CNA Chapter 7-9 Questions and Answers

CNA Chapter 7-9 Questions and Answers proper or protective body mechanics -standing and moving one's body using strongest muscles -helps avoid injury & fatigue -correctly using body techniques will improve safety for you and your patient When lifting an object 1. squat close to the load 2. maintain natural curve in back 3. grip object firmly 4. keep arms close to your sides 5. lift pushing up with strong leg muscles When changing the direction of movement: pivot feet use short steps turn whole body using feet Draping act of covering a patient or a part of a patients body with a sheet or blanket Drape the covering used when providing privacy during examination or operation supine lying flat on back Dorsal recumbent position same as supine (lying flat on back) Fowler's position head of patient's bed is at a 45 to 90 degree angle Semi-Fowler's position head of bed 30 to 45 degrees (helps keep patient from sliding down) Knee-chest position a bent posture with knees and chest touching exam table (used for examining rectum) Sidelying positions of comfort to relieve pressure points Trendelenberg Position bed inclined with HOB positioned below feet Reverse trendelenberg feet lower than head Dorsal Lithotomy position same as dorsal recumbent position except the patient's legs are well separated and the knees are bent more (used often for examination of bladder, vagina, rectum, and perineum) Prone position lying on stomach Sim's position patient lies on left side with right thigh and knee drawn up Nonambulatory unable to walk Bedridden unable to get out of bed Body alignment the correct positioning of a patient's body when ENTERING a room: 1. knock on the door 2. introduce yourself 3. explain procedure to patient 4. wash hands when LEAVING room: 1. Bed in lowest position 2. Bed/chair wheels locked 3. Side rails up if ordered 4. Call light within reach 5. Ask if patient needs anything 6. Wash hands When using a Stretcher: stand at the head and push the stretcher feet first Using a Gait Belt: Position yourself slightly behind weaker side of patient. Try to have the patient's stronger side close to wall and keep hand on gait belt at ALL times. Wheelchair Transport -position properly in wheelchair -hands should never be on wheels -always lock wheels -move down ramps w/ patient facing backwards OBRA Guidelines: Moving/ Lifting Patients 1. Tell pt what you're going to do 2. Watch out for tubing 3. SUpport heaviest body parts 4. Hold pt close to body 5. Avoid jerking motions OBRA Guidelines: Assisting a Falling Patient 1. Widen stance, bend knees, lower your body to the floor w/ patient 2. Maintain the natural curves of back 3. Protect pt's head from injury 4. Stay w/ pt, call for help, dont move pt until instructed 5. Get assistance to stand pt back up 6. Report details to supervisor and complete incident report (DO NOT put in patients med. records) Children wonder what might happen to them and may be scared of equipment and noises of the environment. Allow parents to stay with child as much as possible. Explain thing in simple language and let the child touch and explore equipment. With adolescents avoid medical jargons, maintain privacy, but let them know their parents are available if wanted. For adults and elderly Allow them to make as many decisions as possible. Explain things in understandable terms and allow time for questions and concerns. Admission the period of time from when the patient enters the institution door until he is settled. Things to make a good 1st impression: -Introduce yourself -Learn patient's name and use it often -DO NOT call patient by first name without permission -Smile and be friendly -Do not appear to be rushed or busy with other things -Do your work quietly and efficiently Each institution has its own policy and procedure for admitting patients Info given to patient and/or family may include: 1. usual activities 2. info about tests and procedures 3. usual meal times 4. visiting hours A patient coming into a health care institution may be frightened & uncomfortable. As a member of a health care team you should be courteous and pleasant from the time the patient enters the institution door. Patient Plan of Care plan written by the RN that states the nursing diagnosis, patient goals, and nursing actions to be taken Assessing Gather all facts and identify the needs and problems Planning Deciding what to do and how to do it Implementing Carrying out the given plan Evaluating Was the plan effective? An individualized patient plan of care is written by the RN The plan of care serves as a course of action to assist the patient to achieve optimum wellness Patient plans of care are one way for the nursing team to communicate. How does the Patient plan of care help the CNA? -Provides specific instructions regarding care to be given -Gives info needed prior to giving care -Promotes continuity of care -Provides essential info for organizing and planning work Parts of the plan of care that most directly involve CNA are ADLs Direct bedside care Making & reporting objective, factual observation Types of Scales: A. standing scales B. Scale with mechanical lift C. Wheelchair scale D. Bed scale Accurate weighs are important for medication _________ problems are assessed using weight to compare and evaluate Nutrition Transfer moving of a patient from one room, unit, or facility to another When transferring a patient remember: 1. Explain change is being made for patient's benefit (Reassure if necessary) 2. Make sure new unit is ready 3. Make sure you have all the patient's belongings Discharge the official procedure for helping the patient leave the healthcare facility _________ permission is need from a doctor is required for the patient to be discharged. Written If patient wants to leave and you have not been told that the discharge order has been written, report this to your immediate supervisor immediately. AMA against medical advice As a result of the DRGs systen of Medicare payment to health care institutions, patients are staying in health care institutions for shorter periods of time. This means the patients may have longer convalescence, or recovery period, at home. Teaching patients how to care for themselves at home is the responsibility of the entire nursing team. The patient's ______ should be included in the education process whenever possible. family Holistic approach that reflects the 4-dimensions of a whole person. (must be used to meet a patient's plan of care) Physiological person's biological response (physical change) to alterations in the body's structure and functions Phychological a person's cognitive and emotional response to himself and his surrounding environment Sociocultural a person's interpersonal responses to socialization practices in the family and community Spiritual personal response to inspirational forces Discharge Instructions Should Include: -info on the patient's disease, signs & symptoms, & what to report to doctor -explanation of meds ordered by doctor -explanation of any ordered treatments -explanation of nutrition & diet -outline what activities allowed to do -future doctors appointments -referral agencies EX: Home Health Discharge Planning: -starts @ admission -work with MD, patient, family, & social worker to develop the discharge plan -assess the home situation -make sure patient has copy of discharge instructions Patient unit the room, space, equipment, and furniture for one patient Equipment materials or tools used to perform a task The unit should be arrange for the convenience of the patient. The call light system must be easily accessible for the patient as well as other important items such as telephone & eyeglasses Alternating-pressure mattress similar to air mattress that can be placed beneath the patient to reduce pressure on the head, shoulders, back, heels, elbows, and bony preminences. Bed cradle frame shaped like a barrel cut in half lengthwise used to keep bed linens off a part of the patient's body. Bed board board placed beneath the mattress to provide additional support for patients with back, muscle, or bone problems. Binders strips of heavy cotton cloth with Velcro fasteners. Wrap securely around the patient's body over the abdomen to give support and comfort following abdominal surgery. Foot Board a small board placed upright at the foot of the bed and used to keep the patient's feet aligned properly to prevent foot drop. Intravenous Pole a tall pole, also call IV pole which attaches to a bed or is on rollers or casters; this pole is used to hold the containers or tubes needed during a blood transfusion or giving a patient fluids such as medication & liquid food. Lamb's Wool Wide strip of lamb's wool cloth used to increase patient comfort. Patient lift a mechanical device with a sling seat used for lifting a patient into and out of a bed, bathtub, or wheelchair Specialty bed a bed that constantly changed pressure under the patient. Used to minimize pressure points in the treatment or prevention of bedsores or pressure ulcers. Stretcher A narrow rolling table w/without a mattress or simple a canvas stretched over a frame used to transport patients; the latter may also be called a gurney, litter, or cart. Walker a stable frame made of metal tubing used to support the unsteady patient while walking; the patient holds the walker while taking a step, moves forward, and takes another step. Wheelchair a chair on wheels used to transport patients Disposable equipment equipment that is used 1 time only for 1 patient only and then thrown away Bedpan a pan used by patients who urinate or defacate while in bed Emesis Basin A kidney-shaped pan used for catching anything that a patient spits out, vomits, or expectorate (coughs up). Urinal A portable container given to male patients in bed so they can urinate without getting out of bed Specimen container a container used to collect a sample of material from the patient's body; sent to lab for testing Patients must be made to feel safe and comfortable The temperature, lighting, position of the bed, and volume of the TV & phone should be adjusted to suit the patient unless conditions do not allow it or it interferes with another patient Provide privacy for the patient by drawing the curtain or closing the door when activity or procedures might expose the patient. What can be different in every home that you work in Home Health? the atmosphere & lifestyle People of different backgrounds may eat foods you have never seen or tasted Let patient know it is your pleasure and not just your job to assist them Always remember you are a guest in their home You can create a safe environment for your patient and yourself by eliminating, preventing, or correcting conditions that could cause accidents. Safety includes proper infection control, electrical, and fire safety, and accident prevention. Report every accident to your immediate supervisor immediately. It is important to know emergency phone numbers