Podcast
Questions and Answers
What are standard precautions primarily designed to prevent?
What are standard precautions primarily designed to prevent?
What is medical asepsis?
What is medical asepsis?
Which of the following is an example of a localized infection?
Which of the following is an example of a localized infection?
What is one of the legal responsibilities of a Nursing Assistant?
What is one of the legal responsibilities of a Nursing Assistant?
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What defines chronic pain?
What defines chronic pain?
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Which of the following is an effective strategy to enhance communication with a client?
Which of the following is an effective strategy to enhance communication with a client?
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What is a susceptible host in the context of infection prevention?
What is a susceptible host in the context of infection prevention?
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What does 'thinking on one's feet' refer to in healthcare?
What does 'thinking on one's feet' refer to in healthcare?
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What does the R.A.C.E. acronym stand for in fire response?
What does the R.A.C.E. acronym stand for in fire response?
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Which step is the most crucial in handwashing and why?
Which step is the most crucial in handwashing and why?
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What is the primary purpose of the OBRA (Omnibus Budget Reconciliation Act of 1987)?
What is the primary purpose of the OBRA (Omnibus Budget Reconciliation Act of 1987)?
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What defines a systemic infection?
What defines a systemic infection?
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Which of the following is an example of an intrinsic risk factor for falls?
Which of the following is an example of an intrinsic risk factor for falls?
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How can a Nursing Assistant safely respond to a resident who is choking and they are alone?
How can a Nursing Assistant safely respond to a resident who is choking and they are alone?
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What distinguishes acute pain from chronic pain?
What distinguishes acute pain from chronic pain?
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Which agency oversees the scope of practice for Nurse Aides?
Which agency oversees the scope of practice for Nurse Aides?
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What is the primary function of calcium in the body?
What is the primary function of calcium in the body?
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What does allowing resident involvement in care demonstrate?
What does allowing resident involvement in care demonstrate?
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What role does compromise play in healthcare relationships?
What role does compromise play in healthcare relationships?
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How can a nurse aide promote a client’s self-esteem?
How can a nurse aide promote a client’s self-esteem?
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Which body system does Vitamin C help boost?
Which body system does Vitamin C help boost?
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What are some goals of patient-centered care?
What are some goals of patient-centered care?
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What does connectedness refer to in the context of patient care?
What does connectedness refer to in the context of patient care?
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What should a nurse aide do in response to an acute change in a patient’s condition?
What should a nurse aide do in response to an acute change in a patient’s condition?
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Which nutrient is primarily necessary for growth and repair in the body?
Which nutrient is primarily necessary for growth and repair in the body?
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In Maslow's Hierarchy of Needs, what is the first level of need that must be addressed?
In Maslow's Hierarchy of Needs, what is the first level of need that must be addressed?
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What is the main purpose of a nursing care plan?
What is the main purpose of a nursing care plan?
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What does dysphagia refer to in a medical context?
What does dysphagia refer to in a medical context?
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Which of the following is a common method for preventing foot drop in patients?
Which of the following is a common method for preventing foot drop in patients?
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Study Notes
Healthcare-Associated Infections (HAIs)
- HAIs are infections acquired in a healthcare setting
- They can be caused by bacteria, viruses, fungi or parasites
HIPAA (Health Insurance Portability and Accountability Act)
- Enacted in 1996
- Protects patient privacy and confidential healthcare information
- Ensures patient health information is kept secure
CNA Renewal Requirements
- Requires 24 hours of continuing education for renewal
- Must be completed within 24 months prior to license expiration
OBRA (Omnibus Budget Reconciliation Act of 1987)
- Enacted to improve quality of care for nursing home residents
- Established training standards for CNAs
- Requires nursing homes to provide resident care plans
Chain of Infection
- Infectious Agent: microorganism that causes the infection (e.g., bacteria, viruses, fungi, parasites)
- Reservoir: Place where the agent lives (e.g., humans, animals, environment)
- Portal of Exit: Route the agent leaves the reservoir (e.g., respiratory secretions, open wounds)
- Mode of Transmission: How the agent travels (e.g., direct contact, airborne droplets)
- Portal of Entry: Route the agent enters the host (e.g., mucous membranes, broken skin)
- Susceptible Host: Person who is at risk for infection (e.g., elderly, immunocompromised)
Pain Types
- Acute Pain: Short-term, usually associated with injury or surgery
- Chronic Pain: Long-lasting, may persist for months or years
Common Causes of Pain in Residents
- Arthritis
- Cancer
- Nerve damage
- Degenerative conditions
Effects of Pain
- Emotional: Anxiety, depression, anger, irritability
- Physical: Decreased mobility, appetite changes, sleep disturbances, fatigue
R.A.C.E. Fire Response
- Rescue: Remove residents from danger
- Alarm: Activate the nearest fire alarm
- Contain: Close doors and windows to limit fire spread
- Extinguish: Use a fire extinguisher if safe
P.A.S.S. Fire Extinguisher Use
- Pull: Pull the pin on the extinguisher
- Aim: Aim the nozzle at the base of the fire
- Squeeze: Squeeze the handle to release the extinguishing agent
- Sweep: Sweep the nozzle back and forth across the base of the fire
Resident Seizure Care
- Stay with the resident: Do not leave them alone
- Clear the area: Move furniture or objects to prevent injury
- Protect the head: Position a pillow or blanket under the head
- Turn the resident on their side: Prevent choking
- Do not put anything in the resident’s mouth: This can cause injury
- Document the seizure: Record the time it started and ended, type of seizure, and any other relevant details
Seizures
- Definition: Abnormal electrical activity in the brain causing involuntary muscle contractions
- Causes: Epilepsy, head injury, stroke, infection
Effective Team Communication
- Clarity
- Respect
- Active listening
- Open communication
- Feedback
Ineffective Team Communication
- Lack of clarity
- Judgmental communication
- Disrespect
- Closed communication
Dignity in Patient Care
- Definition: Treating residents with respect and valuing their individuality
- Importance: Helps residents maintain their sense of self-worth and autonomy
Empathy
- Definition: Understanding and sharing the feelings of others
-
Examples:
- "I can imagine how difficult this must be for you."
- "That sounds like a frustrating experience."
Electronic Documentation
- Accuracy: Ensure all information is correct
- Timeliness: Record information promptly
- Confidentiality: Protect patient privacy by adhering to HIPAA regulations
Overcoming Communication Barriers
- Use clear and concise language
- Speak slowly and enunciate clearly
- Use nonverbal cues to reinforce communication
- Be patient and understanding
- Ask for clarification if needed
Verbal vs. Nonverbal Communication
- Verbal: Use of spoken words
- Nonverbal: Body language, facial expressions, tone of voice
Military Time Conversion
-
Military to Conventional:
- Subtract 1200 from military time if it’s greater than 1200.
- Add "a.m." after the time if it’s 0100 to 1159.
- Add "p.m." after the time if it’s 1300 to 2359.
- 0000 = 12 a.m.
- 1200 = 12 p.m.
-
Conventional to Military:
- Add 1200 to the conventional time if it’s after 12 p.m.
- Keep the time between 1 a.m. and 12 p.m.
Handwashing Technique
- Wet hands with running water
- Apply soap
- Lather hands for at least 20 seconds
- Rinse hands thoroughly under running water
- Dry hands with a clean paper towel or air dryer
Most Crucial Step in Handwashing
- Rinsing: Removes soap and germs effectively
Objective vs. Subjective Data
- Objective: Measurable and observable facts (e.g., blood pressure, temperature)
- Subjective: Information provided by the resident about their experience (e.g., pain level, feelings)
Systemic Infection
- Definition: Infection that affects the entire body
- Example: Sepsis
Fall Risk Factors in Geriatric Clients
- Impaired balance and gait
- Muscle weakness
- Vision or hearing problems
- Medications that cause drowsiness or dizziness
- Cognitive impairment
Extrinsic vs. Intrinsic Fall Risk Factors
- Extrinsic: Environmental factors (e.g., poor lighting, clutter, slippery floors)
- Intrinsic: Individual factors (e.g., age, medical conditions, medications)
PPE (Personal Protective Equipment)
- Putting On: Gown, mask, eye protection, gloves
- Taking Off: Gloves, eye protection, gown, mask
-
Items and Purpose:
- Gloves: Prevent contamination and protect from germs
- Mask: Protects from airborne particles
- Gown: Protects clothing from contamination
- Eye Protection: Protects eyes from splashes or sprays
Elopement in Healthcare Setting
- Definition: A resident leaving the healthcare facility without authorization
TOSS POWS Dressing Method
- TOSS: Turn resident to their side
- POWS: Pull garment away from the resident’s body
Foot Care Steps
- Wash the feet: Use warm water and mild soap
- Dry thoroughly: Including between toes
- Examine for any signs of infection: Redness, swelling, pain
- Moisturize: Apply lotion to the feet, avoiding the area between the toes
- Trim toenails: Straight across, not into the corners
- Wear comfortable, well-fitting shoes: Avoid tight shoes that restrict circulation
Nail Care Steps (Fingernails)
- Trim nails: Straight across using clippers
- File edges: Smooth edges for better hygiene and to prevent scratching
Nurse Aide General Duties
- Assisting residents with ADLs (Activities of Daily Living): Bathing, dressing, toileting, eating
- Observing and reporting changes in resident condition: Vital signs, pain levels, behavior
- Providing companionship and emotional support
- Maintaining a safe and clean environment
Anaerobic vs. Aerobic Organisms
- Anaerobic: Can survive without oxygen
- Aerobic: Require oxygen to survive
Alcohol-Based Hand Rub Use
- Appropriate when hands are not visibly soiled
- Not effective against certain organisms like Clostridium difficile (C. diff)
Breaking Links in the Chain of Infection
- At least one link in the Chain of Infection must be broken to prevent infection
Sharing Resident Information
- Can only share information with other healthcare professionals involved in the resident’s care
NA Scope of Practice
- Determined by the state or licensing agency: Each state has specific regulations for CNAs
Respoonding to Choking
- If alone, call for help by dialing 911 or your facility’s emergency number
- If two people are present, one person calls for help while the other assists the choking resident
Culture in Healthcare
- Definition: The shared beliefs, values, traditions, and practices of a group of people
- Importance: Helps healthcare providers understand and respect the diverse needs and preferences of residents
Ethics for CNAs
- Defined as moral principles that guide behavior
- Important for guiding CNAs to make ethical decisions in their practice
BEFAST Stroke Recognition
- Balance: Sudden loss of balance or coordination
- Eyes: Vision changes or sudden blurry vision
- Face: Facial drooping or weakness
- Arms: Weakness or numbness in one arm
- Speech: Slurred speech or difficulty speaking
- Time: Time is crucial. Call 911 immediately
Nurse Aide Supervision
- Supervised by a licensed nurse
Standard Precautions
- Definition: Infection control practices used to prevent the spread of all germs
- When to use: With every resident, regardless of their diagnosis
Most Effective Disease Spread Prevention
- Handwashing: Most effective way to prevent the spread of germs
Nursing Assistant Legal Responsibilities
- Following facility policies and procedures
- Reporting abuse or neglect
- Maintaining resident confidentiality
- Providing safe and competent care
- Documenting care accurately and completely
Localized Infection
- Definition: Infection confined to a specific area of the body
- Example: Skin infection
Caring for Residents with Impaired Vision
- Identify yourself when entering the room
- Use clear and simple language
- Explain procedures and actions
- Orient residents to the environment using verbal cues
Strategies for Communication Enhancement
- Use open-ended questions
- Active listening
- Use nonverbal cues
- Be patient
- Adjust communication style to the resident’s needs
Therapeutic Communication Questions
- Open-ended questions that encourage the resident to express their thoughts and feelings
-
Examples:
- "Tell me about your day."
- "How are you feeling today?"
- "What are your concerns?"
Medications Nurse Aides Can Administer
- Generally none, except for mouth swabs for oral care or medications already prepared in oral syringes
Importance of Infection Prevention
- Protects residents and staff from the spread of infectious diseases
- Helps maintain a safe and healthy environment
Standard Precautions Use
- Used with all residents and their bodily fluids
Medical Asepsis
- Definition: Clean technique that reduces the number of pathogens
- Examples: Handwashing, wearing gloves, using clean equipment
Aerobic Microorganism Thriving Conditions
- Presence of oxygen
- Warm temperatures
- Moisture
Encouraging Independence During Personal Care
- Allow residents to participate in their care as much as they can
- Offer choices
- Provide assistance as needed
Medical Record
- Definition: A collection of documents containing a patient’s health information
- Purpose: Provides a comprehensive record of a resident’s care and helps healthcare professionals make informed decisions
Pain Definition in Healthcare
- Defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage
Comfort Measures to Decrease Pain
- Massage
- Warm or cold compresses
- Positioning
- Relaxation techniques
- Distraction
NA Choice for Pain Management
- NAs can offer the resident comfort measures but cannot administer pain medication
NA Role in Pain Management
- Observing and reporting pain level
- Providing comfort measures
- Encouraging the resident to express their pain
Nurse Aide in North Carolina
- A licensed healthcare professional who assists registered nurses in providing patient care
Omnibus Budget Reconciliation Act Enactment
- Enacted in 1987
Chain of Infection First Link
- Infectious Agent: microorganism that causes the infection
- Examples: Bacteria, viruses, fungi, parasites
Reservoir
-
Definition: Place where the infectious agent lives
- Examples: Humans, animals, environment
- The reservoir can be a link in the Chain of Infection because it provides a place for the infectious agent to multiply
Portal of Exit
-
Definition: Route the agent leaves the reservoir
-
Examples:
- Respiratory secretions (coughing, sneezing)
- Open wounds
- Feces
- Urine
- Blood
-
Examples:
Modes of Transmission
- Direct Contact: Person-to-person contact (e.g., touching)
- Indirect Contact: Contact with a contaminated object (e.g., touching a contaminated doorknob)
- Droplet Transmission: Coughing or sneezing that spreads droplets
- Airborne Transmission: Infectious particles remain suspended in the air (e.g., tuberculosis)
- Vector Transmission: Spread by animals or insects (e.g., mosquitoes transmitting malaria)
Portal of Entry
- Definition: Route the agent enters a new host (e.g., mucous membranes, broken skin)
-
Examples:
- Mucous membranes (nose, mouth, eyes)
- Open wounds
- Respiratory tract
- Urinary tract
- Digestive tract
Susceptible Host
- Definition: Person who is at risk for infection
-
Examples:
- Elderly
- People with compromised immune systems
- People with chronic illnesses
- They are more susceptible because their immune system is weaker and less able to fight off the infection
Patient Rights Regarding Medical Condition
- Patients have the right to know their diagnosis, treatment plan, and prognosis
- Right to refuse treatment
- Right to confidentiality
- Right to access their medical records
Promoting Dignity During Elimination
- Provide privacy
- Allow the resident to choose their preferred time for toileting
- Respect the resident’s personal preferences during care
Routine Tasks Concerns
- The NA should be concerned about all aspects of resident well-being, not just routine tasks
“Thinking on One’s Feet”
- Ability to adapt and respond to unexpected situations in a quick and decisive manner
Managing Family Members during Medical Procedures
- Respect family members: Allow them to participate in the resident’s care as appropriate
- Communicate with family: Keep them informed of the resident’s condition and any changes in the care plan
Person-Centered Care
- Definition: Care that focuses on the individual needs and preferences of the resident
-
Involves:
- Respecting the resident’s autonomy
- Providing individualized care
- Communicating effectively with residents and their families
Person-Centered Care Example
- Asking a resident what their favorite foods are and incorporating those preferences into their meal plan
Acute Pain
- Definition: Short-term pain, usually associated with injury or surgery
- Duration: Typically lasts for less than 6 months
Chronic Pain
- Definition: Pain that persists for longer than 3 to 6 months
- Characterization: Often associated with a persistent medical condition
- May not always have a clear cause
Tactful Statement Communication with Family Members
- Statements that are respectful, supportive, and avoid making judgments
Tactful Statement Purpose
- To build rapport with family members and foster a positive relationship
Identifying with a Patient’s Needs or Situation
- Understanding their perspective and showing empathy
Patient Right Violated by Lack of Privacy During Bath
- Right to privacy
Critical Thinking in Patient Care
- The ability to analyze a situation, consider different perspectives, and make informed decisions based on evidence
Assisting a Client Faced with a Difficult Decision
- Provide unbiased information and support to help them make a decision
Healthcare Family Definition
- Anyone identified by the resident as family, including family members, close friends, and significant others
Family Member Assistance with Patient Care Response
- Welcome family members and encourage their involvement
Family Assistance with Resident Adjusting to a New Environment
- Families can provide familiar items from the residents' home
- Families can help the resident navigate the new environment
- Families can provide emotional support
Patient-Centered Care Goals
- Improve resident satisfaction
- Promote resident well-being
- Increase resident independence
- Reduce hospital readmissions
Type of Care That Allows Unique Individuality
- Person-centered care
Resident Involvement in Care Demonstration
- Demonstrates respect for their autonomy and sense of control
Pain Effects on Lifestyle
- Decreased mobility
- Fatigue
- Sleep disturbances
- Social isolation
- Emotional distress
- Cognitive impairment
Comfort Measures to Decrease Pain
- Massage
- Warm or cold compresses
- Positioning
- Relaxation techniques
- Distraction
Severe Acute Pain Indication
- May indicate a serious medical condition
Patient History Collection and Critical Thinking
- Helps understand if the patient is experiencing something new or if their pain is related to a known issue
Respecting Personal Space Actions
- Asking permission before touching
- Maintaining a safe distance
- Knocking before entering a resident’s room
Empathy Demonstrations in Patient Care
- Active listening
- Validating feelings
- Offering words of comfort and support
NA Options for Pain Management
- Comfort measures: Massage, warm or cold compresses, repositioning
- Encourage the resident to describe their pain to the nurse
Responding to Acute Condition Change
- Immediately report the change to the nurse
Responding to Crying Patient
- Provide comfort and a listening ear
- Identify the cause of the crying if possible
Actions Supporting Resident Dignity
- Providing privacy
- Respecting the resident’s choices
- Promoting independence
- Treating the resident with respect
Resident Interests Display in Room
- Support their dignity by allowing them to personalize their space
Rigid Schedules Failing to Support
- Resident autonomy and individual preferences
Subjective Pain
- Pain described by the resident
Assisting with Chronic Pain
- Offer comfort measures
- Report changes in pain levels to the nurse
- Encourage communication with the resident's doctor
NA Role in Pain Management
- Observing and reporting pain level
- Providing comfort measures
- Encouraging the resident to express their pain
Sleep Patterns with Pain
- Often interrupted and of poor quality
Pain Being Worse At Night
- Pain may be worse at night because there are fewer distractions
Key to Successful Patient-Centered Care
- Effective communication
Compromise Role in Healthcare Relationships
- It is important to compromise to find solutions that meet the needs of both healthcare providers and residents
Promoting Self-Esteem
- Allowing residents to participate in their care
- Acknowledging their achievements
- Treating them with respect and dignity
Family Importance in Healthcare
- Families provide emotional support and help residents adjust
- Families can assist in providing care
Connectedness in Patient Care
- Building meaningful relationships with residents and their families
Milliliters in an Ounce
- 30 milliliters (ml)
Nutrients that Provide Energy and Flavor
- Carbohydrates and fats
Thickened Fluids Utensil
- A special spoon designed to administer thickened fluids
Nursing Process Steps
- Assessment: Gather information about the resident
- Diagnosis: Identify the resident’s health problems
- Planning: Develop a plan of care
- Implementation: Carry out the plan of care
- Evaluation: Monitor the resident’s progress
Incident Report Information
- Date and time of the incident
- Location of the incident
- Description of the incident
- Names of any witnesses
- Details of any injuries
Most Essential Nutrient
- Water
Food Thickeners Required by
- People with dysphagia (difficulty swallowing)
Protein Sources
- Meat, poultry, fish, beans, eggs, dairy products
Vitamin C Boosting System
- Immune system
Assessment Phase in Nursing Process
- Gather information about the resident’s condition, needs, and preferences
Incident Report Narrative Exclusion
- Personal opinions or judgments
Prosthesis Example
- Artificial limb
Calcium Function
- Strong bones and teeth
Incident Report Completion Situations
- Falls
- Medications errors
- Near misses
- Accidents
- Resident complaints
Nursing Care Plan
- Definition: A written plan that outlines the resident’s care needs
- Purpose: Ensures consistent care for the resident
MyPlate Campaign Encouragement
- Eating a balanced diet from all food groups
- Focus on fruits, vegetables, whole grains, and lean protein
Nutrient Necessary for Growth and Repair
- Protein
Good Nutrition Physical Characteristics
- Healthy weight
- Strong and shiny hair
- Clear skin
- Good energy levels
MyPlate Sections
- Fruits
- Vegetables
- Grains
- Protein
- Dairy
NA Contribution to Care Plan Development
- Providing information about the resident’s needs and preferences
- Reporting observations to the nurse
Dysphagia
- Definition: Difficulty swallowing
Medical Legal Forms an NA Can Explain
- Advance Directives: Documents that specify a resident's wishes for future healthcare
- Informed Consent: The resident’s consent to receive treatment after being informed of the risks and benefits
Clear Liquid Diet Allowed Foods
- Water
- Clear broth
- Juice without pulp
- Gelatin
- Popsicles
Nutrients and Primary Functions
- Carbohydrates: Provide energy
- Proteins: Growth and repair
- Fats: Provide energy, cushion organs, and insulate the body
- Vitamins: Support various bodily functions
- Minerals: Support various bodily functions
- Water: Hydration, transports nutrients, regulates body temperature
Person-Centered Care Encouragement
- Asking the resident their preferences and making decisions together
Maslow's Hierarchy of Needs Steps
- Physiological Needs: Basic needs for survival (e.g., food, water, shelter, sleep)
- Safety Needs: Needs for security and protection (e.g., safety from harm, stability)
- Love and Belonging Needs: Needs for affection, love, and connection (e.g., relationships, friendship)
- Esteem Needs: Needs for self-respect and recognition (e.g., accomplishment, confidence)
- Self-Actualization Needs: Needs for personal growth and fulfillment (e.g., achieving full potential)
Maslow's Hierarchy of Needs Order
- Important needs begin at the bottom of the hierarchy and work their way up
Maslow's Hierarchy of Needs Definition
- A model that describes the hierarchy of human needs
- States that basic needs must be met before higher-level needs can be achieved
Incident Report Completion
- When: As soon as possible after the incident occurs
- By whom: The person who witnessed or discovered the incident
HIPAA Reasons
- To protect patient privacy and confidentiality
- To prevent the misuse or unauthorized disclosure of patient health information
- To create a more secure healthcare system
Military Time Conversion
- See explanation above
Ethics in Healthcare
- Moral principles that guide professional behavior
- Encourage professionals to act in a responsible, honest, and caring manner
False Imprisonment in Healthcare
- Restricting a resident’s freedom of movement without legal justification
- Example: Keeping a resident confined to a room without a valid medical reason
Negligence in Patient Care
- Failing to provide reasonable care, resulting in harm to the resident
-
Examples:
- Giving a resident the wrong medication
- Failing to report a change in a resident’s condition
- Leaving a resident unattended in a dangerous situation
Food Thickeners Purpose
- To make liquids thicker and easier to swallow
- Helps prevent aspiration (inhaling food or liquid into the lungs)
Bowel and Bladder Re-training Program Duration
- Typically lasts for several weeks
NA Role in Nursing Process
- Assessment: Reporting observations to the nurse
- Planning: Assisting with implementing the care plan
- Implementation: Providing direct care
- Evaluation: Reporting changes in the resident’s condition and progress
Nursing Care Plan Purpose
- Ensures consistent care for the resident
- Outlines the resident’s specific needs and how they should be addressed
Foot Drop Prevention Methods
- Ankle-foot orthosis (AFO)
- Regular foot exercises
- Proper positioning
MyPlate Campaign Awareness
- Recognizing it as a guide to overall healthy eating
- Encourage residents or patients to follow these guidelines
Elimination in Healthcare Context
- Bowel and bladder function
- Includes toileting, bowel movements, and urination
NA Approach to Applying Prosthetic Device
- Respect and dignity: Allow the resident to participate as much as possible
- Safety: Ensure the device is properly fitted and safe to use
Body Mechanics ABCs
- Alignment: Maintain proper posture
- Balance: Distribute weight evenly
- Coordination: Work efficiently with controlled movement
Lateral Position
- Lying on the side with hips and knees bent
Restrained Resident Observation and Repositioning
- Residents with restraints should be observed and repositioned at least every two hours
Body Mechanics for Working with Clients in Bed
- Use proper lifting techniques
- Use assistive devices as needed (e.g., lift sheets, slide boards)
- Maintain a stable base of support
Food Thickeners Common Usage
- Persons with dysphagia (difficulty swallowing)
False Imprisonment Definition
- Restricting a resident’s freedom of movement without their consent or legal justification
Informed Consent Requiring Medical Procedure Example
- Surgery
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