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CNA > Chapter 7 > Flashcards

Chapter 7 Flashcards

1
Q

NAs should know the resident’s _______ at the time of discharge

A

Condition

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2
Q

Vital signs order

A

Temp
Pulse
Resp
BP
Pain
O2 sat
Pulse ox

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3
Q

What are vital signs?

A

Show how well organs are working

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4
Q

Which changes in vitals require nurse attention

A

1.Temp outside of normal range

  1. Too rapid or too slow resp rate
  2. Abnormal pulse
  3. Changes in BP
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5
Q

Ranges: mouth (oral) temp

A

97.6-99.6

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6
Q

Temp rectum (rectal)

A

98.6-100.6

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7
Q

Temp Armpit (axillary)

A

96.6-98.6

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8
Q

Temp ear (tympanic)

A

96.6-99.7

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9
Q

Temporal artery (forehead) temp

A

97.2-100.1

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10
Q

Normal pulse rate

A

60-100 bpm

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11
Q

Normal resp rate

A

12-20

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12
Q

Blood pressure normal systolic

A

90-119 systolic

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13
Q

Body temperature is normally very close to ___

A

98.6

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14
Q

Body temperature is a balance between

A

The heat created by the body, and the heat lost to the environment

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15
Q

Factors that affect body temperature

A

Age
Illness
Stress
Environment
Excercise
Circadian rythym

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16
Q

What should you do if a resident has just done done something with their mouth, eating, drinking, smoking EXCERCISED etc

A

Wait 20 minutes and come back

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17
Q

True or false: body temperature fluctuates?

A

True

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18
Q

When is body temperature lower?

A

Morning

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19
Q

Increases in body temperature may indicate an ___or____

A

Infection or disease

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20
Q

Which is the most common way of taking body temperature

A

Oral

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21
Q

Which is the most accurate way of taking body temperature

A

Anal

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22
Q

Places where you can take temperature

A

Oral
Rectal
Axillary
Tympanic
Temporal artery

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23
Q

Types of thermometers

A

Digital
Electronic
Tympanic
Temporal artery
Mercury-free

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24
Q

What color is a rectal thermometer

A

Red

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25
Q

What color is an oral thermometer?

A

Blue or green

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26
Q

Which temperature is least accurate

A

Axillary

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27
Q

Who should not have an oral temperature recorded?

A
  1. Unconscious
  2. Had facial surgery
  3. Is younger than 5
  4. Is confused or disoriented
  5. Is heavily sedated
  6. Is likely to have a seizure
  7. Is coughing
  8. Is using oxygen
  9. Has facial paralysis
  10. Has a nano gastric tube
  11. Has soreness, redness, swelling or pain
  12. Has injury to face or neck
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28
Q

Rectal temp should be a last resort?

A

Yes
1.oral
2. Axillary
3. Rectal

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29
Q

How to use a digital thermometer

A
  1. Put on sheath
  2. Turn on thermometer
  3. Wait until ready sign appears
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30
Q

How to use electronic thermometer?

A

Remove probe from base unit.

Put on probe cover

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31
Q

Mercury free thermometer

A
  1. Hold thermometer by stem
  2. Shake thermometer before inserting it in resident’s mouth. Shake thermometer down to lowest #. Below 96 f
  3. Hold it at end opposite with bulb with thumb and 2 fingers. Stand away from furniture and walls.
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32
Q

Digital thermometer

A

Insert end of the thermometer into the resident’s mouth, under the tongue and to one side.

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33
Q

Electronic thermometer

A

Insert the end of the thermometer into the resident’s mouth, under the tongue and to one side.

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34
Q

Hold thermometer in until it

A

Beeps

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35
Q

How long should a mercury free thermometer stay in?

A

At least 3 minutes

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36
Q

How should residents breathe while getting oral temp taken?

A

Through nose

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37
Q

Should resident talk while getting temp checked

A

No

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38
Q

Should resident bite on thermometer?

A

No

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39
Q

Why should you never let go of a thermometer during rectal temperature?

A

It can get lost or puncture the colon

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40
Q

On what side should a resident lie for a rectal temperature assessment?

A

Left side

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41
Q

How far does the thermometer go in for rectal temperatures?

A

1/2 inch to 1 inch

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42
Q

What should you do if you feel resistance during rectal temperature?

A

Stop

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43
Q

In what direction should you pull an ear for adult when taking tympanic temp

A

Up

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44
Q

In what direction should you pull an ear when taking tympanic temp for child?

A

Down

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45
Q

Pulse

A

Number of heartbeats per minute

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46
Q

Beat

A

Wave of blood moving through artery as result of heart pumping

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47
Q

When do you add a superscript to a temperature

A

Rectal or axillary
Superscript R for rectal
Superscript Ax for axillary

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48
Q

Radial pulse

A

Inside of wrist, using radial artery

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49
Q

Brachial pulse

A

Pulse inside the elbow. 1- 1&1/2 inches above the elbow

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50
Q

Normal Pulse range for children

A

100-120 bpm

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51
Q

Newborn pulse rate

A

120-180 bpm

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52
Q

What affects pulse rate

A

Excercise,
Fear
Anger
Anxiety
Heat
Infection
Illness
Medications
Pain

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53
Q

A rapid pulse could indicate

A

Fever
Dehydration
Heart failure

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54
Q

Slow, weak pulse could indicate

A

Infection

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55
Q

Respiration

A

One inhale one exhale

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56
Q

Inspiration

A

Breathe in

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57
Q

Expiration

A

Breathe out

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58
Q

Infant respiratory rate

A

30-40

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59
Q

Should you report irregular pulse rythym even if the bpm are normal?

A

Yes you also should if breathing is irregular

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60
Q

Blood pressure

A

Pressure of blood in heart. Input/output rate. Pressure on walls and arteries

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61
Q

How is BP recorded?

A

Fraction mmHg

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62
Q

Systolic

A

Heart contractions. Filling the bucket.
Top number.

Pushes blood from left ventricle

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63
Q

Diastolic

A

Heart relaxes.
Blood leaves bucket.

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64
Q

Hypertensive

A

Blood pressure is constantly high

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65
Q

Sphygmomanometer

A

Used alongside stethoscope to take BP

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66
Q

Systolic pressure is the ____ sound

A

First

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67
Q

Diastolic pressure sound

A

Last sound. Soft muffled thump

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68
Q

On which arms shouldn’t you take BP

A

IV
Dialysis shunt
Arms with medical equipment

Cast
Recent burns
Trauma or mastectomy

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69
Q

Pulse oximeter

A

Measures percentage of oxygen in blood. Uses light. Also measures pulse.

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70
Q

Less than ___% O2 saturation must be reported

A

95%, but re check first

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71
Q

Is pain a vital sign?

A

No it isn’t, but some refer to it as the fifth vital sign

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72
Q

Is pain a normal part of aging?

A

No

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73
Q

What should an NA ask about pain?

A

Where is the pain?
When did the pain start?
How long does the pain last?
How often does it happen?
Rate it on 1-10
Can you describe pain?
Use resident’s exact words

What makes pain better?

What makes pain worse?

What were you doing when you started?

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74
Q

Which changes in weight must be reported?

A

All of them

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75
Q

Restraint

A

Physical or chemical way to restrict voluntary movement or behavior

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76
Q

Physical restraints

A

Anything that restricts a person’s freedom of movement

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77
Q

Chemical restraints

A

Medications that control someone’s mood or behavior

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78
Q

Enabler

A

Equipment that promotes safety, comfort, independence and mobility.
Person must be able to remove it independently

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79
Q

LTCs are prohibited from using restraints unless they are ___ _______

A

Medically necessary

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80
Q

NAs can’t use physical restraints unless

A
  1. Doctor ordered it in care plan and they have been trained in the restraint’s use
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81
Q

Restraint free care

A

Restraints are not kept or used for any reason

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82
Q

Restraint alternatives

A

Measures in place instead of using restraints

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83
Q

How often must a restrained resident be checked on

A

At least every 15 minutes

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84
Q

Output

A

Urine, feces, vomit, sweat, perspiration, moisture that a person exhales and wound drainage

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85
Q

Fluid balance

A

Maintaining equal input an output. Taking in and eliminating an equal amount of fluids

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86
Q

Specimen

A

Sample that’s used for analysis

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87
Q

Routine urine specimen

A

Collected every time resident voids

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88
Q

Void

A

Urinate

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89
Q

Hat

A

Container that’s sometimes used to measure urine or stool

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90
Q

Seal must be ____ before specimen collection

A

Intact

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91
Q

Clean catch specimen

A

Mid stream specimen.
Does not include first and last urine voided in the sample

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92
Q

Purpose of a clean catch specimen

A

Detect bacteria in the urine

93
Q

True or false: you shouldn’t touch the inside of the container or the inside of the lid when collecting specimens

A

True

94
Q

Should you clean perineal area first when collecting a clean catch?

A

Yes

95
Q

Why can’t residents also urinate when you’re taking a stool sample?

A

It ruins it

96
Q

When is the best time to collect sputum?

A

Early morning

97
Q

How much sputum should an NA collect?

A

1 teaspoon

98
Q

Catheter

A

Thin tube inserted into bodies used to drain or inject fluids

99
Q

Urinary catheter

A

Drains urine from bladder

100
Q

Oxygen therapy

A

Administering oxygen to increase the supply of oxygen to the lungs

101
Q

Do nursing assistants stop, adjust or administer oxygen?

A

No, they never stop, adjust or administer oxygen

102
Q

Water temperature should be no higher than ___ when providing catheter care?

A

105

103
Q

Indwelling catheter

A

Remains in bladder for periods of time

104
Q

Indwelling catheter is also known as

A

Foley catheter

105
Q

Condom catheter is also called

A

Texas catheter

106
Q

Condom catheter.

A

External, goes on penis. Fastened with special tape. Has leg bag.

107
Q

Should bag hang above catheter opening

A

No! Can cause infection. Bag should never flow back into water

108
Q

Drainage bag must be ___ the floor

A

Off

109
Q

Is it okay for catheter tubing to touch the floor?

A

No! Catheter tubing should never touch the floor

110
Q

How do you prevent accidentally dislodging the catheter tube?

A

Keep it as straight as possible. No kinks

111
Q

Things to report about catheters

A

-blood or unusual urine
-cathether bag doesn’t fill after several hours
-cathether bag fills suddenly
-cathether is not in place
-urine leaks from catheter
-resident reports pain or pressure
-odor is present

112
Q

Should the spout and clamp touch the graduated container?

A

No

113
Q

Oxygen therapy

A

Administering oxygen to increase the supply of oxygen to lungs

114
Q

Combustion

A

Burning

115
Q

Can you use oil based lubricants on resident or any part of the cannula or mask?

A

No

116
Q

IV therapy

A

Giving medication, nutrition or fluids through a vein

117
Q

Port

A

Permanent IV opening

118
Q

Closed bed

A

Bed completely made with the bedspread and blankets in place.

119
Q

Who is a closed bed made for?

A

Residents who will be out of bed most of the day

120
Q

Open bed

A

Folding linen down to foot of bed. Bed ready to receive a resident

121
Q

Sterile dressings

A

Cover new, open or draining wounds. Nurse changes these

122
Q

Non sterile dressings

A

Applied to dried, closed wounds that have less chance of infection. Depending on state regulations

123
Q

Which changes in weight should NAs report?

A

NAs must report every change in weight, no matter how small

124
Q

1 lb is equal to ___ oz

A

16

125
Q

1 kg is equal to ___ grams

A

1000

126
Q

1 kg equals ___ lbs

A

2.2

127
Q

Can you put your hand on a resident’s back while weighing?

A

No, resident must be able to fully hold themselves up on scale without any help

128
Q

Can a resident hold, touch or lean on something while weighing?

A

No

129
Q

What kind of shoes should a resident wear before walking on the scale?

A

Nonskid

130
Q

Which things should stay the same when weighing a resident?

A
  1. Amount of clothes
  2. Time of day
  3. Scale used
131
Q

Residents shouldn’t gain more than __ lbs per day

A

3

132
Q

Which scale is the least accurate

A

Bed scale

133
Q

How often are height and weight measured

A

Height: once
Weight: at least monthly

134
Q

What should you do if a resident can’t stretch out to be measured?

A

Get the nurse

135
Q

Examples of restraints

A

belt restraints, vest restraints, wrist/ankle restraints

136
Q

Examples of enablers

A

Wheelchairs, geriatric chairs, cushions and pillows, assistive devices

137
Q

Are side rails restraints?

A

Sometimes

138
Q

Are geriatric chairs restraints?

A

Sometimes

139
Q

Doctor’s note for restraints has to be signed within __ to __ hrs

A

24-48

140
Q

Does family have to be notified if their resident is restrained?

A

Yes

141
Q

Why is it important to document what you did to prevent using restraints

A

Because restraints are a last resort! Document everything you did to keep from putting on restraints. Offered backrub. Document everything done to patient

142
Q

How often do residents have to be released from restraints?

A

Every 2 hours for 10 minutes

143
Q

Restraints can easily cause

A

Pneumonia
Incontinence
Pressure sores
Constipation
Blood clots

144
Q

What is a good way to distract a resident instead of restraining them?

A

Giving them a repetitive task

145
Q

An NA cannot use a restraint unless the _______ ______ has approved it &

A

Charge nurse
NA has been trained to use it properly

146
Q

How do you give a restrained resident proper care

A
  1. Help with elimination often. Check for incontinence and give skin care
  2. Offer fluids and food
  3. Measure vital signs
  4. Check for irritation, bruising or odd marks
  5. Check for swelling
  6. Reposition the resident
  7. Ambulate resident
147
Q

1 oz= ___ml

A

30

148
Q

How much water should we drink a day

A

64 oz

149
Q

1/4 cup= __oz

A

2

150
Q

1/2 cup = __ oz

A

4

151
Q

Older women should drink

A

Just over 1.5 quarts /1.6 liters

152
Q

Older men should drink

A

2 L about 2 quarts

153
Q

Specimen

A

Sample that is used for analysis to make a diagnosis

154
Q

Urine breaks down after ___ seconds

A

15

155
Q

You should make sure hats and pans have been ____ before getting resident to go again

A

Cleaned

156
Q

Where should you label a specimen?

A

On the side of the cup

157
Q

Can you get a urine sample from a diaper

A

No

158
Q

Can you get a stool sample from a diaper?

A

Sometimes. Not for worms. Just for blood

159
Q

Anything that comes from the body should go in a

A

Biohazard bag

160
Q

What does rusty sputum sometimes indicate

A

TB

161
Q

Is sputum spit?

A

No

162
Q

The NA should ask ___ to find out a resident’s personal preferences and ___

A

Questions
Routines

163
Q

The NA should always call the resident by their _____ name

A

Formal

164
Q

The NA should not____ the admission process or the resident

A

Rush

165
Q

New residents must be given a copy of their _____

A

Rights

166
Q

It is important for the NA to ___ the resident in case something important was missed

A

Observe

167
Q

T/F the resident will pack their own belongings for a transfer

A

False

168
Q

T/F an NA writes discharge order for resident

A

False

169
Q

What may changes in vital signs indicate

A

Issues with health
Worsening condition

170
Q

What changes should be immediately reported to the nurse

A
  1. Fever
  2. Abnormal pulse/resp
  3. Changes in BP
  4. Pain is worse
171
Q

Apical pulse

A

Pulse on chest, most accurate

172
Q

Femoral pulse

A

Groin

173
Q

Pedal pulse

A

Foot

174
Q

8 things you can do to reduce resident’s backpain?

A
  1. Backrub
  2. Comfortable position
  3. Distract them
  4. Notify nurse
  5. Align pillows
  6. Help resident to restroom
  7. Calm, quiet environment
  8. Ask if they want bath
175
Q

Why must an NA report weight losses

A

Could indicate health problems

176
Q

Restraint free care means that

A

Restraints are never used for any reason

177
Q

What 8 care tasks need to happen every 2 hours when resident is restrained

A
  1. Moving around
  2. Bathroom/incontinence/skin
    3.bruises
  3. Measure vitals
  4. Offer fluids &food
  5. Swelling
  6. Check for bruising and signs of irritation
  7. Reposition resident
178
Q

7 things that can disrupt resident’s sleep

A
  1. Other residents
  2. Fear/anxiety
  3. Stress
  4. Diet
  5. Noise
    6.medication
    7.Illness
179
Q

Things affected by lack of sleep

A

Decreased mental function

Reduced reaction time

Irritability

Compromised immune system function

180
Q

T/f: urinals and bedpans are normally stored on the over bed table

A

False

181
Q

When a resident cannot get out of bed,

A

The bed should be raised to a safe height before making it

182
Q

A bed made with the bedspread and blankets in place is called a

A

Closed bed

183
Q

Sterile dressings cover

A

Open or draining wounds

184
Q

Elastic bandages are also known as

A

Non sterile bandages
ACE bandages
ACE wraps

185
Q

How soon should an NA check on a resident after applying a bandage?

A

10 minutes

186
Q

T/f: Soiled linens should be placed on the over bed table when changing a resident’s bed

A

False

187
Q

How many inches down should you clean a catheter

A

At least 4

188
Q

Can NAs turn off oxygen in case of fire?

A

Yes, but they can’t adjust setting or dose

189
Q

Can you use oil based lubricants on resident or on cannula?

A

No

190
Q

Which fabrics can cause electric discharges ?

A

Nylon and wool

191
Q

Can oxygen tubing or cords for under rugs or furniture?

A

No

192
Q

Can you use an extension with an oxygen concentrator?

A

No

193
Q

Examples of fire hazards

A

Electric equipment
Electric razors
Hair dryers
Cigs
Flammable liquids
Alcohol and nail polish remover

194
Q

Intravenous Therapy

A

Delivery of medication, nutrition or fluids through a vein

195
Q

What is the NAs responsibility in regards to IV

A

Report and document problems with the IV line

196
Q

What should you report about IV therapy

A

1.Tube/needle falls out
2. Tubing disconnects
3. Dressing around IV is loose or not intact
4. Blood is in tubing or around IV site
5. Site is swollen or discolored
6. Bag is broken
7. Amount of fluid doesn’t decrease
8. IV fluid doesn’t drip or leak
9. IV fluid is almost out
10. Pump beeps indicating a problem
11. Pump is dropped
12. Resident complains or has trouble breathing

197
Q

Can you wet an IV site?

A

No

198
Q

Can you catch IV tube on anything?

A

No

199
Q

Can an NA lower an IV bag below the IV site?

A

No, it should be at least 3 ft above heart so the fluid has enough pressure to infuse

200
Q

Why shouldn’t an NA disconnect the IV pump or turn off the alarm?

A

Will hurt resident’s treatment

201
Q

Why shouldn’t you touch the IV clamp

A

It controls the flow rate

202
Q

What goes on top of bedside stand?

A

Water pitcher, cup

Phone, radio, photos, other items

203
Q

What is the over bed table used for

A

Meals,
Personal care,
Must be kept clean
Uncluttered
(No contaminated items)

204
Q

Do privacy curtains block sound?

A

No

205
Q

What should an NA do when she doesn’t know how to use equipment?

A

Ask for help

206
Q

When should over bed table be cleaned?

A

After each use.

207
Q

Where should over bed table be before leaving?

A

Within resident’s reach

208
Q

Temperature range required by obra

A

71-81f

209
Q

When should meal trays be removed?

A

Right after meals
Check for bread crumbs

210
Q

Do wrinkled linens have to be changed?

A

Yes

211
Q

Why should you check to see if resident can lift pitcher and cup

A

So they always have access to water

212
Q

Who cleans bathrooms?

A

Housekeeping

213
Q

Is it okay to move a resident’s belongings?

A

No

214
Q

What should be reported about sleep issues

A

1.Sleeping too much
2.Eating or drinking caffeinated items late in day
3. Wearing night clothes during day
4. Eating heavy meals late at night
5. Refusing to take sleep meds
6. Taking new meds
7. Having TV, radio, computer on late at night
8. Having pain

215
Q

Linens should be changed after:

A

1.Bedbath
2. Personal care
3. Damp sheets/soiled/need straightening

216
Q

Sheets that don’t lie flat increase the risk of

A

Pressure injuries

217
Q

Bag soiled linen at:

A

Point of origin

218
Q

When making the bed the NA should

A

Use a wide stance and bend her knees. Bending at the waist should be avoided. Especially when tucking sheets under mattress

219
Q

Always work from _____ to ____ area of bed

A

Cleanest
Dirtiest

220
Q

Hospital corners prevent

A

Residents feet from getting tangled when getting in and out of bed

221
Q

Should resident see soiled side of dressing?

A

No

222
Q

What should you note when changing a dressing

A

Color
Odor
Drainage

223
Q

What do ace bandages do?

A

Help decrease swelling
Hold dressings in place
Secure splints
Support and protect body parts

224
Q

How should bandage be wrapped?

A

In figure 8 pattern
So no part of wrapped area is pinched

225
Q

Why shouldn’t you tie a bandage?

A

Cuts off circulation

226
Q

Signs and symptoms of poor circulation

A
  1. Swelling
  2. Pale gray cyanotic skin
  3. Shiny, tight skin
  4. Skin that is cold to touch
  5. Sores
  6. Numbness
  7. Tingling
  8. Pain or discomfort
227
Q

What should do in case of poor circulation?

A

Loosen bandage and notify nurse

228
Q

Normal diastolic BP

A

60-79 diastolic

229
Q

What is sims position

A

Resident lying on left side to straighten colon for rectal temp

CNA (10 decks)

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