NAB Review Care, Services, Supports 1 Flashcards
What NORMAL aging process include muscle loss, skin texture changes, bruise easily, lose taste buds, sense of smell lessens, problems with balance.
Physical Aging Process
What aging process includes Parkinson’s, Alzheimer’s , strokes, Glaucoma, hallucinations, incontinence, arthritis, macular degeneration, and prostate diseases, AND DEMENSIA.
Abnormal aging process.
What is Preadmission Screening and Resident Review (PASRR)?
PASRR is a federal requirement to help ensure that individuals are not inappropriately placed in nursing homes for long term care.
What are the PASRR requirements?
- All applicants to a Medicaid certified nursing facility must be evaluated for mental illness and/or intellectual disabled.
- Be offered the most appropriate setting for their needs (in the community, a nursing facility, or acute care setting).
- Received the services they need in those settings.
What is a Resident Assessment?
- A comprehensive, accurate, standardized reproducible assessment of each resident functional capacity.
What areas must a Resident Assessment cover?
Assessment areas include an assessment of the resident’s ability to perform ADL ‘s, communication skills, vision, psychological well-being, among others.
A facility must maintain all resident assessments completed within the previous ________ in the resident’s active record?
15 Months.
Facility must complete and electronically submit residents assessments within _______?
14 Days
Resident Assessments must be certified by whom?
An RN also referred to as the RNAC (registered nurse assessment coordinator)
When is a Resident Assessment done?
- No later than 14 days after admission
- After significant change
- Annually
- Quarterly reviews.
- 21 days
What is considered a Significant Change?
- A deterioration of two or more ADL’s, in cognitive abilities, or communication that appears permeant.
- Loss of ambulation or use of hands to grasp small object to feed or groom.
- Deterioration in mood or behavior to the point where daily problems arise, or relationship problems develop.
- Deterioration of health status.
- Improvement to point where care is no longer needed.
What is an Insignificant change (short term)? What are some examples?
Decline that does not require reassessment.
- Drug effect
- Re-dosage level
- Colds
- Symptoms associated with previous diagnosis.
- Steady progress requires assessment when stabilized.
What is a Baseline Care Plan? When must they be done?
Instructions needed to provide effective and person-centered care of the resident that meet professional standards of quality of care.
WITHIN 48 HOURS OF ADMISSION.
What are the Late Lost ADL’s?
- Transfer
- Bed Mobility
- Toileting
- Eating
What is an Acute disease? What’s an example?
Rapid onset disease that’s curable with proper treatment.
e.g. Flu, pneumonia, UTI, and acute myocardial infarction.
What is a Chronic disease? What’s an example?
A disease that develop over time, can be treated but not cured.
e.g. Alzheimer’s, Diabetes, COPD
How does CMS define falls?
An episode where a resident lost his or her balance and would have fallen if not for staff intervention.
A fall without injury is still a fall
Unless there is evidence suggesting otherwise, when a resident is found on the floor, a fall has occurred.
CMS gives residents the right to fall.
What is Medication Control?
Is primarily for protection of resident-also to prevent illicit use, and to meet government regulations.
What are the 2 primary roles of a NH Pharmacist?
- Review each drug regimen at least monthly
- Consult on overall medications programs.
CAN ALSO REPORT IRREGULARITIES TO THE ATTENDING PHYSICIAN, MEDICAL DIRECTOR, AND DON.
When a prescriptions has B.I.D?
Twice Daily
When a prescriptions has T.I.D
Three Times Daily
When a prescriptions has Q.I.D?
Four times daily
Who typically prescribes meds in a NH?
Medical Director
Doctor of Osteopathic Medicine
Nurse Practitioner
Physician Assistant
Registered Dietitians can prescribe therapeutic diet orders but only if?
The attending physician deems and the state permits it.
Who can DISPENSE drugs in a NH?
Pharmacist!
Dispensing-Placing two or more doses in separate container and labeling
Medication Error must not be more than ____?
5%
What is considered a Significant Medication Error?
Causes resident discomfort or jeopardizes health and safety.
What is the formula to calculate Med Error Rate?
of Errors/# of opportunities = Error Rate
100 Residents
5 Errors
5/100 = .05
.05 x 100= 5%
What is Tardive Dyskinesia?
Prolonged use of anti-psychotic drugs
Head jerking, loss of control of tongue.
ALSO REFERED TO AS FLYCATCHER TONGUE
For how long are PRN anti-psychotic orders good for?
14 days
Medicaid typically only pays for what kind of drugs?
Generic drugs.
When does Discharge Planning begin?
Upon admission
Discharge summaries must include?
- A recapitulation of the resident’s entire stay
- A final summary of the resident’s status
- Contain a post discharge plan of care, developed with the participation of the resident.
AND WITH THE RESIDENT’S CONSENT, THE RESIDENT REPRESENTATIVE which will assist the resident to adjust to his/her new living environment.
Who approves the Emergency Drug Kit (EDK)?
Approved by state board of pharmacy
Who uses a Crash Cart?
Both nurses and MD
Who determines which medications are in the EDK? NOT APPROVED BY.
Medical Director, DON, and pharmacist collaborate.
Major cause of dizziness and is one of the major cause of falls?
Vertigo
BDA?
Benign Disequilibrium of Aging.
What is a physical restraint?
Any manual method or physical or mechanical device, material, or equipment attached or adjacent to the resident’s body that the individual cannot remove easily.
When do you use a restraint?
Only to control harmful behavior, never for convenience, discipline, or when necessary for treatment.
Monitoring procedures for restraints?
Monitor every 30 minutes. Release for 10 mins every 2 hours.
Inventory on hand for dietary?
Three (3) days supply of perishables.
Seven (7) days of staples.
Weight Loss Formula?
% loss = Usual weight - actual weight / usual weight
Usual weight-110
Actual weight-100
110-100/110 = .09
9%
Significant weight loss for 1 month?
5%
SEVERE weight loss for 1 month?
Greater than 5%
SIGNIFICANT weight loss 3 months?
7.5%
SEVERE weight loss 3 months?
Greater than 7.5%
SIGNIFICANT weight loss 6 months?
10%
SEVERE weight loss 6 months?
Greater than 10%
Cost of Raw Food formula?
Total cost/# of residents days.
Cost = $15,000
100 residents x 30 days = 3,000
$15,000/3,000 = $5.00 ppd.
