modules 3,12,14 Flashcards
Define verbal communication.
Expressing ideas or information through speech
What is nonverbal communication?
Expressing ideas or emotions through body language and facial expressions
What does therapeutic communication combine?
Active listening and acknowledging feelings
What is active listening?
Truly hearing what the other person is saying
What is empathy in communication?
Having compassion and understanding for others around you
List techniques for therapeutic communication.
- Maintain eye contact
- Have positive body language
- Paraphrase or summarize message from the sender
- Pay attention to sender’s nonverbal communication
- Be open to suggestions
- Use ‘I’ statements instead of ‘you’ statements
- Brainstorm ideas to improve or avoid difficult situations
- Ask supervisor to intervene if needed
What is a communication disorder?
A speech or language problem that results in impaired interactions with others
Differentiate between congenital and acquired communication disorders.
- Congenital: the resident is born with the disorder
- Acquired: the disorder develops sometime during the resident’s lifetime
Name strategies to improve communication with hearing-impaired residents.
- Speak clearly
- Ensure resident can see your face
- Speak at eye level with the resident
- Speak in a normal or low, not high, pitch
- Allow time for resident to read lips
- Use whiteboard or tablet to write down messages
What is expressive aphasia?
Inability to speak or to speak clearly
What is receptive aphasia?
Inability to understand spoken language
List interventions to improve communication with the speech-impaired resident.
- Picture boards
- Personal computer
- Break up tasks into small steps
- Speak in a respectful tone at a comfortable level for the resident
- Demonstrate task to be completed
What should be avoided when communicating with vision-impaired residents?
Changing placement of furniture/objects in the room
Describe emotional communication deficit.
Occurs when the resident does not understand nonverbal messages
What is a common example of emotional communication deficit?
Autism
What are defense mechanisms in communication?
Psychological strategies used to cope with reality and maintain self-image
Define denial in the context of defense mechanisms.
When a person refuses to accept or experience a situation
What is projection in communication?
When a person attributes feelings or thoughts to another person
What is repression in communication?
When the unconscious brain ignores thoughts or situations to protect itself
What should be done if a situation becomes dangerous with defense mechinaism?
Stay calm, listen, only allow one person to speak at a time, do not use personal attacks, stop any verbal abuse
Define ethnicity and culture
The national, racial, or cultural group a person belongs to
- a set of traidions and attitude that are share within a group of people
What is cultural competence?
Ability to see past differences and look at each resident as a unique person with unique needs
What is social awareness?
Being sensitive to diversity, equity, and inclusion
How can a nursing assistant support a resident’s positive outlook?
- Encouraging independence
- Meeting the resident’s needs with a kind and supportive attitude
- Reporting findings of sadness or hopelessness to the nurse
- Talking with residents about their strengths
- Helping residents talk about how it might look or feel once their symptoms are controlled
What are signs of distress? Objective (can measure)
- Excessive bleeding
- Decreased or rapid respirations
- Decreased or rapid heart rate
- Decreased or elevated blood pressure
- Nonresponsiveness
- Altered mental state
What are symptoms of distress? subjective ( cannot measure)
- Difficulty breathing
- Feeling of the throat closing
- Chest pain or pressure
- Numbness or tingling in the face, lips, or extremities
- Nausea
- Visual disturbances
What is partial (mild) airway obstruction?
Some air exchange is occurring; encourage resident to cough
What is complete airway obstruction?
Little to no air exchange; activate EMS immediately
high pitched wheezing sound
obtain consent for intervention
perform abdominal thrusts or use five and five approach
if they are pregnant/obsess thrust over the sternum
What is cardiac arrest?
Heart is unable to contract and pump blood throughout the body
- may be a result of heart attack, trauma, choking, drowning, or overdose
What is syncope (fainting)?
Temporary and sudden loss of consciousness
usually due to decreased level of oxygen in brain
Resident may feel shaky/weak, have clammy skin, report visual disturbances
List possible causes of syncope.
- Low blood volume
- Orthostatic hypotension
- Cardiac arrhythmias
- Low blood sugar
- Respiratory disease
- Straining to have a BM
- Fasting
- Pregnancy
- Fear
- High-intensity exercise
- Hyperventilation
- Anxiety
What should you do if a resident faints?
Assist them to a safe position, activate EMS, have nurse assess resident promptly
What are seizures?
Disrupted electrical activity in the brain May be result of high fever, brain tumors,
medications, previous brain injury, or drug and alcohol use
* Most occur without known cause
* Some residents experience an aura or have seizure
in response to a trigger
* Symptoms vary depending on type of seizure
What is status epilepticus?
Life-threatening seizure lasting longer than 5 minutes
What are signs of hemorrhage?
Internal: Blood in urine or feces
* Bruising
* Distended abdomen
* Black Tarry stools
External:
Aterial bleeding is bright red and may spurt
venous bleeding flows steadily and is darker red
How to treat nosebleeds?
Have resident lean forward, pinch nostrils, and breathe through nose for 10 to 15 minutes
Define shock in medical terms.
Disruption of cardiovascular system where heart does not pump blood effectively
body doesn’t not receive adequate oxygen
What are the types of shock?
Cardiogenic: heart cannot pump blood effectively- Myocardial infraction
Anaphylactic: all blood vessels dilate uncontrollably: allergic reaction
Hypovolemic: extreme blood loss: gun shot wond
What are responsibilities when treating shock?
- Activate EMS immediately
- Assist resident to lying position with legs elevated
- Cover resident with blanket
- Obtain vital signs
- Report to nurse or EMS
What are the three types of burns?
- Superficial: epidermis is involved
- Partial thickness: epidermis and dermis
- Full-thickness: epidermis, dermis, subcutaneous, may not hurt as first, requires surgery and rehab
What are signs and symptoms of poisoning?
- Nausea and vomiting
- Reddened areas or burns around mouth
- Chemical smell on breath
List risk factors for falling.
- Medication use
- Orthostatic hypotension
- Loss of vision
- Loss of hearing
- Fatigue
- Weakness and muscle atrophy
- Loss of balance
- A new illness
What to do after a fall?
- Remain with resident
- Provide emotional support
- Follow nurse directives regarding vital signs or transferring resident
restraint guidelines and checking on PT
Check resident’s 15 min
release restraint every 2 hour
fasten with a quick release knot
remove at mealtime
- check areas where restraint is appiled
ask if they experienced pain
look for color, warmth, function, and circulation
Look for color, warmth, sensation, function, and circulation.
What are some physical risks associated with restraint use?
- Increased dependency
- Decreased mobility
- Bowel and bladder incontinence
- Muscle soreness and atrophy
- Pressure injury
- Respiratory infections
- Constipation and/or fecal impaction
- Urinary tract infections
- Falls and death
What are the types of restraints mentioned?
- Physical
- Chemical
- Environmental
Fill in the blank: Alarm systems are used for residents at risk of _______.
[falling]
What are some interventions to reduce the risk of fall injuries?
- Wipe up spills promptly
- Install nonskid strips
- Assist resident in daily exercise
- Install grab bars
- Ensure vision and hearing aids are used
True or False: Alarm systems are considered fall prevention strategies.
False
Alarm systems alert staff but do not prevent falls.
What is the purpose of therapy services in nursing?
To help residents restore prior ability or maximize potential
Main types include physical, occupational, and speech therapy.
What does physical therapy focus on?
Improving gross motor skills for ADLs
Climbing stairs, walking
May treat resident recovering from stroke, surgery or injury
Skills may include climbing stairs, walking, and fall prevention.
What should be done when releasing a restraint?
- Offer to assist resident to the toilet
- Perform range-of-motion exercises
- Reposition resident
- Offer food and fluids
- Encourage resident to socialize
What is the effect of regular movement on the cardiovascular system?
Helps keep heart strong and working effectively
Decreases swelling in lower legs and pumps excess fluid back to heart.
What is the definition of flexion in range-of-motion exercises?
Decreasing the angle of the joint
What is the recommended duration for applying hot or cold therapies?
10 to 15 minutes
Avoid direct skin contact to prevent burns or frostbite.
What is restorative care?
Activity that maintains resident’s level of ability
Promoting independence with all ADLs is an important goal.
What should be done if a resident experiences pain during range-of-motion exercises?
Stop the exercise and inform the nurse
caring for a resident with an emotional deficit
- be literal; do not joke or use slang
speak clear and concisely
maintain routines
tell the resident what to expect
go slow
Absence seizures
only small part of brain is affected
person remains conscious
last only a couple of seconds
resident may stare off into space. be moving extremities repetitively, or have aphasia
Generalized seziure - grand tonic clonic
large part of brain affected
person loses consciousness, collapses, shakes uncontrollably
- loss of bowel or bladder
- injury may occur from fall
responsibilities during seizure
Activate EMS immediately if seizure
lasts more than 2 minutes
* Note start and end time of seizure
* Assist resident to a safe place
* Remove any objects resident may
strike
* Place resident in recovery position if
they vomit
* Do not place anything in resident’s
mouth
* Do not restrain resident
* Report all seizures to nurse or
superviso
responsibilities after seizure
Place resident in recovery position until able to
move
* Assist resident with hygiene and fresh clothing
* Take vital signs
* Provide quiet environment for sleep
* Allow resident to sleep as much as needed
if resident is bleeding
Ensure scene is safe
* Don gloves and any PPE required
* Cover wound with clean absorbent material
* Keep firm pressure on wound
* Place more material over top of saturated dressing
* If bleeding does not slow, apply pressure to artery above wound
* Maintain pressure until EMS takes over
* Complete any directives from the nurse or EMS
shocks signs and symptoms
rapid pulse
cool/clammy skin
low BP
increased respiration and anxiety
nausea and vomiting
altered mental state
burns responsibilities
Activate EMS
* Ensure area is safe before approaching
resident
* Don gloves
* Cleanse skin or remove clothing as needed
* Cover burn with moistened sterile dressing
* Keep resident comfortable
* Obtain vital signs
* Report to nurse
* Follow any directives from nurse or EMS
if resident is seriously injured from fall
they must remain on floor until EMS arrives
take vital signs
follow directives of nurse and EMS
occupational therpay
rehab of fine motor skills
consist of retraining to perform ADL and IADLs
skills may includes bathing cooking
cane
place cane in residents strong or unaffected hand
stand on residents affecte side while ambulating
why we move digestive system
increases motility in gut
decreases risk of constipation
help prevent or abdominal bloating and gas
why we move cardio sys
keeps heart strong and working effectively
decrease swelling in lower leg
pump excess fluid back to heart
decreases risk of blood clot
why we move integumentary sys
decreases risk pf pressure injuries
increases blood flow to tissues
helps skin stays healthy and repair itself
musculosketeal sys
maintain muscle tone
improves balance
keeps joints flexible
increase/ maintain ROM
prevents contractures and atrophy
AROM and PROM
AROM: resident actively participates in exercises and moving joint
PROM: nursing assistant moves pt
when performing ROM
Ask resident to tell you if anything hurts during
exercises
* Support joint with your hands
* Move slowly and smoothly
* Do not go past point of resistance
* If resident experiences pain, stop and inform
nurse
* Follow care plan for specific directives
Flexion/ Extension
Flexion: decreasing angle of joint
Extension: increasing the angle of joint
Hyperextension
moving joint posterior to anatomical position
planter/dorsiflexion
Plantar: pointing toes down
Dorsi: pointing toes upward
abduction/ adduction
abduction: moving away from midline
adduction: moving toward midline
