chapter 1 the role of the nursing assistant Flashcards
mandated reporter
must report suspected abuse or neglect
ethics
code of moral standards
confidentiality
privacy and respecting someones wishes and information
OBRA
the law that states the standards for nursing homes and ensure the protection and safety of patients
assault
the threat to harm
battery
- touching someone without permission
- restraining
- forcing someone to do something they don’t want to do
slander vs libel
slander: gossip damaging a person’s rep
libel: written lies damaging a person’s rep
uniform disciplinary act
discipline procedures for health professionals
false imprisonment
restraint of a persons freedom or movement
long term care facility
examples:
- nursing home
- adult family homes
abuse
harm of a person, physical or verbal
neglect
causing harm to someone due to not fulfilling duties and responsibilities
geriatric
the elderly
ombudsman
an official appointed to investigate individuals’ complaints against maladministration
Identify three members of the nursing department
- CNA
- LPN
- RN
- ARNP: nurse practitioner= RN with a masters degree
Name 3 members of the restorative/ rehabilitative department and describe what they do
physical therapist: develops plans of care to strengthen muscles and regain mobility
occupational therapist: develops plans of care to help the person regain ADLs, feeding themselves, dressing themselves
speech language pathologist: works with clients with speech problems and assists with eating and swallowing difficulties
What are your responsibilities regarding confidentiality??
HIPAA, we must only discuss people’s personal information with others in a non gossipy manner, and only to discuss the person’s care to help them. We must discuss people’s personal information only with those who can help us help them. You must protect the privacy of the client. Only speak in private areas, in a quiet voice so that nothing can be overheard.
Three things an NA isn’t allowed to do
- give medication and pills, even vitamins and pain killers
- tasks that involve piercing the skin
- anything that requires tubes, inserting or removing tubes, nasogastric (through the nose) tube feeding, central line maintenance
How to become certified
- Complete state-approved CNA training
- Pass clinicals
- 40 hours of hired in person training at a hospital, clinic, certified place to work
3 ways to maintain privacy
- Close curtain
- close blinds, door, drapes
- expose only one part of the body at a time when bathing
- knock before entering a clients room
- Treat their belongings with respect
How can you assist client in voicing grievances??
somethings can be fixed on the spot, like cold coffee, but somethings need to be taken to your supervisor
hierarchy of needs
- physiological needs, food, water, shelter sleep
- safety needs
- love and belonging
- self esteem
- self actualization
clients bill of rights
The Client Bill of Rights is designed to recognize, promote, and protect, an individual’s right to be treated with dignity and respect within the health care system
Psycho social losses
- retirement from work
- decreased income
- health problems
death of spouse
-increases isolation
workplace violence
can come from the client of the caregiver
- dementia patients especially
empathy
the ability to understand and share the feelings of another.
aging changes of the cardiovascular system
consists of heart, blood and blood vessels
- hypertension: bp goes up
- edema may occurs in lower legs and feet
- blood vessels become narrow. less elastic, and possible clogged. leads to poor circulation throughout the body
- heart attack, stroke, congestive heart failure
aging changes of the respiratory system
respiratory system: nose, throat, voice box, lungs
- less effective coughs, less breathing capability
- pneumonia
- asthma
- COPD
aging changes with the digestive system
includes: mouth, throat, esophagus, stomach, small intestine, large intestine, liver, gall bladder, pancreas
1. decreased appetite
2. absence of teeth, difficulty chewing and swallowing
3. greater risk of choking
- constipation
- fecal impaction
- hemorrhoids
aging changes with the muscular system
includes muscles, bones, ligaments, tendons, and cartilage
- decrease of muscle strength= atrophy and weakness
- bones are more brittle= leads to fractures
- joints become stiff= arthritis
aging changes in the urinary system
includes: kidneys, ureters, bladder
1. inability to hold urine, causes UTI
2. ENLARGED PROSTATE IN MEN
aphasia
inability to communicate verbally
subjective reporting
an individual describing their own subjective experience
objective reporting
fact-based, measurable and observable reporting
good communication
- body language
- facial expressions
- tone of voice
- relaxed
- non threatening
- speak clearly
- be non judgemental
storing a hearing aid
turn it off, remove batteries, store in a clean and dry place
how to put in a hearing aid for a client
- check batteries
- before putting in the hearing aid turn down the volume
things to remember about the medical record
- must be kept confidential
- can be subpoenaed for court
- has results, orders, forms, contact information\
- can be done on paper or electronically
- has to be done in pen
- don’t erase or white things out. draw a line and write error
contents of medical record
- contact information
- x-ray results
- financial records
- medication documentation
- history
- physical
things that must be reported to a nurse
- falls
- abnormal amounts of food or liquid consumption
- any abnormal signs
- reddening of skin
- breaks in skin
- cuts or bleeding
- complaints of pain
- abnormal vital signs
contracture
shortening or tightening of a muscle or tendon
what does Q mean?
every
oral care should be done…
Q every two hours
MRSA
A staph disease that is resistant to methacillin
staph
an infection from bacteria found on the skin or in the nose. Staph can also cause food poisoning resulting in nausea, vomiting, and stomach ache.
8 oz= ___ ccs
- Multiply the number of oz by three and add a zero
what are the grieving stages as described by Dr. Elizabeth Kubler-Ross?
- denial
- anger
- bargaining
- depression
- acceptance
what do pressure stockings prevent
edema, the swelling of parts of the body because of stored fluid, usually blood. Usually occurs on the legs and feet.
Bony promincences
- elbows
- coccyx
- ankles
- hips
- heels
Symptoms of impaction
- Bm smears
2. absence of normal BMs, constipation
What is defibralation
delivering shock to the heart from a AED
Causes of aggressive behavior in a client
- lack of control
- neglect
- being fearful
- lack of choices
Observations about stool that should be reported
- black stool
- stool with blood
- hard stool
aging change in the skin
- dry
- fragile
- wrinkles
aging change in vision
impaired depth perception
What should you do if the client expresses thought of suicide?
- contact patients physician
- notify charge nurse immediately
- Con tact the national suicide lifeline
When should you wash your hands
- between each client
- after removing gloves
- before putting on gloves
- after using the bathroom
what is TB??
TB is a disease of the lungs.
Spread when the infected person coughs or sneezes
what is VRE?
Vancomycin-resistant Enterococcus
Spread through the touching
what are vital signs??
- temperature
- respiration
- pulse
- blood pressure
Different spots for pulse
- carotid pulse: neck
- brachial pulse: inner arm at the elbow
- apical pulse: chest pulse, use stethoscope
- radial pulse: wrist
systolic and diastolic blood pressure
written as systolic pressure, the force of the blood against the artery walls as your heart beats, over diastolic pressure, the blood pressure between heartbeats.
febrile definition
having or showing the symptoms of a fever
tachycardia definition
fast heartbeat
bradycardia definition
slow heartbeat
dyspnea definition
difficult or labored breathing
passive ROM vs Active ROM
passive ROM: someone performing them for you
active ROM: you performing the exercise for yourself
physical signs if impending death
- Loss of Appetite
- labored breathing
- Increased Physical Weakness
- Changes in Urination
- Swelling to Feet, Ankles and Hands
definition of palliative care
care giving approach aimed at optimizing quality of life and mitigating suffering among people with serious, complex illness
what is pulse oximetry??
way to see how much oxygen is in the blood through the finger tip
Why might specimens (stool, sputum, urine) be helpful?
- A stool analysis is a series of tests done on a stool (feces) sample to help diagnose certain conditions affecting the digestive tract. These conditions can include infection (such as from parasites, viruses, or bacteria), poor nutrient absorption, or cancer
- A urinalysis is a test of your urine. A urinalysis is used to detect and manage a wide range of disorders, such as urinary tract infections, kidney disease and diabetes.
- A sputum test, is a test that your doctor may order when you have a respiratory tract infection or other lung-related disorder to determine what is growing in the lungs.
What happens during psychosis
During a period of psychosis, a person’s thoughts and perceptions are disturbed and the individual may have difficulty understanding what is real and what is not.
What is a transient ischemic attack?
A brief stroke-like attack that, despite resolving within minutes to hours, still requires immediate medical attention to distinguish from an actual stroke.
What is bronchitis?
Inflammation of the lining of bronchial tubes, which carry air to and from the lungs.
what is emphysema?? COPD??
- In emphysema, the walls between many of the air sacs in the lungs are damaged.
- A group of lung diseases that block airflow and make it difficult to breathe.
true of false alzheimers is one of the leading causes of death in the US
true
What are delusions
false beliefs
difference between dementia and delirium
delirium comes immedietly and goes away within a few weeks
dementia comes slowly and stays. It’s a progressive mental disease
What is sundowning
when the client has exaddurated dementia symptoms in late evening and early evening
what is the integumentary system?
the skin system
If you didn’t complete an assignment what should you do?
write in your initials, circle them, and notify the charge nurse
Aphasia:
dysphagia:
dyspnea:
aspiration:
- inability to communicate verbally
- partial inability to speak
- difficulty/ painful breathing
- when anything gets inhaled into the airways
cardio
heart
hepa
liver
gastro
stomach
osteo
bone
cerebro
brain
hemiphlegia
half paralysis
up ad lib C̅ BRP
up as desired with bathroom privileges
NPO p (with bar) midnight until FBS in am
nothing by mouth after midnight until fasting blood sugar in the morning
400 cc. PO TID c (with bar) meals
400 cubic centimetres by mouth 3 times a day with meals
TID
three times a day
up in w/c, assist c (with bar) transfers PRN
up in wheelchair, assist with transfers as necessary
c with bar
with
p with bar
after
PRN
as necessary
BID
two times a day
take pt. to PT BID
take patient to physical therapy two times a day
QID
four times a day
Q
every
admov.
apply
BM
bowel movement
pt.
patient
SOB
short of breath
amb
ambulate, to take on a walk
amb pt. c (with bar) SBA to BR
ambulate patient with stand by assistance to bed rest
SBA
stand by assistance
BR
bed rest
ROM to RUE QID
Range of motion to right upper extremity 4 times a day
RUE
right upper extremity
PROM to LUE BID
passive range of motion to left upper extremity twice a day
Obtain TPR and BP and report to CN stat
obtain temperature, pulse, respiration, and blood pressure and report to clinical nurse immediately
check V.S. on client stat and QH after
check vital signs on client immediately and every hour after
HR
heart rate
post op
after surgery
pre op
before surgery
SOB
shortness if breath
elevate HOB of the person c (with line) CHF
elevate head of bed of person with congestive heart failure
temperature taken in the ear is called
tympanic
Diastolic is pressure in the blood vessels when the heart
relaxes
the color code for the rectal thermometer is
red
normal respiration is
14-20 per minute
normal rectal temperature is
99.6
elevated body temp may indicate
- infection
- shock
- inflammation
bending an arm or leg is called
flexion
self adaptive device to help with self feeding
food guards on plate, build up edge, rolling knife, spork
self dressing devices
- button hook
- shoes with Velcro
- shoe horn
hazards of immobility
- bone loss= osteoporosis
- decubitus ulcers
- contractures
true or false: TB is spread through the air
true: can be spread through coughing, sneezing, singing, laughing
mucus membranes
moist lining of mouth, nose, eyes, genitals
