and breathing and give CPR is possible.
8. Remove and discard gloves
9. Report and document incident immediately. Including duration of seizure.
360
Cerebral vascular accident (brain attack)
Blood vessel that supplies brain is blocked or bursts
361
TIA transient ischemic attack
Signs of CVS.
Temporary lack of blood supply to brain. Symptoms may last up to 24 hours.
362
TIA symptoms
Difficulty speaking
Weakness on one side of body
Temporary loss of vision
Numbness and tingling
363
Other signs of tia or cva
Facial numbness, weakness or dropping partially on one side.
Hemiplegia
Hemiparesis
Expressive aphasia
Receptive aphasia
Use of inappropriate words
Severe headache
Blurred vision
Ringing in ears
Redness in face
Noisy breathing
Elevated BP
Slow pulse rate.
Nausea or vomiting
Loss of bowel and bladder control
Seizures
Dizziness
Loss of consciousness
364
May be TIA signs in women
Pain in face
Weakness
Chest pain
Shortness of breath
Palpitations
365
FAST
Face: is one side of face drooping? Is it numb? Ask person to smile. Is smile uneven?
Arms: is one arm numb or weak. Ask them to raise arms palms up. Does one drift back down?
Speech: is their speech slurred? Is the person unable to speak. Can person be understood? Ask person to repeat simple sentences
Time: time is important. Get help immediately.
366
Hemiplegia
Paralysis on one side of body
367
Hemiparesis
Weakness or numbness on one side of body
368
Expressive aphasia
Inability to speak/slurred speech
369
Receptive aphasia
Inability to understand spoken or written
370
Emesis
Vomiting
371
___ is common in residents under chemo
Vomiting
372
Responding to vomiting?
1. Notify nurse immediately
2. Put on gloves
3. Turn head up or to one side. Turn onto left side if unconscious. Place emesis basin under chin
4. Remove soiled linens and clothes.. replace
5. Measures vomit if possible. If I&o is being monitored.
6. Flush vomit down toilet unless it has blood or dried coffee grounds. Show to nurse
7. Remove and discard gloves
8. Wash hands
9. Put on clean gloves.
10. Comfort resident. Wipe face & mouth and provide oral care.
11. Put soiled linens in containers
12. Remove and discard gloves.
13. Wash hands
14. Report and document
15. Note time, amount, color, odor and consistency of vomit
373
What guidelines apply to all disaster situations
1. Calm
2. Know exits, extinguishers, stairways and alarms
3. Know what to do in every situation
4. Use Internet or TV to keep up
374
Two important steps to take first
Assess victim & situation
