CNA Unit 3 Review Questions
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Questions and Answers

List examples of activities of daily living.

Bathing, perineal care, toileting, mouth care, shampooing and combing the hair, nail care, shaving, dressing, eating, walking and transferring.

List 5 reasons that a resident may need help with personal care.

Give examples of how to promote dignity and independence while giving personal care.

Encourage residents to do as much as they can, knock and wait for permission to enter, not interrupt residents while they are in the bathroom, leave the room when residents receive or make phone calls, respect residents' private time and personal things, not interrupt resident while they are dressing.

What are five things about a resident that a NA can observe during personal care?

<p>Skin, mental state, mobility, flexibility, comfort level, ability to perform ADLs, and emotional state.</p> Signup and view all the answers

Why is preventing pressure ulcers extremely important?

<p>Stage 1: Intact skin with redness; Stage 2: Partial skin loss involving the outer and/or inner layer of skin (looks like blister); Stage 3: Full skin loss involving damage or death of tissues that may extend down to the tissue covering muscle; Stage 4: Full skin loss with major destruction, tissue death, and damage to muscle, bone, or supporting structures.</p> Signup and view all the answers

When skin begins to break down, what does it look like?

<p>Pale, white, or reddened color.</p> Signup and view all the answers

List ten signs to observe and report about a resident's skin.

<p>Pale, white, reddened, or purple areas; blisters or bruises; complaints of tingling, warmth, or burning of skin; dry or flaking; itching; rash; swelling; fluid or blood draining from skin; broken skin; wounds or ulcers on skin; changes in wound or ulcer; redness or broken skin between toes or toenails.</p> Signup and view all the answers

At a minimum, how often should residents be repositioned?

<p>Every 2 hours.</p> Signup and view all the answers

List four examples of positioning devices and explain how they can help.

<p>Backrest, bed cradles, draw sheets, footboards.</p> Signup and view all the answers

Why is it unnecessary for many elderly people to have a complete bath or shower every day?

<p>Because they have partial baths on the other days; they have dry and fragile skin, and not bathing every day prevents further dryness.</p> Signup and view all the answers

Why should residents, as well as NAs, test the water temperature before bathing?

<p>To ensure it is not too hot and the resident is comfortable.</p> Signup and view all the answers

Why should the NA wipe from front to back when giving perineal care?

<p>To prevent spreading bacteria from the rectum to the genitals.</p> Signup and view all the answers

List two benefits of back rubs.

<p>Reflex and increase circulation.</p> Signup and view all the answers

Why should bath oils, lotions, or powders NOT be used in showers or tubs?

<p>They are slippery.</p> Signup and view all the answers

Explain why NAs must be especially careful while giving nail care to diabetic residents.

<p>Poor circulation can lead to infections in diabetics, which can result in severe wounds or amputation.</p> Signup and view all the answers

Why should an NA wear gloves while shaving residents?

<p>To reduce the risk of being exposed to blood.</p> Signup and view all the answers

List the reasons why electric razors should not be used near water or when O2 is in use.

<p>They may cause explosion.</p> Signup and view all the answers

What are the symptoms of head lice?

<p>Itching, bite marks on the scalp, skin sores, matted, bad smelling hair and scalp.</p> Signup and view all the answers

If a resident has an affected side due to stroke or an injury, how should the NA refer to that side?

<p>Weaker side.</p> Signup and view all the answers

When dressing a resident with a weaker side, which arm is usually placed through the sleeve first?

<p>The weak side is put through first and the strong side is taken off first.</p> Signup and view all the answers

What does oral care consist of?

<p>Brushing teeth, tongue, and gums; flossing teeth with dental floss; caring for lips and dentures.</p> Signup and view all the answers

What is the minimum number of times per day that oral care is done?

<p>2 times/day.</p> Signup and view all the answers

How can NAs help prevent aspiration during oral care of unconscious residents?

<p>By turning the resident on their side.</p> Signup and view all the answers

Why should hot water not be used on dentures?

<p>To prevent them from warping.</p> Signup and view all the answers

What is the normal color of urine?

<p>Pale yellow.</p> Signup and view all the answers

List five things to observe and report to the nurse about urine.

<p>Cloudy, dark, strong fruit-smelling urine; pain or burning; blood or pus; protein or glucose; incontinence.</p> Signup and view all the answers

What is the best position for women to be in to have normal urination? And for men?

<p>Women, sitting; men, standing; supine should be avoided as a person can't put pressure on the bladder and must work against gravity.</p> Signup and view all the answers

When performing perineal care, in what direction should the NA wipe the resident?

<p>Front to back to prevent infection.</p> Signup and view all the answers

How should a standard bedpan be positioned? How should a fracture pan be positioned?

<p>Standard: should be positioned with the wider end aligned with the resident's buttock; fracture: should be positioned with the handle toward the foot of the bed.</p> Signup and view all the answers

List and define types of incontinence.

<p>Urinary: inability to control the bladder; Stress: loss of urine due to increased intra-abdominal pressure (coughing, sneezing, laughing); Urge: involuntary voiding from a sudden urge to void; mixed: combination of both urge and stress incontinence; reflex: occurs when a specific bladder volume is reached; Functional: urine loss caused by external factors; Overflow: loss of urine due to over-distention of the bladder.</p> Signup and view all the answers

Is urinary incontinence a normal part of aging?

<p>False</p> Signup and view all the answers

Why should a NA never refer to an incontinence brief as a diaper?

<p>It is important for dignity and to avoid embarrassment; if not changed frequently, it can cause pressure ulcers.</p> Signup and view all the answers

What are four ways that NA can help prevent UTIs?

<p>Careful perineal care when changing incontinence briefs, encourage fluids (water, cranberry, blueberry, and Vit C), offer a bedpan or toilet every two hours, and take showers rather than baths.</p> Signup and view all the answers

Why should the catheter drainage bag always be kept lower than the hips or bladder?

<p>To ensure that urine does not flow back into the bladder, thus causing infection.</p> Signup and view all the answers

Why should catheter tubing be kept as straight as possible?

<p>To prevent kinks which can cause pressure and hinder urine drainage.</p> Signup and view all the answers

What are the types of catheters?

<p>Straight catheter: does not remain inside the person and is removed immediately after urine is drained; Indwelling catheter: remains inside the bladder for a period of time; Condom catheter: has an attachment that fits onto the penis and is fastened with special tape.</p> Signup and view all the answers

List five signs and symptoms to report to the nurse about catheters.

<p>Blood in urine or any unusual appearance; catheter bag does not fill after several hours; catheter is not positioned properly; urine leaks from the catheter; resident reports pain or pressure; odor is present.</p> Signup and view all the answers

What is a clean catch urine specimen?

<p>The perineal area is cleaned first, then the person begins to urinate a small amount into the toilet to clear the urethra, before urinating again into a clean or sterile container and stopping before urination is complete.</p> Signup and view all the answers

How can NAs help reduce discomfort and embarrassment when assisting with specimen collection?

Signup and view all the answers

List four things reagent strips can test for in urine.

Signup and view all the answers

Why do residents who are incontinent need careful perineal care?

Signup and view all the answers

About how long after fluids are taken should the NA offer to take a resident to the bathroom?

Signup and view all the answers

Out of the list of guidelines for bladder retraining, list two that help promote dignity.

Signup and view all the answers

How does stool normally appear?

<p>Brown, soft, and tubular.</p> Signup and view all the answers

List five things to observe and report to the nurse about stool.

<p>White, black, red, or hard stools; liquid stools; constipation; gas; pain during bowel movement; blood, pus, mucus, discharge; incontinence.</p> Signup and view all the answers

What is the best position for bowel elimination? What should be done if a person cannot get out of bed for defecation?

<p>Squatting and leaning forward; if bedridden, NA can raise the head of the bed for elimination.</p> Signup and view all the answers

List three possible treatments for constipation.

<p>Physical activity, appropriate personal habits/positions, medications (laxatives or adjusted prescriptions).</p> Signup and view all the answers

List three signs of fecal impaction.

<p>No stool for several days with liquid stool oozing out; cramping; abdominal swelling and rectal pain.</p> Signup and view all the answers

List three causes of diarrhea.

<p>Bacterial and viral infections; microorganisms in food and water; irritating foods and medications.</p> Signup and view all the answers

What is gastroesophageal reflux disease (GERD)?

<p>A chronic condition where the liquid contents of the stomach back up into the esophagus, damaging the esophageal lining, which can cause bleeding or ulcers.</p> Signup and view all the answers

What are two things that people with peptic ulcers should avoid?

<p>Raw sores in stomach or small intestine; smoking and drinking alcohol.</p> Signup and view all the answers

What are three symptoms of colorectal cancer?

<p>Changes in normal bowel patterns, cramps, abdominal pain, and rectal bleeding.</p> Signup and view all the answers

In what position must the resident be placed for an enema?

<p>Sims position, because water does not have to flow against gravity.</p> Signup and view all the answers

What should the NA do if a resident feels pain or if the NA feels resistance while giving an enema?

<p>Stop immediately and tell the nurse.</p> Signup and view all the answers

What two things should not be included in a stool specimen?

<p>Urine and toilet paper.</p> Signup and view all the answers

If a stool specimen needs to be tested for ova and parasites, what could be done immediately and why?

<p>Taken to the lab, to ensure timely and accurate analysis.</p> Signup and view all the answers

What may occult blood in stool indicate?

<p>It may indicate colorectal cancer or other illnesses.</p> Signup and view all the answers

What are three reasons that a resident may need a colostomy or ileostomy?

<p>Bowel disease, cancer, or trauma.</p> Signup and view all the answers

How often should an ostomy bag be emptied?

<p>Whenever stool is eliminated.</p> Signup and view all the answers

What kind of foods may need to be eaten when a resident is going through bowel retraining?

<p>Plenty of fluids, foods high in fiber, and a special diet as ordered.</p> Signup and view all the answers

Study Notes

Activities of Daily Living

  • Includes bathing, perineal care, toileting, mouth care, hair care, nail care, shaving, dressing, eating, walking, and transferring.

Reasons for Assistance with Personal Care

  • Elderly or disabled residents may require help due to physical limitations, cognitive impairments, recovery from surgery, lack of energy, or fear of falling.

Promoting Dignity and Independence

  • Encourage residents to participate in personal care as much as possible.
  • Knock and await permission before entering resident's spaces.
  • Avoid interrupting residents while using the bathroom.
  • Respect residents' privacy during phone calls and personal time.

Observations During Personal Care

  • Important areas to observe include skin condition, mental state, mobility, flexibility, comfort level, emotional state, and ability to perform Activities of Daily Living (ADLs).

Pressure Ulcers

  • Stages of pressure ulcers range from intact skin with redness to full skin loss involving deeper tissue damage.
  • Preventing pressure ulcers is essential for resident comfort and health.

Skin Breakdown Indicators

  • Skin appears pale, white, or reddened in areas beginning to break down.

Signs to Report About Skin

  • Key indicators include discoloration, blistering, pain or change in sensation, dryness, rashes, and any drainage, broken skin, or wounds.

Repositioning Residents

  • Residents should be repositioned every 2 hours to prevent skin breakdown and enhance comfort.

Positioning Devices

  • Devices like backrests, bed cradles, draw sheets, and footboards can aid in resident positioning and comfort.

Bathing Frequency for the Elderly

  • Daily complete baths are often unnecessary; partial baths help maintain skin health without excessive dryness.

Water Temperature Testing

  • Both residents and NAs should check water temperature to ensure comfort and prevent burns.

Perineal Care Hygiene

  • Wiping from front to back helps prevent bacterial infections.

Benefits of Back Rubs

  • Provides reflex relief and enhances circulation.

Bath Oils and Lotions

  • Should not be used in bathtubs or showers as they create slippery surfaces.

Nail Care for Diabetic Residents

  • Nail care should be conducted carefully to avoid infections due to poor circulation that can lead to severe wounds or amputation.

Safety Measures While Shaving

  • Wearing gloves is necessary to prevent exposure to blood.

Electric Razor Precautions

  • Should not be used near water or with oxygen present to avoid explosion hazards.

Head Lice Symptoms

  • Characterized by itching, bite marks, sores on the scalp, and matted, foul-smelling hair.

Referring to Weaker Side

  • Affected side from a stroke or injury should be referred to as the "weaker side."

Dressing Techniques

  • When dressing, start with the weak side first and undress the strong side last.

Oral Care Components

  • Involves brushing teeth, tongue, gums, flossing, and caring for lips and dentures.

Oral Care Frequency

  • Minimum of twice a day.

Preventing Aspiration

  • For unconscious residents, turning them on their side can help prevent aspiration during oral care.

Dentures Care

  • Hot water can warp dentures, so should be avoided.

Normal Urine Color

  • Urine is typically pale yellow.

Urine Observation

  • Key signs to report include changes in color, odor, presence of pain, or unusual substances.

Normal Urination Positions

  • Women should sit, while men can stand; avoid lying supine to reduce pressure on the bladder.

Perineal Care Technique

  • Wipe from front to back to minimize infection risks.

Bedpan Positioning

  • Standard bedpans should align with resident's buttocks, while fracture pans have the handle directed towards foot.

Types of Incontinence

  • Includes urinary, stress, urge, mixed, reflex, functional, and overflow incontinence; each type defined by its causes and characteristics.

Incontinence and Aging

  • Not considered a normal part of aging; requires reporting and monitoring of symptoms.

Dignity in Incontinence Products

  • Referring to incontinence briefs as "diapers" can cause embarrassment and should be avoided.

UTI Prevention Strategies

  • Involves proper perineal hygiene, encouraging fluid intake, regular toileting, and prompt reporting of suspicious urine characteristics.

Catheter Care

  • Place catheter drainage bags lower than the hips to prevent backflow and potential infections; tubing should remain straight to avoid kinks.

Catheter Types

  • Straight catheter (used once), indwelling catheter (remains in place), and condom catheter (external attachment) each serve different needs.

Signs to Report for Catheters

  • Report blood in urine, lack of bag filling, urinary leaks, discomfort, or unusual odors.

Clean Catch Urine Specimen Procedure

  • Clean area, initiate urination into the toilet to clear urethra, then catch urine in a sterile container.

Care for Specimen Collection

  • Offer privacy and support to reduce discomfort and embarrassment during collection.

Reagent Strips for Urine Testing

  • Can test for pH, protein, glucose, and other characteristics indicative of health status.

Importance of Perineal Care

  • Required for residents with incontinence to maintain skin integrity and prevent infections.

Bathroom Assistance Timing

  • Offer bathroom assistance about 30 minutes after fluid intake to encourage regular urination.

Bladder Retraining Dignity Guidelines

  • Strategies should emphasize resident dignity and comfort during training.

Normal Appearance of Stool

  • Stools should appear brown, soft, and tubular.

Stool Observations

  • Report unusual stool colors, consistency, pain during bowel movements, or any discharge.

Bowels Elimination Position

  • Best posture is squatting; raise the head of the bed for bedridden residents.

Treatment Options for Constipation

  • Encourage physical activity, develop healthy personal habits, and consider medications like laxatives.

Signs of Fecal Impaction

  • May manifest as a lack of stool for several days, cramping, or oozing liquid stool.

Causes of Diarrhea

  • Bacterial or viral infections, and irritants from foods or medications; treatment may involve dietary adjustments.

Gastroesophageal Reflux Disease (GERD)

  • A chronic condition where stomach contents back up into the esophagus, potentially causing serious complications.

Peptic Ulcer Precautions

  • Individuals should avoid smoking and alcohol, as they exacerbate conditions.

Colorectal Cancer Symptoms

  • Changes in bowel habits, cramps, abdominal pain, and rectal bleeding are key indicators.

Enema Positioning

  • Residents should be positioned in the Sims position for effective treatment.

Enema Administration Cautions

  • If the resident experiences pain or resistance, halt the procedure and inform a nurse immediately.

Stool Specimen Collection Considerations

  • Ensure specimens are collected without contamination from urine or toilet paper.

Specimen Testing for Ova and Parasites

  • Specimens should be transported to the lab promptly for analysis.

Occult Blood Presence in Stool

  • Indicates possible colorectal cancer or other serious infections.

Colostomy and Ileostomy Requirements

  • May be needed due to bowel diseases, cancers, or traumatic injuries.

Ostomy Bag Maintenance

  • Should be emptied whenever stool is expelled to ensure cleanliness and comfort.

Dietary Considerations During Bowel Retraining

  • Encourage fluid intake, fiber-rich foods, and adherence to specific dietary guidelines as ordered.

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Test your understanding of the essential activities of daily living and the importance of personal care in nursing. This quiz covers reasons residents may require assistance and ways to promote dignity and independence during personal care. Perfect for CNA students preparing for their exams.

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