Hartman's Nursing Assistant Care: The Basics

Hartman's Nursing Assistant Care: The Basics Beginning steps for client care - ANS -Knock and wait for permission to enter -Introduce yourself as Nurse Aide Student -identify the patient by name -wash your hands -Explain procedure and ask for permission -Provide privacy (cutain, screen, or door) -Adjust bed to a safe level, usually waist high. -Lock the bed wheels Ending steps for client care - ANS -Return to lowest position -Remove privacy -Place call light in reach -wash your hands -Report any changes in the client to the nurse -Document procedure Long Term Care (LTC) - ANS care given in long-term care facilities for people who need 24-hour skilled care skilled care - ANS medically necessary care given by a skilled nurse or therapist, it is available 24 hours a day, and it is ordered by a doctor and involved a treatment plan chronic condition - ANS any disease or condition that lasts a long time (usually longer than six months). It usually can't be cured and therefore requires ongoing treatment and management. Examples include arthritis and asthma. Example of chronic condition - ANS Physical disabilities terminal illness - ANS a disease or condition that will eventually cause death acute care - ANS 24-hour skilled care for short-term illnesses or injuries; generally given in hospitals and ambulatory surgical centers subacute care - ANS care for an illness or condition given to people who need less care than for an acute (sudden onset, short-term) illness or injury but more than for a chronic (long-term) illness Example of chronic condition - ANS Heart disease Example of chronic condition - ANS Dementia outpatient care - ANS Care given for less than 24 hours for people who have had treatments or surgery and need short-term skilled care. They do not require an overnight stay in a hospital or other care facility Rehabilitation - ANS Restore or improve function after an illness or injjury hospice care - ANS treatment of the terminally ill in their own homes, or in special hospital units or other facilities, with the goal of helping them to die comfortably, without pain. For people who have about 6 months or less to live Medicare - ANS A federal health insurance program for persons 65 years of age and older Medicaid - ANS A medical assistance program that pays for health care services for people who cannot afford them. For people who have low income, as well as for people with disabilities. Nursing assistants are not allowed to - ANS Insert or remove tubes, give tube feedings, or change sterile dressings Nursing assistants are part of - ANS A team of health professionals assistive or adaptive devices - ANS special equipment that helps a person who is ill or disabled perform activities of daily living (ex: occupational therapy) occupational therapist - ANS assess and plan for the client to regain ADLs, esp motor skills of the upper extremities; direct care of occupational therapy assistants The chain of command protects employees from - ANS Liability chain of command - ANS the line of authority that moves from the top of a hierarchy to the lowest level In continence is - ANS Not a normal part of aging transmission-based precautions - ANS CDC precautions used in patients known or suspected to be infected with pathogens that can be transmitted by airborne, droplet, or contact routes; used in addition to standard precautions scope of practice - ANS defines the tasks that healthcare providers are legally permitted to perform as allowed by state or federal law care plan - ANS is individualized for each resident. It lists the tasks that team members, including NAs, must preform. policy - ANS Is a course of action that should be taken every time a certain situation occurs procedure - ANS a method, or way of doing something Omnibus Budget Reconciliation Act (OBRA) - ANS Passed in 1987 in response to reports of poor care and aside in long-term care facilities. OBRA requires that the Nursing Aide Training and Competency Evaluation Program (NATCEP) - ANS Set minimum standards for nursing assistant training. NAs must complete at least 100 hours of training To cite - ANS Means to find a problem through a survey Battery - ANS The intentional touching of a person without his or her consent False Imprisonment - ANS unlawful restraint or restriction of a person's freedom of movement active neglect - ANS the purposeful failure to provide needed care, resulting in harm to a person passive neglect - ANS the unintentional failure to provide needed care, resulting in physical, mental, or emotional harm to a person An Ombudsman - ANS is assigned by law as the legal advocate for residents OAA (Older Americans Act) - ANS Federal law that requires all states to have an ombudsman program Health Insurance Portability and Accountability Act (HIPAA) - ANS A comprehensive set of standards and practices designed to give patients specific rights regarding their personal health information. Protected Health Information (PHI) - ANS Information that can be used to identify a person and relates to the patients condition, any health care that the person has had and payment for that health care military time - ANS To change the hours between 1:00 pm to 11:59 pm to military time, add 12 to the regular time 1600 as regular time - ANS 4 pm 2100 as regular time - ANS 9 pm 0900 as regular time - ANS 9 a.m. 0000 as regular time - ANS 12 am 1200 as regular time - ANS 12 pm Minimum Data Set (MDS) - ANS a detailed form with guidelines for assessing residents in long-term care facilities; also details what to do if resident problems are identified Incident reporting guidelines - ANS -tell what happened (state the time and the mental and physical condition of the person) -describe the persons reaction to the incident -state the facts; do not give opinions -do not document that an incident report was completed on the medical record -describe the action taken to give care Anything the endangers the resident should be - ANS Reporter immediately (ex: falls, chest pain, severe headache, trouble breathing) Objective information - ANS based on what a person sees, hears, touches, or smells subjective information - ANS something a person cannot or did not observe, but is based on something the resident reported that may or may not be true "Mr Hartman says he has a headache" - ANS Subjective information "Mr Hartman is holding his head and rubbing his temples" - ANS Objective information brady- - ANS slow -pathy - ANS disease body mechanics - ANS the way the parts of the body work together when a person moves base of support - ANS The foundation that supports an object scalds - ANS burns caused by hot liquids Always check the water temperature with.. - ANS A water thermometer or on the inside of your wrist before using Residents must always be identified before - ANS Giving care or serving food Anytime you are feeding a resident they should be - ANS Sitting at a 75-90 degrees angle OSHA (Occupational Safety and Health Administration) - ANS a federal government agency that makes rules to protect workers from hazards on the job Abrasion - ANS an injury in which superficial layers of skin are scraped or rubbed away P.A.S.S. (acronym for using fire extinguisher) - ANS Pull the pin Aim at the base of fire when spraying Squeeze the handle Sweep back and forth at the base of the fire RACE acronym for fire - ANS Remove anyone in danger if you are not in danger Activate alarm or call 911 Contain fire if possible by closing all doors and windows Extinguish the fire, or the fire department will extinguish it. Evacuate the area if instructed to do so. cardiopulmonary resuscitation (CPR) - ANS refers to medical procedures used when a person's heart or lungs have stopped working choking - ANS When something is blocking the tune through which air enters the lungs, the person has an obstructed airway As long as the resident can speak, breath, or cough, the NA should - ANS Encourage her to cough as forcefully as possible to get the object out abdominal thrusts - ANS a method of attempting to remove an object from the airway of someone who is choking Cyanosis of the skin is caused by - ANS decreased blood oxygen cyanotic skin - ANS Blue/gray, inadequate oxygenation or perfusion, inadequate respiration, heart attack Shock can occur: - ANS When organs and tissues in the body do not receive an adequate blood supply Myocardial infraction (MI) - ANS Heart Attack; Caused by partial or complete occlusion of one or more coronary arteries. Results in heart tissue death. Occurs when the heart muscle itself does not receive enough oxygen because blood vessels are blocked Dyspnea - ANS difficulty breathing To treat a minor burn - ANS Do not use ice or ice water, as ice may cause further skin damage. Dampen a clean cloth with cool water. Place it over the burn Syncope - ANS fainting insulin reaction (hypoglycemia) - ANS can result from either too much insulin or too little food Diabetic Ketoacidosis (DKA) - ANS Is caused by having too little insulin Seizures - ANS Involuntary, often violent, contractions of muscles type 2 diabetes - ANS Diabetes of a form that develops especially in adults and most often obese individuals and that is characterized by high blood glucose resulting from impaired insulin utilization coupled with the body's inability to compensate with increased insulin production. MOST COMMON type 1 diabetes mellitus (juvenile onset) - ANS diabetes caused by a total lack of insulin production; usually develops in childhood, and patients require insulin replacement therapy to control the disorder cerebrovascular accident (CVA) - ANS a.k.a. "Stroke". Lack of blood supply to the brain causing brain damage Transient Ischemic Attack (TIA) - ANS Aka "little stroke" the result of a temporary lack of oxygen in the brain hemiplegia - ANS paralysis of one side of the body hemiparesis - ANS Arm numbness or weakness on one side of the body expressive aphasia - ANS slurred speech or inability to speak receptive aphasia - ANS inability to understand spoken or written words Emesis - ANS vomiting infection prevention - ANS the set of methods practiced in healthcare facilities to prevent and control the spread of disease Microorganism (MO) - ANS a living thing or organism that is so small that it can be seen only through a microscope; also called microbe. Microbe - ANS another name for a microorganism Infections occurs when harmful microorganisms, called pathogens - ANS Invade the body and multiply localized infection - ANS an infection that is limited to a specific location in the body and has local symptoms systemic infection - ANS affects the entire body Healthcare-associated infection (HAI) - ANS an infection acquired within a healthcare setting during the delivery of medical care chain of infection - ANS a way of describing how disease is transmitted from one being to another Link 1: causative agent - ANS a pathogen, such as a bacterium or virus that can cause a disease Link 2: reservoir - ANS where the pathogen lives and grows Link 3: portal of exit - ANS any body opening on an infected person that allows pathogens to leave Link 4: Mode of Transmission - ANS How the pathogen travels; direct or indirect contact Link 5: Portal of Entry - ANS any body opening on an uninfected person that allows pathogens to enter; nose, mouth, eyes, and other mucous membranes Link 6: Susceptible Host - ANS uninfected person who could get sick medical asepsis - ANS refers to measures used to reduce and prevent the spread of pathogens Surgical asepsis (sterile technique) - ANS Makes an object or area free of all microorganisms (not just pathogens) CDC (Centers for Disease Control and Prevention) - ANS a federal agency that conducts and supports health promotion, prevention and preparedness activities in the United States with the goal of improving overall public health. sputum - ANS mucous secretion from the lungs, bronchi, and trachea expelled through the mouth hand hygiene - ANS washing hands with either plain or antiseptic soap and water and using alcohol-based hand rubs antimicrobial agent - ANS destroys, resists, or prevents the development of pathogens Personal Protective Equipment (PPE) - ANS equipment that helps protect employees from serious workplace injuries or illnesses resulting from contact with workplace hazards don - ANS to put on doff - ANS to remove Nonintact skin - ANS Skin that has a break in the surface Disinfection - ANS The process of destroying pathogens transmission-based precautions - ANS Precautions caused for persons who are infected or may be infected with certain diseases Droplet precautions - ANS are used for patients known or suspected to be infected with pathogens transmitted by large particle droplets expelled during coughing, sneezing, talking or laughing Bloodborne pathogens - ANS microorganisms found in human blood that can cause infection and disease Hepatitis - ANS inflammation of the liver caused by a virus or a toxin Hepatitis B and C - ANS Blood borne disease that can cause death Hepatitis B - ANS Spread through sexual contact, by sharing needles, or from a mother to her baby Tuberculosis (TB) - ANS Airborne highly contagious disease caused by a bacterial infection. MRSA (methicillin-resistant Staphylococcus aureus) - ANS An infection that is resistant to methicillin. Drugs no longer work to kill the specific bacteria VRE (vancomycin-resistant enterococcus) - ANS Spread through direct and indirect contact VRE infections are often difficult to treat and may require several medications Clostridium difficile infection (C. Diff or C. Difficile) - ANS Spore-forming bacterium which can be part of the normal intestinal flora psychosocial needs - ANS needs which involve social interaction, emotions, intellect, and spirituality. Maskow's hierarchy of needs - ANS A model developed by Abraham Maslow to show how physical and psychosocial needs are arranged in order of importance -physical needs -safety and security -need for love -need for self-esteem -need for self-actualization holistic care - ANS care that provides for the well-being of the whole person and meets not only physical needs, but also social, emotional, and mental needs OBRA requires that facilities provide - ANS An activity program designed to meet the interests and the physical and psychosocial well-being of each resident Activity is an - ANS Essential part of a persons life Ageism - ANS Discrimination based on age GAD (Generalized Anxiety Disorder) - ANS A psychological disorder characterized by tension or anxiety much of the time about many issues, but without the presence of panic attacks. panic disorder - ANS An anxiety disorder marked by unpredictable minutes-long episodes of intense dread in which a person experiences terror and accompanying chest pain, choking, or other frightening sensations. apathy - ANS a lack of feeling, emotion, or interest Schizophrenia - ANS Affects a persons ability to think and communicate clearly. It also affects the ability to manage emotions, make decisions, and understand reality Hallucinations - ANS false sensory experiences Delusions - ANS Are persistent false beliefs Psychotherapy - ANS Involves talking about ones problems with mental health professionals CBT (cognitive behavioral therapy) - ANS popular integrative therapy that combines cognitive (thinking) and behavior therapy durable power of attorney - ANS a legal agreement that allows an agent or representative of the patient to act on behalf of the patient DNR - ANS do not resuscitate advance directives - ANS A legal document designed to indicate a person's wishes regarding care in case of a terminal illness or during the dying process living will - ANS A document that indicates what medical intervention an individual wants if he or she becomes incapable of expressing those wishes. Hearing is usually - ANS The last sense to leave the body The dying persons bill of rights - ANS affirms the dying person's right to dignity, privacy, informed participation, and competent care Cheyne-Stokes - ANS Periods of difficult breathing (dyspnea) followed by periods of no respirations (apnea) Postmortem care - ANS care of the body after death palliative care - ANS Care designed not to treat an illness but to provide physical and emotional comfort to the patient and support and guidance to his or her family. Ex: hospice care Hospice care - ANS holistic, compassionate care given to dying people and their families blood vessels dilate or widen - ANS When the outside temperature is too high Blood vessels constrict or narrow - ANS When the outside temperature is too cold Atropy - ANS The muscle wastes away, or decreases in size, and becomes weak contracture - ANS The lack of joint mobility caused by abnormal shortening of a muscle Arthritis - ANS inflammation of a joint rheumatoid arthritis - ANS a chronic autoimmune disorder in which the joints and some organs of other body systems are attacked osteoarthritis (degenerative joint disease) - ANS May occur with aging or as the result of joint injury PWB (partial weight bearing) - ANS a doctor's order stating that a person is able to support some body weight on one or both legs NWB (non-weight bearing) - ANS indicates that no weight at all can be placed on the extremity involved FWB (full weight bearing) - ANS able to bear 100 percent of the body weight on one or both legs on a step THR (total hip replacement) - ANS Total hip arthroplasty - iis replacement of the femoral head and acetabulum with prostheses that are fastened into the bone TKR (total knee replacement) - ANS A surgical procedure in which damaged parts of the knee joint are replaced with artificial parts. compression stockings - ANS Plastic, air-filled, sleeve-like device that is applied to the legs and hooked to a machine CNS (central nervous system) - ANS brain and spinal cord PNS (peripheral nervous system) - ANS the sensory and motor neurons that connect the CNS to the rest of the body CVA (cerebrovascular accident) - ANS a.k.a. "Stroke". Lack of blood supply to the brain causing brain damage Dysphasia - ANS difficulty swallowing expressive aphasia - ANS The inability to produce language ( despite being able to understand language) receptive aphasia - ANS inability to understand spoken or written words Emotional liability - ANS Inappropriate or unprovoked emotional responses gait - ANS manner of walking Parkinson's disease - ANS a progressive, incurable disease that destroys brain cells and is identified by muscular tremors, slowing of movement, and partial facial paralysis MS (multiple sclerosis) - ANS A progressive disease in which the Myelin sheet breaks down overtime, without this protective covering nerves cannot conduct impulses to and from the brain in a normal way -paresis - ANS paralysis paraplegia - ANS paralysis from the waist down quadriplegia - ANS paralysis of all four limbs Cataracts symptoms - ANS -Progressive blurring of vision over years -Needing increased light to see clearly -Decreased night vision -NO pain or rednes -Poorly visualized fundus on exam (lost red reflex) Glaucoma - ANS increased intraocular pressure results in damage to the retina and optic nerve with loss of vision Circulatory system - ANS heart, blood vessels, blood HTN (hypertension) - ANS elevated blood pressure persistently 130/80 mm Hg or higher Atherosclerosis - ANS hardening and narrowing of the blood vessels Diuretics - ANS medications that reduce fluid volume in the body CAD (coronary artery disease) - ANS Abnormal narrowing of the blood vessels of the heart, predisposing to heart attacks angina pectoris - ANS chest pain that results when the heart does not get enough oxygen MI (myocardial infarction)/ heart attack - ANS When blood flow to the heart muscles is blocked, oxygen and nutrients fail to reach the cells in that area CHF (congestive heart failure) - ANS heart is unable to pump its required amount of blood 1 inspiration + 1 expiration = - ANS 1 respiration PVD (peripheral vascular disease) - ANS A disease in which the legs feet arms or hands do not have enough blood circulation due to Fatty desposition in the blood vessels and harden overtime COPD (chronic obstructive pulmonary disease) - ANS A group of lung diseases that block airflow and make it difficult to breathe. chronic bronchitis and emphysema - ANS Together called COPD bronchitis - ANS irritation and inflammation of the lining of the bronchi chronic bronchitis - ANS Usually caused by cigarette smoking Emphysema - ANS Chronic disease of the lungs that usually results from chronic bronchitis and cigarette smoking Pneumonia - ANS Illness and that can be caused by a bacterial, viral, or fungal infection Acute inflammation occurs in lung tissue UTI (urinary tract infection) - ANS A bacterial infection that affects any part of the urinary tract. More common in women fecal incontinence - ANS the inability to control the passage of feces and gas through the anus enema - ANS the placement of a solution into the rectum and colon to empty the lower intestine through bowel activity Decal impaction - ANS A hard stool that is stuck in the rectum and cannot by expelled Hemorrhoids - ANS Enlarged veins in the rectum