Unit 1 Flashcards

Chapters 1-4

1
Q

Providers

A

People or organizations that provide healthcare

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2
Q

Facilities

A

Places where care is delivered or administered

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3
Q

Payers

A

people or organizations paying for healthcare services

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4
Q

Long-term care

A

given in longterm facilities for people who need 24 hour skilled care

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5
Q

Skilled care

A

medically necessary care given by a skilled nurse or therapist; available 24 hours a day

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6
Q

Home healthcare

A

Provided in a persons home

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7
Q

Diagnosis

A

medical condition determined by a doctor

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8
Q

Assisted living facilities

A

Places for people who need some help with daily care (showering, meals, dressing)

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9
Q

Adult day services

A

for people who need some assistance and supervision during certain hours, but do not live in the facility where care is provided.
- break for spouses

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10
Q

Subacute care

A

care given in hospitals or long-term care facilities; used for people who need less care than for acute, but more care than for a chronic illness

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11
Q

Outpatient care

A

usually given to people who have had treatments, procedures, or surgeries, and need short-term skilled care. Do not require an overnight stay.

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12
Q

Rehabilitation

A

care given by specialists. Physical, occupational and speech therapists help restore or improve function after illness or injury.

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13
Q

Hospice care

A

given in facilities or homes for people who have approximately 6 months or less to live.

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14
Q

What do hospice workers do?

A

They give physical and emotional care and comfort until a person dies.

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15
Q

Catheters

A

thin tubes inserted into the body to drain or inject fluids.

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16
Q

Policy

A

A course of action that should be taken every time a certain situation occurs.

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17
Q

Procedure

A

A method, or way, of doing something.

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18
Q

To cite

A

to find a problem through a survey

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19
Q

Joint commision

A

an independent, not-for-profit organization that evaluates and accredits healthcare organizations.

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20
Q

Medicare

A

a federal health insurance program established in 1965 for people who are 65 or older

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21
Q

medicaid

A

a medical assistance program for people who have low income, as well as for people with disabilities.

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22
Q

Who is medicaid funded by

A

federal gov. and each state

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23
Q

Culture change

A

The process of transforming services for elders so that they are based on the values and practices of the person receiving care

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24
Q

Person centered care

A

emphasizes the individuality of the person who needs care and recognizes and develops his/her capabilities

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25
Q

List 5 services that are offered at long-term care facilities

A
  1. Wound care
  2. Rehab/therapies
  3. Cathedar care
  4. Nutrition care
  5. Management of chronic diseases
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26
Q

What are two general categories of residents who stay in a care facility for less than 6 months?

A
  1. Subacute

2. Terminal

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27
Q

List 4 common policies at longterm care facilities

A

a. confidentiality
b. only do things assigned
c. dependable
d. arrive to work on time

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28
Q

When surveyors visit a facility, what do they study and observe?

A

quality of care

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29
Q

HMOs (health maintenance organizations)

A

a health plan that states that customers must use a particular doctor or group of doctors

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30
Q

PPOs (preferred provider organizations)

A

A network of providers that contract to provide health services to a group of people

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31
Q

What is the goal of the Joint Commission’s survey process?

A

To improve safety and quality of care

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32
Q

How is eligibility for medicaid determined

A

Determined by income and special circumstances; people must qualify

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33
Q

Activities Director

A

Plans activities to help residents socialize and stay mentally and physically active

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34
Q

Licensed Practical Nurse (LPN) or Licensed Vocational Nurse (LVN)

A

Licensed professional who has completed one to two years of education and is able to administer medications and give treatments

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35
Q

Medical Social Worker (MSW)

A

Helps residents get support services, such as counseling.

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36
Q

Nursing Assistant (NA or CNA)

A

Performs assigned tasks, such as measuring vital signs, providing personal care, and reporting observations to other care team members.

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37
Q

Occupational Therapist (OT)

A

Helps residents learn to adapt to diabilities by training them to perform ADL and other activities

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38
Q

Physical Therapist (PT or DPT)

A

Develops a treatment plan to increase movement, improve circulation, promote healing, reduce pain, prevent disability and regain mobility.

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39
Q

Physician or Doctor (MD or DO)

A

Diagnoses disease or disability and prescribes treatment

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40
Q

Registered Dietician (RDT)

A

Assesses a resident’s nutritional status and develops a treatment plan that may include creating special diets

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41
Q

Registered Nurse (RN)

A

Coordinates, manages, and provides skilled nursing care, as well as supervises nursing assistants’ daily care of residents.

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42
Q

Resident

A

Person whose condition, goals, priorities, treatment, and progress are the focus of the care team

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43
Q

Speech Language Pathologist (SLP)

A

Identifies communication disorders and creates a care plan, as well as teaches exercises to help the residents improve or overcome speech problems

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44
Q

Professional

A

having to do with work or a job

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45
Q

Personal

A

life outside a job

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46
Q

Professionalism

A

behaving properly when on the job

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47
Q

Compassionate

A

being caring, concerned, considerate, empathetic and understanding

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48
Q

Empathy

A

identifying with feelings of others

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49
Q

Sympathy

A

sharing in the feelings and difficulties of others

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50
Q

honest

A

tells the trust and can be trusted

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51
Q

Tactful

A

showing sensitivity and having a sense of what is appropriate when dealing with others; ability to speak and act without offending others

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52
Q

Conscienctious

A

when you try to do your best; guided by a sense of right and wrong

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53
Q

Dependable

A

to make and keep commitments

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54
Q

Patient

A

to not lose temper easily

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55
Q

Respectful

A

valuing other peoples individuality, including their age, religion, culture, feelings, practices, and beliefs.

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56
Q

Unprejudiced

A

giving someone the same quality of care regardless of age, gender, sexual orientation, religion, race, ethnicity, or condition

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57
Q

Tolerant

A

respecting others beliefs and practices and not judging them

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58
Q

liability

A

legal term that states that someone can be held responsible for harming someone else

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59
Q

Scope of practice

A

The tasks that healthcare providers are legally allowed to do as permitted by state or federal law.

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60
Q

What are the 5 steps in the nursing process? Describe each step

A
  1. Assessment: getting information from many sources, including medical history, physical assessment, and environment, and reviewing this information
  2. Diagnosis: identifying health problems after looking at all the residents needs.
  3. Planning: setting goals and creating a care plan in accordance with the resident’s preferences to meet the resident’s needs
  4. Implementation: putting the care plan into action, giving care
  5. Evaluation: a careful examination to see if the goals were met or progress was achieved.
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61
Q

What is the purpose of the assessment stage of the nursing process?

A

The purpose is to identify actual or potential problems

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62
Q

Delegation

A

transferring responsibility to a person for a specific task

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63
Q

What are the 5 rights of delegation

A
  1. Right task
  2. Right Circumstance
  3. Right person
  4. Right direction/communication
  5. Right Supervision/Evaluation
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64
Q

What are the 5 steps in managing time?

A
  1. Plan ahead
  2. Prioritize
  3. Make a schedule
  4. Combine activities
  5. Get help
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65
Q

What are some duties that NA can not perform

A
  1. insert/remove tubes
  2. give tube feedings
  3. change sterile dressings
  4. administer medication
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66
Q

Why should you avoid wearing artificial nails?

A

They harbor bacteria and they could scratch the resident

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67
Q

What are 3 factors considered when formulating a care plan?

A
  1. The residents goals, priorities, or expectations
  2. The residents health and physical conditions
  3. The residents diagnosis and treatment
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68
Q

Why is the chain of command important?

A

It describes the line of authority and it protects employees and employers from liability

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69
Q

The goal of the nursing process is what?

A

To plan and evaluate the residents care

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70
Q

Ethics

A

the knowledge of right and wrong; tells someone

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71
Q

Laws

A

Tells someone what they must do; laws are based on ethics

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72
Q

The Omnibus Budget Reconciliation Act (OBRA) sets minimum standards for who

A

Nursing assistant training

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73
Q

According to OBRA, nursing assistants must complete at least _____ hours of training and pass a competency evaluation before they can be employed

A

75 hours

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74
Q

Which of the following topics is required by OBRA to be covered during NA training?

A

Promoting patients legal rights

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75
Q

The Minimum Data Set (MDS) is a form for…?

A

Assessing residents and solving resident problems

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76
Q

How often must MDS be completed for each resident?

A

Any time there is a major change in a resident’s condition

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77
Q

Residents Rights

A

Specify how residents must be treated while in a facility

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78
Q

Informed Consent

A

The process by which a person, with the help of a doctor, makes informed decisions about his/her health

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79
Q

Abuse

A

Purposeful mistreatment that causes physical, mental, or emotional pain or injury to someone

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80
Q

Active Neglect

A

The purposeful failure to give needed care, resulting in hard to a person

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81
Q

Assault

A

A threat resulting in a person feeling fearful that he or she will be harmed

82
Q

Battery

A

The intentional touching of a person without their consent

83
Q

Domestic violence

A

Physical, sexual, or emotional abuse by spouses, intimate partners, or family members

84
Q

False imprisonment

A

Unlawful restraint that affects a person’s freedom of movement

85
Q

Financial abuse

A

The improper or illegal use of a persons money, possession, property, or other assets

86
Q

involuntary seclusion

A

The separation of a person from others against the persons will

87
Q

Malpractice

A

injury caused by professional misconduct through negligence, carelessness, or lack of skill

88
Q

Neglect

A

The failure to provide needed care that results in physical, mental, or emotional harm to a person

89
Q

Negligence

A

Actions, or failure to act or provide proper care, resulting in unintended injury to a person.

90
Q

Passive neglect

A

the unintentional failure to provide needed care, resulting in physical, mental, or emotional harm to a person.

91
Q

physical abuse

A

Any treatment, intentional or unintentional, that causes harm to a persons body

92
Q

psychological abuse

A

emotional harm caused by threatening, scaring, humiliating, intimidating, isolating, or insulting a person, or by treating them like a child.

93
Q

sexual abuse

A

the forcing of a person to perform/participate in sexual acts

94
Q

sexual harassment

A

any unwelcome sexual advance/behavior that creates and intimidating, hostile, or offensive work environment

95
Q

Substance abuse

A

the repeated use of legal or illegal drugs, cigarettes, or alcohol in a way that harms oneself or others

96
Q

Verbal abuse

A

The use of spoken/written words, pictures or gestures that threaten, embarrass, or insult a person

97
Q

Workplace violence

A

verbal, physical or sexual abuse of staff by staff members or residents.

98
Q

if a resident wants to make a complaint of abuse, what must an NA do?

A

help them in any way possible

99
Q

One task of an ombudsman

A

investigate and resolve resident complaints

100
Q

an ombudsman is assigned by the law as the _____ advocate for the residents

A

legal

101
Q

ombudsman are in facilities to assist and support who

A

residents

102
Q

what is some information included under the protected health information (PHI)

A

SS number, address, phone #, DOB

103
Q

The abbreviation for the law that was enacted as part of the American Recovery and Reinvestment Act of 2009 to expand the protection and security of consumer’s electronic health records (EHR) is called

A

HITECH

104
Q

Advance directives

A

legal documents that allow people to choose what medical care they wish to have if they cannot make those decisions themselves.

105
Q

Durable power of attorney for health

A

A signed, dated, and witnessed legal document that appoints someone else to make medical decisions for a person in the event that he or she is unable to do so.

106
Q

Do not resuscitate (DNR) order

A

A medical order that instructs medical professionals not to perform CRP if breathing/heartbeat stops

107
Q

living will

A

Outlines the medical care that a person wants, or does not want, in case they become unable to make those decisions

108
Q

Living will may also be called

A

medical directive or directive to physician

109
Q

Physician Orders for Life Sustaining Treatment (POLST)

A

Medical order that specifies treatment a person wants when they are very ill decisions are based on conversations with healthcare providers

110
Q

what are the 3 basic steps of communication

A

send, receive, feedback

111
Q

Who must an NA be able to communicate with?

A

everyone

112
Q

the 3 steps of communication occurs how often

A

over and over

113
Q

One way for the NA to be a good listener is to

A

restate the message in her own words

114
Q

Active listening involves

A

focusing on the sending and giving feedback

115
Q

Communication

A

The process of exchanging information with others

116
Q

Verbal communication

A

involved the use of words, spoken or written language

117
Q

nonverbal communication

A

communicating without using words

118
Q

Cultural diversity

A

refers to different groups of people with varied backgrounds and experiences living together in the world

119
Q

Bias

A

prejudice

120
Q

Culture

A

a system of learn beliefs and behaviors that is practiced by a group of people

121
Q

Cliche

A

phrases that are used over and over again and do not really mean anything

122
Q

Objective information

A

based on what a person sees, hears, touches or smells; collected by using senses

  • signs
123
Q

Subjective information

A

something a person cannot or did not observe, but is based on something that the resident reported; may or may not be true

  • symptoms
124
Q

Incontinence

A

the inability to control the bladder or bowels

125
Q

Cyanoic

A

skin that is blue or grey

126
Q

The root “derm” or “derma”

A

skin

127
Q

brady-

A

slow

128
Q

-itis

A

inflammation

129
Q

The root “cardia”

A

heart

130
Q

-pathy

A

disease

131
Q

the root “neuro”

A

nerve or nervous system

132
Q

incident

A

an accident, problem, or unexpected event during the course of care

133
Q

impairment

A

loss of function or ability; it can partial or complete loss

134
Q

Farsightedness

A

the ability to see objects in the distance better than objects nearby

135
Q

hyperopia

A

farsightedness

136
Q

Nearsightedness

A

the ability to see things near but not far

137
Q

myopia

A

nearsightedness

138
Q

Cerebrovascular accident (CVA)

A

stroke; occurs when blood supply to a part of the brain is blocked or a blood vessel leaks or ruptures within the brain

139
Q

most common type of stroke

A

ischemic stroke

140
Q

hemiplegia

A

paralysis on one side of the body

141
Q

hemiparesis

A

weakness on one side of the body

142
Q

tendency to ignore one side of the body

A

one-sided neglect

143
Q

expressive aphasia

A

trouble communicating thoughts through speech or writing

144
Q

receptive aphasia

A

difficulty understanding spoken or written words

145
Q

Emotional lability

A

inappropriate or unspoken emotional responses

146
Q

What are some examples of emotional lability

A

laughing, crying, anger

147
Q

Dysphagia

A

difficulty swallowing

148
Q

combative

A

violent or hostile behavior

149
Q

Examples of combative behaviors

A

hitting, kicking, pushing, verbal attacks

150
Q

What is one positive response to cultural diversity?

A

learn about the culture

151
Q

why should “why” questions be avoided when talking with residents

A

they may feel defensive

152
Q

if the resident speaks a different language than the NA, what can the NA do

A

get a translator or ask the resident if a friend or family can translate

153
Q

what is one way to provide positive feedback while listening

A

nodding, eye contact

154
Q

What can silence or pauses help a resident do ?

A

gather thoughts

155
Q

When making an oral report, should the NA use facts or opinions

A

facts

156
Q

when should care be documented

A

right after it is completed

157
Q

give 2 reasons that a computer may be used in a facility

A

documentation, research

158
Q

When a resident has a hearing impairment, on whose face should the light be shining while communicating?

A

the NA

159
Q

How can a NA explain the position of objected in front of a resident who is visually impaired

A

clock system

160
Q

how should questions be phrased to residents who had a stroke

A

yes/no

161
Q

how should a NA refer to the weaker side of resident who has had a stroke

A

affected/involved side

162
Q

what should a NA always do after a resident behaves inappropriately

A

report it

163
Q

DCW registry stands for

A

direct care worker registry

164
Q

DIA

A

Department of inspections and appeals

165
Q

To remain active on DCW registry:

A
  1. Work in a LTC setting at least 8 hour consecutive paid hours in 24 months
  2. You are responsible to keep personal info updated
166
Q

What is the level of organization for workers at a place like a LTC facility

A
  1. resident
  2. rehab aide, CNA, med aide
  3. LPN, RN, ADON, DON
  4. Administrator, Medical director
167
Q

What are 3 important components in the healthcare system?

A
  1. Provider: people/organization that provides care
  2. Facilities: where the care is provided
  3. Payer: health insurance company
168
Q

Late adulthood

A

60 and up

169
Q

Erickson’s developmental tasks: integrity vs. despair

A
  • late adulthood
  • understand and accept the meaning of temporary life
  • or complains about regrets, not having enough time, and not finding a meaning throughout life
  • questions ones overview of their entire life
170
Q

Developmental tasks of the elderly

A

Level of functional capacity, both physical and emotional

  • dependent (nurse/NA need to be there)
  • assistive (nurse/NA should be present)
  • independent (nurse/NA does not need to be there)
171
Q

Activities promoting quality of life

A

a. Promote Health / prevent illness
b. DX & TX
c. Physical and emotional care
- dignity/individuality
d. Maintain independence
e. Safe and therapeutic environment
- home-like atmosphere

172
Q

Resident centered care

A

a. choice in care (who doc. is)
b. know your resident
c. personalized care
d. relationships
e. recognize “culture care”
- change in residents attitude
- change of care giver’s attitude
- change in societies attitude toward aging
f. recognize individual needs and wants

173
Q

changes in skin

A
  • hair thinning
  • skin dryness/wrinkles/loss of natural oils
  • thickening of finger and toe nails
  • thinning of skin layers
  • skin tears
174
Q

Thinning of skin layers –>

A

pressure sores

175
Q

skin tears –>

A

infections

176
Q

Why is there a loss of natural oils in older adults?

A

older people do not have sebaceous glands

177
Q

Changes in bone in muscle

A
  • loss of muscle, tone and strength
  • decrease in flexibility/loss of dexterity
  • bones become brittle
  • decrease balance
  • degeneration of joint/spine
178
Q

Changes in nervous system

A
  • decreased sense of taste, hearing and vision
  • visual field increases, decrease adaptability
  • decrease in pain threshold/sensitivity
  • increase in memory; better recall of past
179
Q

Digestive system changes

A
  • tooth loss; chewing problems
  • problems swallowing
  • slowed digestion –> constipation
  • food intolerances
180
Q

heart and lung changes

A
  • BLD vessels narrow; fragile
  • decreased strength and output of heart
  • high BP
  • decreased lung capacity –> respiratory infections
181
Q

Benefits of a nursing facility

A
  • health maintenance
  • restorative/rehabilitative services
  • skilled care
  • safety
  • socialization
  • respite and peace of mind for family
  • hospice
  • 24 hour care
182
Q

OBRA

A
  • promotes quality of life
  • must meet ind. interests and needs
  • must promote personal choice
  • residents must be allowed to take part in a variety of activities
183
Q

Types of activities at a nursing home

A
  • music
  • exercise
  • parties
  • field trips
  • craft groups
  • games
  • pet therapy
184
Q

NA roles in assisting with activities

A
  • help with care planning
  • encourage participation
  • help get resident to activity
  • assist with activity as per facility protocol
185
Q

What changes should a NA look out for

A
  • emotional/social/spiritual changes
  • physical/mental
  • behavioral
186
Q

What should a NA record / report

A
  • any changes
  • pain
  • I & O, Wt, Ht, stools, urine
  • anything unusual
187
Q

NA not perform

A
  • any skill of task not included in the 30 skills learned in this class
  • administer medications
  • agencies may choose to provide further training and once documentation of competency, you may perform those skills you are found competent in
188
Q

NA qualities / professionalism

A
  • personal appearance
  • personal hygiene
  • physical and mental health
    • work schedules and contracted to work
    • provide complete resident needs
    • work according to job description
  • dependability
  • follow rules and regulations
189
Q

What are common rules and regulations that are important to follow as a NA

A
  • dress code
  • substance / chemical abuse
  • personal phone / phone calls / mail / visitors
  • absence from work and notification
  • smoking and eating
190
Q

How should a NA demonstrate interpersonal relations with co-workers

A
  • cooperation
  • taking direction
  • accepting constructive criticism
  • team member
191
Q

How should a NA demonstrate a desire for ongoing learning

A
  • in service
  • CCDI training
  • rehab aide
  • medication aide
  • home care aide
192
Q

Ethical vs legal

A
Ethical = a moral guide
a. respected for residents/co-workers/property
b. loyalty
c. non-judgemental
d. accepting 
Legal = act according to law 
a. protection health information (PHI)
b. name of person served
c. phone number 
d. SS #
e. address
f. health information
193
Q

What factors may impact employability for an NA

A

conviction of DUI/recreation/prescription drug

194
Q

NA negligence may include

A
  • performing tasks not trained to do
  • performing procedures incorrectly/unsafely
  • acts that may injure, have potential for energy
195
Q

Resident endangerment would include

A
  • abandonment
  • false imprisonment
  • assault and battery
196
Q

Consequences of abusing confidentiality

A
  • dismissal from NA course
  • Dismissal from job
  • criminal and civil lawsuit
197
Q

Mandatory reporter of Department Adult/Child abuse

A
  • training every 5 years

- your responsibility is to report to your supervisor any potential abuse you have witnessed

198
Q

Resident rights are protected by law, how can you ensure this is upheld?

A
  1. inform resident of their rights

2. protect dignity, self respect and quality of life

199
Q

Assistive technology

A

any tool, equipment or service designed to help develop, maintain or improve your ability to function in life

  • -> can be low-tech such as a magnifying glass or high-tech such as computerized communication system
  • -> tool that provides vocal output for those who can not communicate with their voice
200
Q

Safety devices

A
  • Use lights to warn deaf of fire, or that the door bell or phone is ringing
  • device that shakes bed is smoke alarm is going off
  • relay Iowa & TTY for communication between deaf person and hearing person
201
Q

Where can safety devices be obtained

A

IowaCompass.org, 211, blind association

202
Q

NA role in using and maintaining assistive devices

A
  • notify supervisor when device malfunctions
  • place device in easy access for resident
  • assure electronic devices are charged
  • clean surfaces of assistive devices
  • seeking training on use of device if needed`