Skills

Question 1

Hand Hygiene

Answer 1

1. Hello, and state skill
2. Turn on the water with a paper towel
3. Wet hand and wrist
4. Applies soap
5. Wash all surfaces of hand for 20 seconds
6. Wash fingers on each hand for 5 seconds
7. Rinse all surfaces and let water drip off hands
8. Dry tips of fingers first, then dry hands and wrist
9. Use a clean paper towel to turn off the faucet.

Question 2

Apply a knee high elastic stocking

Answer 2

1. Hello, state skill
2. Privacy
3. Wash hands.
4. Check to see if the client is in a supine position
5. Turn the stocking inside out to the heel
6. Place the foot of the stocking over the toes, foot, and heel
7. Pull the top of the stocking gently
8. Ensure there are no twists or wrinkles
9. Signal device, low bed position, undo privacy, wash, skill complete.

Question 3

Ambulate using a transfer belt

Answer 3

1. Hello, state skill.
2. Privacy, and washing hands
   3a. Locks bed wheels
   3b. Assist resident to the sitting position with legs over the edge of the bed.
3. Resident has feet flat on the floor (bed may need to be lowered).
4. Ensure the resident has non-slip shoes/foot-wear.
5. Apply the transfer belt securely.
6. Provide a signal to alert the resident to begin standing. (Count to 3).
7. Stand knee to knee and toe to toe.
8. Grasp both sides of transfer belt, count to three, help stand, and check to see if they are okay.
9. Hold the back of the strap and side while walking slightly behind and to one side.
10. Walk 10 steps and back.
11. Assist to bed and remove transfer belt.
12. Signal device, low bed position, undo privacy, wash, skill complete.

Question 4

Use bedpan

Answer 4

1. Hello, state skill.
2. Wash, privacy, wash, gloves
3. Ask the resident to roll over, place the bedpan, and then ask to roll onto the bedpan.
4. Remove gloves
5. Raise the head of the bed.
6. Provide hand wipes and toilet paper and signaling device. Allow privacy.
7. Wash and put on clean gloves.
8. Lower the head of the bed in order to remove the bedpan while keeping the resident covered.
9. Empty bed pan into the toilet. Rinse the bedpan and dump into toilet and dispose in designated area.
10. Remove gloves, wash hands, signal device, low bed position, undo privacy, wash, skill complete.

Question 5

Cleaning dentures

Answer 5

1. Hello, state skill.
2. Wash hands, put on gloves, and line the sink with paper towels.
3. Grab dentures and supplies
4. Rinse all sides of the lid and place on top of the paper towel.
5. Rinse all sides of the cup and fill halfway with moderate-temperature water.
6. Rinse all surfaces of the denture.
7. Without contaminating the toothpaste cap, apply toothpaste to the brush.
8. Brush all surfaces of the denture.
9. Rinse all surfaces of the denture and toothbrush. Return denture into the cup and brush to basin.
10. Return denture cup and basin to designated spots.
11. Remove sink liners.
12. Remove gloves, wash hands, skill complete.

Question 6

Help with dressing; client has affected (weak) right arm.

Answer 6

1. Hello, state skill.
2. Privacy, wash hands.
3. Ask which shirt they would like to wear.
4. Remove clothing from unaffected (L) side first, then remove the gown from the affected (R) side.
5. Dispose gown immediately.
6. Put garment on affected (R) side first, ask to sit up, pull garment over other side.
7. Make sure clothing is in place. Button if necessary.
8. Signal device, low bed position, undo privacy, wash, skill complete.

Question 7

Feeding a client who cannot feed self

Answer 7

1. Hello, state skill
2. Provide privacy, wash hands
3. Set up a feeding area with chairs, table, and dining plate.
4. Help client sit up, ask to swing legs over the bed and sit in the chair.
5. Verify resident matches the name card on the food tray.
6. Wash hands.
7. State the foods on tray and ask what they would like.
8. Feed one bite, and ask if they are ready for the next bite or drink.
9. Repeat 1-2 times.
10. Clean hands after meal.
11. Wipe face.
12. Explain they have to sit upright for 15-20 minutes to aid digestion.
13. Unprovide privacy, wash hands, call light, and check bed, skill complete.

Question 8

Modified bed bath.

Answer 8

1. Hello, state skill.
2. Provide privacy, wash hands.
3. Grab supplies: 3 large towels, 5 washcloths, a gown, water, and soap. The resident checks water temp.
4. Remove the soiled gown and dispose while providing cover.
5. Wash hands and put on gloves.
6. Set up a barrier for dirty wash cloths.
7. Wet washcloth.
   -Wash the eye area starting at the inner corner and going outward while using a different area of the washcloth each time.
   -Wash the face starting at the forehead, cheek nose, and chin. Repeat for each side.
8. Dry face with washcloth.
9. Expose one arm and place a barrier underneath it.
10. Use soapy wet wash cloth to wash:
    -Starting at the top of the shoulder; wash all the way down the top of the arm to the fingers.
    -Using the clean side of the wash cloth, wash starting at the armpit down to the fingers.
    -Using the other side of the wash cloth, wash the hands, fingers, between fingers, and finger nails.
11. Rinse all areas of the arm with wet cloth. Dry all areas with dry cloth.
12. Remove barrier.
13. Put on clean gown.
14. Empty, rinse, and dry basin. Dispose basin. Dispose linens. Check to see if sheets are wet. If so, change for infection control.
15. Remove gloves, wash hands, unprovide privacy, low bed position, signal device, skill complete.

Question 9

Urinary output.

Answer 9

1. Hello, state skill.
2. Wash hands, put on gloves.
3. Without spilling or splashing the contents of the bedpan, pour into the measuring container.
4. Rinse bedpan and pour into toilet.
5. Measure urine.
6. Empty into toilet and rinse.
7. Dispose of gloves, wash hands, record the measurement. Skill complete.

Question 10

Range of motion for ankle and knee

Answer 10

1. Hello, state skill.
2. Provide privacy, wash hands.
3. Resident is in a supine position. If pain is felt, the resident should inform the CNA.
4. Supporting the leg at knee and ankle, flex and extend leg 3 times. Ask if pain was felt.
5. Supporting the foot and ankle, practice dorsiflexion and plantar flexion 3 times. Ask if pain was felt.
6. Signal device, low bed position, undo privacy, wash, skill complete.

Question 11

Range of motion for one shoulder

Answer 11

1. Hello, state skill.
2. Provide privacy, wash hands.
3. Resident is in a supine position. If pain is felt, the resident should inform the CNA.
4. Supporting arm at elbow and wrist, practice extension and flexion 3 times. Ask if pain was felt.
5. Supporting arm at elbow and wrist, practice abduction and adduction 3 times. Ask if pain was felt.
6. Signal device, low bed position, undo privacy, wash, skill complete.

Question 12

Position on Side

Answer 12

1. Hello, state skill.
2. Provide privacy, wash hands. Grab 3 pillows
3. Raises side rail on bed.
4. Ask resident to roll over on side and place pillow behind back.
5. Place pillow between knees.
6. Provide pillow for shoulder support.
7. Adjust head pillow.
8. Signal device, low bed position, undo privacy, wash, skill complete.

Question 13

Provide catheter care

Answer 13

1. Hello, state skill.
2. Privacy, wash hands.
3. Supplies: 3 large towel, 3 wash cloths, water, soap. Check water temp.
4. Wash hands, put on gloves.
5. Linen protector under hips, barrier for dirty cloths.
6. Expose only the required area for cleaning.
7. Holding at the meatus without pulling/tugging, clean 4 inches away from the meatus using a new area of the washcloth. Wash, rinse, and dry.
8. Empty, rinse, and dry basin. Dispose dirty linens. Check to see if sheets are wet. If so, change for infection control.
9. Remove gloves, signal device, low bed position, undo privacy, wash, skill complete.

Question 14

Foot care

Answer 14

1. Hello, state skill.
2. Provide privacy, wash hands.
3. Supplies: 3 large towels, 4 washcloths, water, soap, lotion. Check water temp.
4. Wash hands, put on gloves.
5. Expose foot and ankle. Remove sock and place in shoe. Provide barrier under foot and on bed for dirty cloths.
6. Wash, starting at the top of the ankle and going towards the toes. Then, start at the heel and go towards the toes. Then, wash the toes, in between toes, and toenails. Repeat for rinsing and drying.
7. Ask if they’d like lotion.
8. Use a small amount of lotion.
9. Apply lotion in one direction starting at the top of the ankle and stopping at base of toes. Then, start at heel and stop at the base of the toes.
10. Use a wash cloth to wipe off excess lotion.
11. Empty, rinse, and dry basin. Remove dirty linens. If sheet is wet, change for infection control.
12. Remove gloves, signal device, low bed position, undo privacy, wash, skill complete.

Question 15

Provide perineal care.

Answer 15

1. Hello, state skill.
2. Privacy, wash hands.
3. Supplies: 3 large towels, 6 washcloths, water and soap. Check water temp.
4. Wash, put on gloves.
5. Expose the area that needs to be cleaned.
6. Wash genital area from front to back on each side of the genital and down the middle. Use a clean side of the cloth every time. Repeat for rinsing and drying.
7. Position resident on side. Wash genital area from front to back and up the buttocks from front to back. Use a clean side of the wash cloth every time. Repeat for rinsing and drying.
8. Remove barrier and place with dirty cloths.
9. Put away basin, rinse and dry it. Remove dirty linens. Check if sheets are wet. If so, replace for infection control.
10. Remove gloves, signal device, low bed position, undo privacy, wash, skill complete.

Question 16

Transfer from bed to wheelchair

Answer 16

1. Hello, state skill.
2. Provide privacy, wash hands.
3. Get wheelchair and place it facing the head of the bed. Lock wheels and move foot rests.
4. Assist resident in sitting up and swinging their legs over the edge of bed.
5. Lower bed so that their feet lay flat on the floor. Provide non skid foot wear.
6. Apply gait belt. Stand knee to knee and toe to toe, and state that on the count of three we will stand. Grip the sides of the belt,
7. Check to see if they are okay.
8. Lead the resident towards the wheelchair until the back of their knees touch the edge of the seat.
9. If possible, resident can reach behind to grab the arm rests as they sit down.
10. Verify that their hips are touching the back of the wheel chair and their feet is on the foot rests. Remove gait belt. Undo brakes
11. Position resident towards TV. Signal device, low bed position, undo privacy, wash, skill complete.