HOSA Nursing Assistant: legal and ethical guides

• Study notes for HOSA Nursing Assistant

Legal and Ethical Considerations

• Confidentiality means keeping information private.
• Ethical standards are rules for proper personal and professional conduct.
• Legal rights are rights of all people under the law.
• Liability is legal responsibility for actions or failures to act.
• An ombudsman supports the health, welfare, safety, and rights of residents in long-term care facilities.
• Privacy is freedom from intrusion.
• Protocol is a healthcare facility's specific rules for performing tasks.
• Invasion of privacy involves unwanted visitors or release of confidential information.
• Abuse is the willful infliction of injury or harm.
• Assault is a threat or attempt to injure.
• Battery is touching someone's body without consent.
• Coercion is attempting to force someone to do something against their will.
• Discrimination is treating people unfairly based on ethnicity/gender/etc.
• Exploitation is taking advantage of a weaker group.
• A grievance is a complaint.
• Harassment is tormenting or offending someone through behavior or speech.
• Informed consent is a patient's understanding and agreement to an explained action or procedure.
• An intentional tort is a knowingly committed wrongful act.
• Malpractice is working below the standards of practice.
• Negligence is careless neglect, often resulting in injury.
• A tort is a wrong committed against a person or their property.
• An unintentional tort is causing harm to a person by accident.
• Unlawful restraint is restricting movement without consent.

Advance Directives

• An advance directive is a legal document describing medical care preferences.
• A DNR order means "Do Not Resuscitate."
• A health care proxy is a legal document appointing someone to make health decisions on someone's behalf.
• Living wills state what measures should or shouldn't be taken to prolong life.
• An organ donation form states a person's wish to donate organs or tissues.
• A patients bill of rights are guidelines that health care staff must follow to ensure patients are protected in the hospital.
• Resident's rights are rights for home health care clients and residents of long term care facilities provided by OBRA 87 regulations.

Aging Considerations

• Daily soap use is not a part of proper skin care during aging. Note: Skin changes occur during aging
• Bed rest is not needed because of loss of strength. Note: Changes occur in the musculoskeletal system during aging
• People between 65-85 years old are considered elderly.
• The side-lying position is not the best for breathing. Note: Respiratory changes occur with aging
• The older person should not eat fruits and vegetables with skin and seeds, dry and fatty foods, and raw apricots and celery. Note: Changes occur in the digestive system
• Fluids should mostly be given before 5:00 pm for older residents ordered to increase fluid.
• Ovaries and testes do not increase in size. Note: Changes occur in the reproductive system during aging

Safety and Restraints

• Bed rails should not be kept up when the bed is in the highest position.
• Bed rails are restraints under OBRA.
• Calling patients/residents by name is insufficient for identification.
• Restraints are not for staff convenience.
• Restraints are removed every 2 hours.
• A vest restraint is not used to position a person on the toilet..
• Restrained persons are not checked every 30 minutes.
• A vest restraint crosses in front.
• Bed rails are padded when vest restraints are used.
• Equipment should be checked for damage to prevent accidents.
• An item is not sterile if nonpathogens are present.
• Protective equipment is removed before leaving the work area.

Infection Control

• Signs of infection include fever, nausea, vomiting, sores, pain/tenderness, redness, swelling, fatigue, loss of appetite, and discharge.
• Microbes can enter/leave the body through the respiratory tract, gastrointestinal system, blood, the reproductive system, and the urinary system.
• A mask is contaminated when moist.
• Contaminated work surfaces are cleaned after completing a task, immediately when there is obvious contamination, and after blood or potentially infectious material is spilled.
• The Bloodborne Pathogen Standard includes washing hands after removing gloves, discarding sharp objects into containers with the BIOHAZARD symbol, and storing food and blood in separate places.

Nutrition

• The Food Guide Pyramid encourages a low-fat diet.
• 6-11 daily servings of breads, cereals, rice, and pasta are recommended.
• 2-3 daily servings of the meat group are recommended.
• The meat, poultry, fish, dry beans, eggs, and nuts group contains the most fat.
• Fats, oils, and sweets should be used sparingly.
• Protein is needed for tissue growth and repair.
• Meats and fish provide the most protein.
• Sodium-restricted diets are ordered for those with heart, kidney, or liver disease.
• Diet planning for persons with diabetes mellitus involves a consistent daily amount of carbohydrates.
• OBRA requires that hot foods and cold foods be served hot and cold respectively, and that food smells and tastes good.
• Adult fluid requirements for a normal fluid balance are about 2000-2500 mL daily.
• When a person is NPO, the water pitcher and glass should be removed from the room.
• Signs of a swallowing problem include drooling, coughing while eating, and pocketing.
• It is not recommended to engage the person in a pleasant conversation while feeding.
• A person with a feeding tube is usually NPO.
• To prevent regurgitation after a tube feeding, the person is positioned in semi-Fowler's position for 1 hour after the feeding.

Documentation and Communication

• Medical records communicate information about the person, can be used in court, but cannot be read by anyone in the agency (HIPPA).
• Assistance with oral care is recorded on the Activities of Daily Living Flow Sheet.
• Pain is considered a symptom.
• Implementation of comprehensive care plan measures is a step in the nursing process.
• Nursing process communicates the patient's care.
• The comprehensive care plan consists of actions the healthcare team takes to help a person.
• When recording information, use ink, include the date/time, cross out errors with a single line and initial, and sign all entries with name and title.
• When recording, use the person's exact words when possible, record what you observed and did yourself, and do not skip lines.
• When resolving a conflict with a coworker who is often late, explain the problem to your supervisor, give facts and specific instances, and suggest ideas to solve the problem.

Additional Terms

• False imprisonment is the unlawful restraint of a patient's freedom of movement.
• A high-fiber diet is often prescribed for patients with constipation and GI disorders.
• The purpose of passive range-of-motion exercises is to maintain joint mobility.
• Nerve tissue functions to control and communicate.
• Epithelial tissue functions to secrete and protect.
• Cardiac tissue functions to move and protect.
• Connective tissue functions to support and connect.
• Acne vulgaris is inflammation of the sebaceous glands.
• Athlete's foot is a fungus infection usually in the skin of the toes and soles.
• Bursitis is inflammation of a bursa.
• Osteomyelitis is inflammation of bone and bone marrow.
• Fibromyalgia is pain in the muscle fibers.
• Deltoid refers to the shoulder.
• Latissimus dorsi refers to the spine around to chest.
• Sartorius refers to the front of the thigh.
• Tibialis anterior refers to the front of the lower leg.
• Gastrocnemius refers to the calf.
• Mysthenis Gravis is an autoimmune degenerative progressive disease affecting muscles.
• A cerebrovascular accident is a stroke, ischemic or hemorrhagic, where brain tissue dies.
• Amblyopia is lazy eye.
• A cataract is clouding of the lens of the eye.