Unit 1 Flashcards
Chapters 1-4
1
Q
Providers
A
People or organizations that provide healthcare
2
Q
Facilities
A
Places where care is delivered or administered
3
Q
Payers
A
people or organizations paying for healthcare services
4
Q
Long-term care
A
given in longterm facilities for people who need 24 hour skilled care
5
Q
Skilled care
A
medically necessary care given by a skilled nurse or therapist; available 24 hours a day
6
Q
Home healthcare
A
Provided in a persons home
7
Q
Diagnosis
A
medical condition determined by a doctor
8
Q
Assisted living facilities
A
Places for people who need some help with daily care (showering, meals, dressing)
9
Q
Adult day services
A
for people who need some assistance and supervision during certain hours, but do not live in the facility where care is provided.
- break for spouses
10
Q
Subacute care
A
care given in hospitals or long-term care facilities; used for people who need less care than for acute, but more care than for a chronic illness
11
Q
Outpatient care
A
usually given to people who have had treatments, procedures, or surgeries, and need short-term skilled care. Do not require an overnight stay.
12
Q
Rehabilitation
A
care given by specialists. Physical, occupational and speech therapists help restore or improve function after illness or injury.
13
Q
Hospice care
A
given in facilities or homes for people who have approximately 6 months or less to live.
14
Q
What do hospice workers do?
A
They give physical and emotional care and comfort until a person dies.
15
Q
Catheters
A
thin tubes inserted into the body to drain or inject fluids.
16
Q
Policy
A
A course of action that should be taken every time a certain situation occurs.
17
Q
Procedure
A
A method, or way, of doing something.
18
Q
To cite
A
to find a problem through a survey
19
Q
Joint commision
A
an independent, not-for-profit organization that evaluates and accredits healthcare organizations.
20
Q
Medicare
A
a federal health insurance program established in 1965 for people who are 65 or older
21
Q
medicaid
A
a medical assistance program for people who have low income, as well as for people with disabilities.
22
Q
Who is medicaid funded by
A
federal gov. and each state
23
Q
Culture change
A
The process of transforming services for elders so that they are based on the values and practices of the person receiving care
24
Q
Person centered care
A
emphasizes the individuality of the person who needs care and recognizes and develops his/her capabilities
25
List 5 services that are offered at long-term care facilities
1. Wound care
2. Rehab/therapies
3. Cathedar care
4. Nutrition care
5. Management of chronic diseases
26
What are two general categories of residents who stay in a care facility for less than 6 months?
1. Subacute
| 2. Terminal
27
List 4 common policies at longterm care facilities
a. confidentiality
b. only do things assigned
c. dependable
d. arrive to work on time
28
When surveyors visit a facility, what do they study and observe?
quality of care
29
HMOs (health maintenance organizations)
a health plan that states that customers must use a particular doctor or group of doctors
30
PPOs (preferred provider organizations)
A network of providers that contract to provide health services to a group of people
31
What is the goal of the Joint Commission's survey process?
To improve safety and quality of care
32
How is eligibility for medicaid determined
Determined by income and special circumstances; people must qualify
33
Activities Director
Plans activities to help residents socialize and stay mentally and physically active
34
Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)
Licensed professional who has completed one to two years of education and is able to administer medications and give treatments
35
Medical Social Worker (MSW)
Helps residents get support services, such as counseling.
36
Nursing Assistant (NA or CNA)
Performs assigned tasks, such as measuring vital signs, providing personal care, and reporting observations to other care team members.
37
Occupational Therapist (OT)
Helps residents learn to adapt to diabilities by training them to perform ADL and other activities
38
Physical Therapist (PT or DPT)
Develops a treatment plan to increase movement, improve circulation, promote healing, reduce pain, prevent disability and regain mobility.
39
Physician or Doctor (MD or DO)
Diagnoses disease or disability and prescribes treatment
40
Registered Dietician (RDT)
Assesses a resident's nutritional status and develops a treatment plan that may include creating special diets
41
Registered Nurse (RN)
Coordinates, manages, and provides skilled nursing care, as well as supervises nursing assistants' daily care of residents.
42
Resident
Person whose condition, goals, priorities, treatment, and progress are the focus of the care team
43
Speech Language Pathologist (SLP)
Identifies communication disorders and creates a care plan, as well as teaches exercises to help the residents improve or overcome speech problems
44
Professional
having to do with work or a job
45
Personal
life outside a job
46
Professionalism
behaving properly when on the job
47
Compassionate
being caring, concerned, considerate, empathetic and understanding
48
Empathy
identifying with feelings of others
49
Sympathy
sharing in the feelings and difficulties of others
50
honest
tells the trust and can be trusted
51
Tactful
showing sensitivity and having a sense of what is appropriate when dealing with others; ability to speak and act without offending others
52
Conscienctious
when you try to do your best; guided by a sense of right and wrong
53
Dependable
to make and keep commitments
54
Patient
to not lose temper easily
55
Respectful
valuing other peoples individuality, including their age, religion, culture, feelings, practices, and beliefs.
56
Unprejudiced
giving someone the same quality of care regardless of age, gender, sexual orientation, religion, race, ethnicity, or condition
57
Tolerant
respecting others beliefs and practices and not judging them
58
liability
legal term that states that someone can be held responsible for harming someone else
59
Scope of practice
The tasks that healthcare providers are legally allowed to do as permitted by state or federal law.
60
What are the 5 steps in the nursing process? Describe each step
1. Assessment: getting information from many sources, including medical history, physical assessment, and environment, and reviewing this information
2. Diagnosis: identifying health problems after looking at all the residents needs.
3. Planning: setting goals and creating a care plan in accordance with the resident's preferences to meet the resident's needs
4. Implementation: putting the care plan into action, giving care
5. Evaluation: a careful examination to see if the goals were met or progress was achieved.
61
What is the purpose of the assessment stage of the nursing process?
The purpose is to identify actual or potential problems
62
Delegation
transferring responsibility to a person for a specific task
63
What are the 5 rights of delegation
1. Right task
2. Right Circumstance
3. Right person
4. Right direction/communication
5. Right Supervision/Evaluation
64
What are the 5 steps in managing time?
1. Plan ahead
2. Prioritize
3. Make a schedule
4. Combine activities
5. Get help
65
What are some duties that NA can not perform
1. insert/remove tubes
2. give tube feedings
3. change sterile dressings
4. administer medication
66
Why should you avoid wearing artificial nails?
They harbor bacteria and they could scratch the resident
67
What are 3 factors considered when formulating a care plan?
1. The residents goals, priorities, or expectations
2. The residents health and physical conditions
3. The residents diagnosis and treatment
68
Why is the chain of command important?
It describes the line of authority and it protects employees and employers from liability
69
The goal of the nursing process is what?
To plan and evaluate the residents care
70
Ethics
the knowledge of right and wrong; tells someone
71
Laws
Tells someone what they must do; laws are based on ethics
72
The Omnibus Budget Reconciliation Act (OBRA) sets minimum standards for who
Nursing assistant training
73
According to OBRA, nursing assistants must complete at least _____ hours of training and pass a competency evaluation before they can be employed
75 hours
74
Which of the following topics is required by OBRA to be covered during NA training?
Promoting patients legal rights
75
The Minimum Data Set (MDS) is a form for...?
Assessing residents and solving resident problems
76
How often must MDS be completed for each resident?
Any time there is a major change in a resident's condition
77
Residents Rights
Specify how residents must be treated while in a facility
78
Informed Consent
The process by which a person, with the help of a doctor, makes informed decisions about his/her health
79
Abuse
Purposeful mistreatment that causes physical, mental, or emotional pain or injury to someone
80
Active Neglect
The purposeful failure to give needed care, resulting in hard to a person
81
Assault
A threat resulting in a person feeling fearful that he or she will be harmed
82
Battery
The intentional touching of a person without their consent
83
Domestic violence
Physical, sexual, or emotional abuse by spouses, intimate partners, or family members
84
False imprisonment
Unlawful restraint that affects a person's freedom of movement
85
Financial abuse
The improper or illegal use of a persons money, possession, property, or other assets
86
involuntary seclusion
The separation of a person from others against the persons will
87
Malpractice
injury caused by professional misconduct through negligence, carelessness, or lack of skill
88
Neglect
The failure to provide needed care that results in physical, mental, or emotional harm to a person
89
Negligence
Actions, or failure to act or provide proper care, resulting in unintended injury to a person.
90
Passive neglect
the unintentional failure to provide needed care, resulting in physical, mental, or emotional harm to a person.
91
physical abuse
Any treatment, intentional or unintentional, that causes harm to a persons body
92
psychological abuse
emotional harm caused by threatening, scaring, humiliating, intimidating, isolating, or insulting a person, or by treating them like a child.
93
sexual abuse
the forcing of a person to perform/participate in sexual acts
94
sexual harassment
any unwelcome sexual advance/behavior that creates and intimidating, hostile, or offensive work environment
95
Substance abuse
the repeated use of legal or illegal drugs, cigarettes, or alcohol in a way that harms oneself or others
96
Verbal abuse
The use of spoken/written words, pictures or gestures that threaten, embarrass, or insult a person
97
Workplace violence
verbal, physical or sexual abuse of staff by staff members or residents.
98
if a resident wants to make a complaint of abuse, what must an NA do?
help them in any way possible
99
One task of an ombudsman
investigate and resolve resident complaints
100
an ombudsman is assigned by the law as the _____ advocate for the residents
legal
101
ombudsman are in facilities to assist and support who
residents
102
what is some information included under the protected health information (PHI)
SS number, address, phone #, DOB
103
The abbreviation for the law that was enacted as part of the American Recovery and Reinvestment Act of 2009 to expand the protection and security of consumer's electronic health records (EHR) is called
HITECH
104
Advance directives
legal documents that allow people to choose what medical care they wish to have if they cannot make those decisions themselves.
105
Durable power of attorney for health
A signed, dated, and witnessed legal document that appoints someone else to make medical decisions for a person in the event that he or she is unable to do so.
106
Do not resuscitate (DNR) order
A medical order that instructs medical professionals not to perform CRP if breathing/heartbeat stops
107
living will
Outlines the medical care that a person wants, or does not want, in case they become unable to make those decisions
108
Living will may also be called
medical directive or directive to physician
109
Physician Orders for Life Sustaining Treatment (POLST)
Medical order that specifies treatment a person wants when they are very ill decisions are based on conversations with healthcare providers
110
what are the 3 basic steps of communication
send, receive, feedback
111
Who must an NA be able to communicate with?
everyone
112
the 3 steps of communication occurs how often
over and over
113
One way for the NA to be a good listener is to
restate the message in her own words
114
Active listening involves
focusing on the sending and giving feedback
115
Communication
The process of exchanging information with others
116
Verbal communication
involved the use of words, spoken or written language
117
nonverbal communication
communicating without using words
118
Cultural diversity
refers to different groups of people with varied backgrounds and experiences living together in the world
119
Bias
prejudice
120
Culture
a system of learn beliefs and behaviors that is practiced by a group of people
121
Cliche
phrases that are used over and over again and do not really mean anything
122
Objective information
based on what a person sees, hears, touches or smells; collected by using senses
- signs
123
Subjective information
something a person cannot or did not observe, but is based on something that the resident reported; may or may not be true
- symptoms
124
Incontinence
the inability to control the bladder or bowels
125
Cyanoic
skin that is blue or grey
126
The root "derm" or "derma"
skin
127
brady-
slow
128
-itis
inflammation
129
The root "cardia"
heart
130
-pathy
disease
131
the root "neuro"
nerve or nervous system
132
incident
an accident, problem, or unexpected event during the course of care
133
impairment
loss of function or ability; it can partial or complete loss
134
Farsightedness
the ability to see objects in the distance better than objects nearby
135
hyperopia
farsightedness
136
Nearsightedness
the ability to see things near but not far
137
myopia
nearsightedness
138
Cerebrovascular accident (CVA)
stroke; occurs when blood supply to a part of the brain is blocked or a blood vessel leaks or ruptures within the brain
139
most common type of stroke
ischemic stroke
140
hemiplegia
paralysis on one side of the body
141
hemiparesis
weakness on one side of the body
142
tendency to ignore one side of the body
one-sided neglect
143
expressive aphasia
trouble communicating thoughts through speech or writing
144
receptive aphasia
difficulty understanding spoken or written words
145
Emotional lability
inappropriate or unspoken emotional responses
146
What are some examples of emotional lability
laughing, crying, anger
147
Dysphagia
difficulty swallowing
148
combative
violent or hostile behavior
149
Examples of combative behaviors
hitting, kicking, pushing, verbal attacks
150
What is one positive response to cultural diversity?
learn about the culture
151
why should "why" questions be avoided when talking with residents
they may feel defensive
152
if the resident speaks a different language than the NA, what can the NA do
get a translator or ask the resident if a friend or family can translate
153
what is one way to provide positive feedback while listening
nodding, eye contact
154
What can silence or pauses help a resident do ?
gather thoughts
155
When making an oral report, should the NA use facts or opinions
facts
156
when should care be documented
right after it is completed
157
give 2 reasons that a computer may be used in a facility
documentation, research
158
When a resident has a hearing impairment, on whose face should the light be shining while communicating?
the NA
159
How can a NA explain the position of objected in front of a resident who is visually impaired
clock system
160
how should questions be phrased to residents who had a stroke
yes/no
161
how should a NA refer to the weaker side of resident who has had a stroke
affected/involved side
162
what should a NA always do after a resident behaves inappropriately
report it
163
DCW registry stands for
direct care worker registry
164
DIA
Department of inspections and appeals
165
To remain active on DCW registry:
1. Work in a LTC setting at least 8 hour consecutive paid hours in 24 months
2. You are responsible to keep personal info updated
166
What is the level of organization for workers at a place like a LTC facility
1. resident
2. rehab aide, CNA, med aide
3. LPN, RN, ADON, DON
4. Administrator, Medical director
167
What are 3 important components in the healthcare system?
1. Provider: people/organization that provides care
2. Facilities: where the care is provided
3. Payer: health insurance company
168
Late adulthood
60 and up
169
Erickson's developmental tasks: integrity vs. despair
- late adulthood
- understand and accept the meaning of temporary life
- or complains about regrets, not having enough time, and not finding a meaning throughout life
- questions ones overview of their entire life
170
Developmental tasks of the elderly
Level of functional capacity, both physical and emotional
- dependent (nurse/NA need to be there)
- assistive (nurse/NA should be present)
- independent (nurse/NA does not need to be there)
171
Activities promoting quality of life
a. Promote Health / prevent illness
b. DX & TX
c. Physical and emotional care
- dignity/individuality
d. Maintain independence
e. Safe and therapeutic environment
- home-like atmosphere
172
Resident centered care
a. choice in care (who doc. is)
b. know your resident
c. personalized care
d. relationships
e. recognize "culture care"
- change in residents attitude
- change of care giver's attitude
- change in societies attitude toward aging
f. recognize individual needs and wants
173
changes in skin
- hair thinning
- skin dryness/wrinkles/loss of natural oils
- thickening of finger and toe nails
- thinning of skin layers
- skin tears
174
Thinning of skin layers -->
pressure sores
175
skin tears -->
infections
176
Why is there a loss of natural oils in older adults?
older people do not have sebaceous glands
177
Changes in bone in muscle
- loss of muscle, tone and strength
- decrease in flexibility/loss of dexterity
- bones become brittle
- decrease balance
- degeneration of joint/spine
178
Changes in nervous system
- decreased sense of taste, hearing and vision
- visual field increases, decrease adaptability
- decrease in pain threshold/sensitivity
- increase in memory; better recall of past
179
Digestive system changes
- tooth loss; chewing problems
- problems swallowing
- slowed digestion --> constipation
- food intolerances
180
heart and lung changes
- BLD vessels narrow; fragile
- decreased strength and output of heart
- high BP
- decreased lung capacity --> respiratory infections
181
Benefits of a nursing facility
- health maintenance
- restorative/rehabilitative services
- skilled care
- safety
- socialization
- respite and peace of mind for family
- hospice
- 24 hour care
182
OBRA
- promotes quality of life
- must meet ind. interests and needs
- must promote personal choice
- residents must be allowed to take part in a variety of activities
183
Types of activities at a nursing home
- music
- exercise
- parties
- field trips
- craft groups
- games
- pet therapy
184
NA roles in assisting with activities
- help with care planning
- encourage participation
- help get resident to activity
- assist with activity as per facility protocol
185
What changes should a NA look out for
- emotional/social/spiritual changes
- physical/mental
- behavioral
186
What should a NA record / report
- any changes
- pain
- I & O, Wt, Ht, stools, urine
- anything unusual
187
NA not perform
- any skill of task not included in the 30 skills learned in this class
- administer medications
- agencies may choose to provide further training and once documentation of competency, you may perform those skills you are found competent in
188
NA qualities / professionalism
- personal appearance
- personal hygiene
- physical and mental health
- work schedules and contracted to work
- provide complete resident needs
- work according to job description
- dependability
- follow rules and regulations
189
What are common rules and regulations that are important to follow as a NA
- dress code
- substance / chemical abuse
- personal phone / phone calls / mail / visitors
- absence from work and notification
- smoking and eating
190
How should a NA demonstrate interpersonal relations with co-workers
- cooperation
- taking direction
- accepting constructive criticism
- team member
191
How should a NA demonstrate a desire for ongoing learning
- in service
- CCDI training
- rehab aide
- medication aide
- home care aide
192
Ethical vs legal
```
Ethical = a moral guide
a. respected for residents/co-workers/property
b. loyalty
c. non-judgemental
d. accepting
Legal = act according to law
a. protection health information (PHI)
b. name of person served
c. phone number
d. SS #
e. address
f. health information
```
193
What factors may impact employability for an NA
conviction of DUI/recreation/prescription drug
194
NA negligence may include
- performing tasks not trained to do
- performing procedures incorrectly/unsafely
- acts that may injure, have potential for energy
195
Resident endangerment would include
- abandonment
- false imprisonment
- assault and battery
196
Consequences of abusing confidentiality
- dismissal from NA course
- Dismissal from job
- criminal and civil lawsuit
197
Mandatory reporter of Department Adult/Child abuse
- training every 5 years
| - your responsibility is to report to your supervisor any potential abuse you have witnessed
198
Resident rights are protected by law, how can you ensure this is upheld?
1. inform resident of their rights
| 2. protect dignity, self respect and quality of life
199
Assistive technology
any tool, equipment or service designed to help develop, maintain or improve your ability to function in life
- -> can be low-tech such as a magnifying glass or high-tech such as computerized communication system
- -> tool that provides vocal output for those who can not communicate with their voice
200
Safety devices
- Use lights to warn deaf of fire, or that the door bell or phone is ringing
- device that shakes bed is smoke alarm is going off
- relay Iowa & TTY for communication between deaf person and hearing person
201
Where can safety devices be obtained
IowaCompass.org, 211, blind association
202
NA role in using and maintaining assistive devices
- notify supervisor when device malfunctions
- place device in easy access for resident
- assure electronic devices are charged
- clean surfaces of assistive devices
- seeking training on use of device if needed`
