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  1. Beginning procedure actions:
    • Wash hands prior to entering room
    • Assemble needed equipment
    • Go to res. room, know, and PAUSE b4 opening
    • Introduce self by name & title
    • Address res. by name
    • Ask visitors to leave & inform where to wait
    • Answer res. ?'s about procedure
    • Raise bed to comfortable working height
    • Provide procedure to res., speak clearly, slowly, directly to res, face to face
    • Allow res. to assist as much as possible
  2. Ending procedure actions:
    • Position res. comfortably
    • Return bed to lowest position
    • Leave signal cord, phone & water in reach
    • Perform general safety check
    • *******************
    • Open curtains
    • Care for equipment following policy
    • Wash hands
    • Let visitors know they can return
    • Report completion of task & any abnormalities; record actions & observations

    Comfortable Beds Signal Safety!!

  3. Taking vitals
    • Clean ear pieces & diaphragm w antiseptic wipe
    • Position res. arm resting on firm surface, palm up
    • Wrap cuff around arm 1" above antecubital space
    • Place ears in ears, place diaphragm over artery
    • Inflate no more than 180
    • Deflate cuff, noting sys & dia reading
    • Accurately reed within 4mmHg window
    • Accurately record blood pressure
  4. Tympanic Temperature
    • Place tympanic thermometer cover on
    • Ask res. to turn head so ear is in front of you, put new probe cover on
    • Pull ear back (gentle, firm) to straighten ear canal & insert gently in canal toward nose
    • Start thermometer
    • Wait for beep or flashing light
    • Read temp and record accurately
  5. Oral temperature
    • Ask res. if they've eaten, drank (hot or cold), or smoked in last 15 minutes
    • Place sheath on probe
    • Correct placement
    • If necessary, hold probe in place for oral
    • Wait for beep
    • Remove probe sheath & dispose of properly
    • Replace probe
    • Read temp & record accurately
  6. Proper hand washing
    • Dont touch sink w your uniform
    • Turn water to warm
    • Wet and soap hands
    • Wash hands w fingers down for 15-30 sec., including wrist, nails & btwn fingers
    • Rinse w fingertips down
    • Use dry paper towel to dry hands
    • Use paper towel to turn off faucet
    • Immediately discard paper towels in trash w/o touching other hand
  8. Demonstrate 2 ways to prevent pressure ulcers
    • EX:
    • Proper use of bed cradle
    • Elbow/heel protector
    • Using pillows to reduce skin to skin contact
    • Making sure sheets are wrinkle free
  9. Explain 2 ways to prevent pressure ulcers
    • Changing position frequently
    • Good nutrition and hydration
    • Provide good peri care (keep res. dry n clean)
    • Be careful of res skin (no shearing or friction)
    • Check res. skin carefully - provide good skin care
    • Assist res. to bathroom frequently
    • Encourage mobility
    • Use pressure reducing devices
  10. Position foley catheter/bag/tubing
    • Secure tubing to res. inner thigh or abdomen
    • Place tubing over leg 
    • Position tubing to facilitate grav flow, no kinks
    • Attach to bed frame (not cover or on side rail) always-below level of bladder
    • Keep catheter bag from touching floor
  11. Oxygen use guidelines... examples
    • Avoid lighting matches or smoking around oxygen use
    • Ensure all electrical equipment is in good repair
    • No kinks in tubing 
    • Make sure device is placed correctly on res
    • Do not remove mask or cannula, unless told specifically by nurse
    • Make sure humidity bottle doesn't get low
    • check skin irritation behind ears, cheeks, nose
    • make sure oxygen is flowing
  12. If oxygen flow rate is incorrect, what do you do?
    Alert the nurse immediately
  13. Describe Occupied draw sheet change
    • Place clean draw sheet on clean surface with in reach (chair, over the bed table)
    • Provide privacy throughout procedure
    • Lower head of bed, placing resident in supine position
    • After raising side rail, assist resident to turn onto side, moving toward raised side rail
    • Loosen draw sheet, roll soiled draw sheet toward resident
    • Place and tuck in clean draw sheet on working side (this must be done b4 turning resident)
    • Raise side rail and assist resident to turn onto clean draw sheet
    • Remove soiled linens/draw sheet, avoiding contact with clothes, and place in appropriate location within room -- never on floor!
    • Pull and tuck in clean draw sheet, finishing with sheet free of wrinkle
  14. Describe how to apply cold compress
    • Cover cold compress with towel or other protective cover
    • Properly place on correct site as directed by skills examiner
    • When asked by examiner, verbalize frequency of checks and how long you would leave compress on res
    • (Initially check after 5 mins/do not leave on res for more than 20 mins)
    • Assess for redness, swelling, irritation and/or pain. If this occurs, remove compress and report to nurse immed.
  15. Convert 1 ounce to mL's
    1 ounce = 30 mL
  16. How to respond to conscious choking
    • be able to id symptoms of choking
    • Ask res "Are you choking?"
    • Call for help
    • preform abdominal thrust
    • Position fist slightly above navel
    • grasp fist w other hand, press into res abdomen with an inward, upward thrust 
    • Repeat until successful or victim loses consciousness
  17. Explain how to obtain weight
    • make sure scale is at zero
    • assist res to stand on scale
    • ensure res is balanced & centered on scale with arms at side
    • Accurately record weight
  18. Explain how to obtain height
    • Assist res to stand on scale
    • Res is balanced and centered on scale with arms at side
    • Raise folding measuring bar above res head, open and lower gently until bar rests on head
    • accurately record height
  19. Explain application of TED hose
    • "anti-embolism" stockings
    • Explain resident should be in bed or with feet elevated to apply
    • turn stocking inside out till heel
    • smooth up and over leg so hose is even, snug and not twisted or wrinkled
    • Heel and toe in proper location
    • The toe hole may be on the top or bottom, depending on manufactures design
  20. Explain PROM to joints
    • Exercise passively 2 joints~ flexion, extension, adduction, abduction and rotation
    • never exercise past the point of pain for resistance
    • Provide support for joint
    • repeat at least 3 times
  21. name 3 ROM's and explain difference
    • passive ~ you do it all
    • active ~ they can to it all
    • Passive-assisted~ you help them do it
  22. Explain passive range of motion
    • You'll exercise passively 2 joints
    • when asked, explain you understand never to exercise past point of pain
    • Provide support for joint
    • Avoid jerky movements, 
    • Repeat exercise 3 times, or as directed
  23. Explain procedure when moving and positioning residents
    • With all positions, must demonstrate:
    • Raise side rail while turning a pt, except on side you are working on
    • Demonstrate proper body mechanics
    • Maintain residents proper alignment at all times
  24. Explain moving res with draw sheet
    • Is a two person job
    • Provide support for resident's head
    • Grasp rolled draw sheet near residents shoulder's and hips
  25. Explain positioning pt in sims position
    • Semi prone position
    • Left side: res laying on left side, right leg flexed, lower arm behind res
    • (opposite for right side)
    • Provide good alignment: Place a pillow under the head, upper arm and flexed leg
  26. For enema, what position should res be put in
    Left Sims or left lateral position
  27. Explain positioning pt in lateral position
    • Position lateral/side laying on correct side as directed
    • Provide for good alignment: Place a pillow btwn legs, behind back and under arm
  28. Explain assisting to ambulate
    • Make sure bed wheels are locked!!!
    • Demonstrate proper use of gait belt
    • Res should have non-skid footwear
    • Sit res up, allow to dangle
    • Apply gait belt propertly
    • Assist res to stand while holding gait belt
    • Grasp belt at eat side, not the front
    • Do not allow res to hold onto your neck while transferring
    • Walk at res side or slightly behind (on weak side if res has one)
    • Demonstrate proper use of assistive devices (walker, cane-should be placed on res strong side)
  29. Explain Pivot trans from bed to wheelchair
    • Lock bed wheels
    • Res has non-skid footwear
    • Position wheelchair close to bed on res strong side
    • Move or remove foot rests
    • Lock wheelchair brakes
    • Lower bed and rails
    • Sit res up, allow to dangle
    • Apply gait belt
    • Assist res to stand while holding belt
    • Transfer to strong side by pivoting on strong side toward wheelchair
    • Position res properly w hips against back seat
    • Remove gait belt
    • Place feet in foot rests
  30. Explain feeding dependent resident
    • Check that the name and diet on meal tray matches name of resident
    • Positions res in upright position, Min 60 degrees

    • Wash/dry res hands before feeding
    • If res has dentures, check to make sure dentures are in 
    • Protects clothing from soiling by using napkin, protector or towel
    • Describes foods being offered
    • Offer fluid frequently
    • When asked, explain pace and amount when feeding res (offer food in small amounts, allow res to chew and swallow)
    • Wipe res face and hands throughout meal as needed
    • when asked, verbalize need to stop feeding when complications occur and report to nurse
    • Leave res clean and in a position of comfort
  31. Explain reasons to stop feeding a dependent res and report to nurse
    • choking
    • persistent coughing
    • mouth sores
    • drooling
    • cyanosis
    • difficulty swallowing
  32. What supplies do you need for denture care
    • gloves
    • Dentures
    • denture cup
    • toothbrush
    • paste
    • kidney basin
    • 2 towels (barrier for counter & sink bottom)
  33. Explain denture care
    • Before beginning, protect dentures from possible damage (line sink with towel/washrag or fill w water)
    • When asked, explain water for cleaning dentures should be luke warm (not hot or cold)
    • Brush dentures under running water w brush and paste
    • Place dentures in denture cup w water, adding cleaning tablet (if avail) and cover w lid to soak
    • Perform mouth care while dentures are out of mouth
  34. Explain log rolling res with hip fracture precautions
    • Use at least 2 people
    • Lower head of bed as flat as possible
    • Do not roll res on injured side
    • Place abduction splint or pillows btwn legs to support hip
    • On count of 3, roll person in single movement, keeping body in alignment
  35. Describe oral care for an unconscious res w aspiration precautions
    Verbalize frequency of oral care (every 2 hrs)

    • Place towel or drape under res head
    • Position res (as medical cond indicates) to prevent aspiration: In supine pos w head to side, lateral position, or with HOB elevated and head turned to side

    • Insert swab/sponge tip gently into res mouth
    • Don't use toothpaste/brush unless nurse says
    • Rotate against all tooth surfaces, mucous membranes and tongue
    • Clean res lips
    • Moisturize lips
    • Report any abnormalities such a gum bleeding
  36. Describe a back rub/massage
    • Place res in sitting or lateral position
    • Pour small amt of lotion into palm, rub hands together to warm lotion
    • Apply w gentle pressure, using both hands, from buttocks to back of neck w/o pulling skin, using long firm strokes
    • Use short circular strokes across shoulders
    • Perform backrub for 3 - 5 mins
    • Assess skin condition
    • Remove excess lotion
    • When asked, verbalize actions needed if redness or skin break down are noted. 
    • Do not rub reddened area and report immed to nurse
  37. Describe foot/toenail care
    • Inspect for cracked, broken nails/skin and btwn toes
    • Do not clip toenails
    • Soak feet in warm water
    • Dry feet completely, include btwn toes
    • Apply lotion if desired
    • Apply socks/shoes
    • Report abnormalities
  38. Describe how to dress/undress resident w hemiplegia
    • Provide privacy
    • dress weak side first
    • Undress weak side last
  39. Describe shaving res w razor blade
    • Place towel to protect res clothing
    • Soften beard w warm washcloth and apply shaving cream
    • Gently pull skin taut
    • Use short strokes of razor in direction hair is growing
    • Rinse razor often
    • Rinse and dry res face
    • Apply after shave if desired
    • Dispose blade in sharps container
  40. What supplies will you need for peri-care
    • soap or cleaning agent
    • At least 4 washrags
    • bath towel
    • bath blanket
    • wash basin
    • gloves
  41. Describe providing peri-care for female res
    • Provide for privacy
    • Assist res in removing clothing, only as necessary, exposing only area being washed
    • Obtain bath basin w water at comfortable temp
    • Apply appro cleanser preferred by res to washcloth
    • Separate labia, clean inside front to back, then wash outside of labia from to back, going to insides of thighs
    • Use different part of cloth for each stroke
    • Rinse and gently dry area
    • Turn res on side
    • Clean anal area from front to back
    • Rinse and gently dry area
    • Redress res
  42. Describe providing peri-care for male res
    • Provide for privacy
    • Assist res in removing clothing, only as necessary, exposing only area to be washed
    • Obtain bath basin w water @ comfortable temp
    • Apply appropriate cleaner as preferred by res to wash cloth
    • Cleanse penis from tip to base (clean to dirty)
    • Repeat until clean, using different part of wash cloth for each stroke
    • *if male is uncircum, retract forskin & clean
    • Rinse and gently dry area after washing
    • Turn res on side
    • Clean anal area from front to back
    • Rinse and gently dry each area after washing
    • Redress res
  43. Describe assisting with a bedpan/fracture pan
    • Position benpan correctly
    • *If using fracture pan, the flat side should be toward back of res
    • Raise head to comfortable level
    • Place tissue w/in reach
    • Position call light w/in reach
    • Provide privacy
    • Gently removes bedpan
    • Provide or assist w pericare
    • Empty bedpan in toilet
    • Rinse, dry, and store bedpan in proper location
    • Washes/assists res to wash/dry hands
    • record results accordingly
  44. Collecting a stool specimen
    • Properly fill out label given and place on specimen container
    • Using tongue depressor, take sample
    • Not color, amount and quality of feces
    • Dispose of tongue depressor in disposable bag
    • Empty remaining contents of bedpan into toilet
    • Put lid tightly on specimen cup
    • Place specimen cup into transport bag
    • Wash hands
    • Take specimen cup to designated location
  45. What is the critical criteria for every skill tested?
    • Infection control and Standard Precautions (following rules of medical asepsis)
    • Safety (Protecting resident and self from harm)
    • Residents' rights (Taking action to prevent or minimize emotional stress to res)
    • Communication (explaining procedure to resident prior to initiating it)
    • Recognizing and reporting changes (Observing and reporting abnormalities)
Card Set:
2015-05-04 03:25:50

CNA skills
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