Questions and Answers
What might changes in vital signs indicate?
The resident's condition is worsening.
Which changes should be immediately reported to the nurse? (Select all that apply)
What are five sites for measuring body temperature?
The mouth (oral), rectum (rectal), armpit (axilla), ear (tympanic), temporal artery.
Name seven conditions that indicate a person's temperature should not be taken orally.
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A rectal thermometer is usually color coded.
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Which temperature site is another word for the armpit area?
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Which temperature site is considered to be the most accurate?
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How long do digital thermometers take to display a person's temperature?
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How are temporal artery thermometers used to measure body temperature?
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Where is the apical pulse located?
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Which pulse is most often used for measuring pulse rate?
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The medical term for difficulty breathing is?
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Which of the following is an instrument that can listen to sounds within the body?
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Inhaling air into the lungs is also called?
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Exhaling air out of the lungs is also called?
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The normal respiration rate for adults ranges from?
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Why is it important for the nursing assistant to observe respirations without letting the resident know what she is doing?
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Blood pressure measurement that reflects the phase when the heart relaxes?
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The medical term for high blood pressure is?
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The medical term for low blood pressure is?
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Abbreviation for millimeters of mercury?
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Device that measures blood pressure?
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Blood pressure measurement that reflects the phase when the heart is at work?
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If a resident complains of pain, what questions should the nursing assistant ask to get the most accurate information?
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What are barriers to managing pain?
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One benefit of cold applications is that they can bring this down.
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Type of application that helps stop bleeding.
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A warm soak of the perineal area to clean perineal wounds and reduce pain is called?
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A condition that could cause a person to be unable to feel or notice damage occurring from a warm or cold application is?
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Numbness, pain, blisters, or skin that is this color should be reported to the nurse.
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Type of application that increases blood flow to an injured area is?
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Moisture reduces the effects of heat and cold.
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Dry applications are more likely to cause injury than moist applications.
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Redness, pain, blisters, and numbness are signs that an application may be causing tissue damage.
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A disposable warm pack is a type of dry application.
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Circulation to the perineal area is decreased when having a sitz bath.
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Sitz baths may stimulate voiding (urination).
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Residents may feel weak or dizzy after a sitz bath.
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Sterile dressings cover new, ____ or ____ wounds.
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A ____ changes sterile dressings.
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Non-sterile dressings are applied to dry, ____ wounds that have less chance of ____.
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What are the supplies that may be needed for a sterile dressing change?
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What should a nursing assistant observe and report about the wound site during sterile dressing changes?
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Elastic bandages are also known as?
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One purpose of elastic bandages is to?
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Elastic bandages should be applied snugly enough to control ____ and prevent movement of ____.
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How soon should an NA check on a resident after applying a bandage?
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IV therapy allows direct access to?
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What is the nursing assistant's responsibility for IV care?
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If the fluid in an IV bag is nearly gone, the NA should?
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Which of the following is a box-like device that changes air in the room into air with more oxygen?
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When should the nursing assistant administer a resident's oxygen?
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What is the purpose of a nasal cannula?
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Liquid oxygen can cause which of the following?
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What kind of water is used in the humidifying bottles for oxygen concentrators?
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What is the purpose of a humidifier?
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Study Notes
Vital Signs and Their Implications
- Changes in vital signs can indicate a worsening condition.
- Immediate reporting of specific changes is crucial, including fever, abnormal respiratory or pulse rates, blood pressure changes, and worsening pain.
Body Temperature Measurement
- Common sites for measuring body temperature include oral, rectal, axillary (armpit), tympanic (ear), and temporal artery.
- There are conditions under which temperature should not be taken orally: unconsciousness, facial/oral surgery, age under 5, confusion, heavy sedation, seizure risk, coughing, or oxygen use.
Thermometers
- Rectal thermometers are typically color-coded red or orange.
- The rectum is considered the most accurate site for temperature measurement.
- Digital thermometers provide readings in 2 to 60 seconds, and temporal artery thermometers scan across the forehead for quick measurements.
Pulse Measurement
- The apical pulse is located on the left side of the chest, just below the nipple.
- Radial pulse is the most commonly used site for measuring pulse rate.
Respiratory Terms
- Dyspnea refers to difficulty breathing, with respiration rates for adults ranging from 12 to 20 breaths per minute.
- Observing respiration without the resident's knowledge is important as awareness can alter breathing patterns.
Blood Pressure Basics
- Diastolic pressure reflects the heart's relaxation phase, while systolic pressure reflects when the heart is active.
- Hypertension indicates high blood pressure, and hypotension indicates low blood pressure.
- Blood pressure is measured in millimeters of mercury (mmHg) using a sphygmomanometer.
Pain Assessment
- Key questions for accurate pain assessment include location, timing, intensity (0-10 scale), activity during onset, duration, frequency, and relieving/worsening factors.
- Barriers to effective pain management can include fear of addiction, misconceptions about aging, concern over medication side effects, and caregivers' perceived busyness.
Heat and Cold Applications
- Cold applications can reduce fever and control bleeding, while heat can increase blood flow to an injured area.
- Sitz baths are used to clean perineal wounds and alleviate pain, but may cause weakness or dizziness.
Dressings and Wound Care
- Sterile dressings are used for open or draining wounds and should be changed by a nurse.
- Non-sterile dressings apply to closed wounds with lower infection risks.
- Supplies for sterile dressing changes include gauze dressings, adhesive tape, scissors, gloves, and a plastic bag for disposal.
Bandaging Techniques
- Elastic bandages help hold dressings in place and should be applied tightly enough to control bleeding.
- Residents should be monitored within 10 minutes after applying a bandage.
IV Therapy and Oxygen Administration
- IV therapy provides direct access to the bloodstream, with assistants responsible for documenting observations.
- Oxygen concentrators enhance air oxygen levels and nasal cannulas deliver concentrated oxygen.
- Humidifiers add moisture to the air, using distilled water for humidifying bottles with oxygen concentrators.
Safety Precautions
- Never administer a resident's oxygen; trained personnel should handle such duties.
- Liquid oxygen can potentially cause frostbite if mishandled.
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Description
Test your knowledge on vital signs and basic nursing skills with these flashcards from Chapter 14 of the workbook. Learn the crucial indicators to observe in patient assessment and what vital changes necessitate immediate reporting. This quiz will reinforce your understanding of monitoring patient conditions effectively.