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181 Cards in this Set
- Front
- Back
what is the name of the facility that provides health care and nursing care for residents who have many or severe health problems, or who need rehab
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skilled nursing facility (SNF)
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an illness that comes on suddenly from which a person should recover
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acute
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an illness that is ongoing, may develop slowly or gradually
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chronic illlness
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health care agency or program for persons who are dying
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hospice
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member of health care team who assists with mobility, ambulation or use of muscles
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physical therapist
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member of healthcare team who assists with relearning ADLs
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occupational therapist
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the speech therapist may also help with a person who is having difficulty doing what?
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swallowing
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health insurance for people who are over 65 or with certain disabilities
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medicare
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health insurance for low income person
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medicaid
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name resident rights
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to leave
to stay to share a room if married to complain without fear to send/receive unopened mail to be free from abuse and neglect to be free from unnecessary restraints to live in a clean, safe environment to work to form groups to practice religion to personal choices to personal possessions to refuse to privacy to confidentiality |
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what information is listed in the nurse aide registry
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name, aliases, addresses, employers, any allegations of abuse or neglect
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what are the skills a nurse aide CANNOT perform
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give meds
take orders from a doctor supervise others insert or remove tubes participate in sterile procedures tell a resident/family about diagnosis or treatments |
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what is delegation and when can you refuse a task that is delegated to you?
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delegation is the act of authorizing another person to perform a task- only the RN delegates tasks to you. You can refuse if
a. it is the right task- something you are legally allowed to do b. you have been taught the task before c. the nurse will supervise you doing the task if it is the first time d. it is legal and ethic e. you have the supplies you need to perform the task |
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is it ethical to accept tips
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no
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how can you invade a residents privacy
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not knocking before entering a room
not providing privacy by closing door and privacy curtain exposing the body without need |
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what should you do if a resident or family ask you to witness a will
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refuse.
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what are 5 ways a person can be abused
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verbal- yelling, cursing at him
physical mental- name calling, making person feel bad sexual financial |
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what do you do if you observe abuse occurring
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stop the abuser and then report
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who can you report abuse to
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**nurse
ombudsman abuse hotline dept. of health |
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what is a kardex
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type of card file that summarizes routine care (diet, toileting, whether side rails are used, etc) as a quick, easy source of info the the CNA
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what are the rules for recording in a chart
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no erasable ink or white out
blue/black ink don't leave any spaces sign, date, time all entries document after the fact only document the care you gave if you make a mistake, draw a line thru it and initial it |
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what are the parts of a whole person
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we are physical beings
we are psychological beings we are social beings and we are spiritual beings when caring for a resident, make sure you attend to the whole person, not just the physical part |
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what are the basic needs of all humans, according to Maslow?
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Physiological (physical) needs: water, food, oxygen, rest, shelter
Safety/Security- call bells, side rails Love/belonging- good care, encouraging participation in groups and activities, family visit Self esteem- allow resident to do for self, compliments Self actualization- ask him to tell you about his past accomplishments |
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what areas of a person's life are affected by culture
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religion, food preferences, beliefs about illness and death, music, style of dress, values, language spoken
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how can people communicate NONverbally?
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with gestures, posture, gait, outward appearance, facial expressions
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should touch and silence be used to communicate
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yes. touch is a powerful communicator that is comforting and shows caring, but can mean different things to different people so only use if person is comfortable with touch; silence says you are listening
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how can you be a good listener?
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lean in, face the person, nod your head, respond with "mmm" and "i see"
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what are some barriers to effective communication that you should NOT do
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interrupting
changing the subject failing to listen giving your opinion pat answers "don't worry" illness and disability (blind, deaf) noise profanity foreign language |
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should you talk to a person in a coma
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yes, assume he or she can hear and understand
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what are some losses experienced by seniors
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loss of income, family/friends. mobility, independence, health, job, private home
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how can you promote sexuality for your seniors
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groom nicely, makeup, nail polish, perfume or cologne, shave the male, give privacy during visits or when masturbating
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what should you do if a resident is sexually aggressive to you
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ask the person not to touch you, refuse his request, tell him what behaviors make you uncomfortable and report to nurse
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what is the difference between a paraplegic, hemiplegic and a quadriplegic
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paraplegia- paralyzed from waist down
hemiplegic- paralyzed on one side of body quadriplegic- paralyzed from neck down |
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when should you perform the heimlich maneuver (abdominal thrusts)
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when a person is choking- unable to speak or cough
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what should you do if a choking victim is pregnant or obese
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perform chest thrusts instead of applying pressure to the stomach
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why do all electrical plugs in nursing homes have to be three pronged
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two prongs carry electrical currents, the third prong is the ground that carries leaking electricity to the earth and away form an electrical item (if ungrounded could carry electricity to the person)
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what are safety guidelines for wheelchair use
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brakes on when transferring into chair
hips back in chair feet on footrest arms on armrest go down ramps and into elevators backwards |
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where can you find out about storage, disposable, and care for accidental exposures of chemicals used on your job
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the Material Safety Data Sheets (MSDS manual) list every chemical used on the job and what do if accidentally swallowed, splashed in eyes, etc
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what are the 3 things needed for a fire
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oxygen
a material that burns a spark or flame (friction) |
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what should you do if a person is to receive o2
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remove smoking materials
remove small electrical appliances (like a hair dryer) place no smoking sign on door remove wool products remove flammables like nail polish |
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what are two carry's you can use when evacuating a nonambulatory person during a fire
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swing carry (requires two people)
or one rescuer carry - drag person on a blanket, supporting the head |
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who is evacuated first during a fire
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ambulatory residents (the ones that can walk)
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what is an incident and when should an incident report be filled out
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an incident is any event that has harmed or could harm a resident, a staff member or visitor; it can involve losses, thefts, accidents, errors in care
fill out ASAP after incident while details are still fresh in your mind |
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during what shift do most falls occur
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between 6pm and 9pm
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what are some fall prevention measures
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clean up spills STAT
floor cushions next to bed bed and wheelchair alarms proper fitting clothes and footwear bed rails keep clutter free environment keep call bell within reach answer call bells ASAP good lighting in rooms and hallways no throw rugs no extension cords (may trip over) make sure needs are met (toilet, hydrate, give eyeglasses) brakes on bed before transferring |
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what are some alternatives to restraints
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hip protectors (looks like a girdle)
roll guards diversional activities floor cushions bed/chair alarms wedge cushions lap tray |
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when can a restraint be used
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after alternatives have been unsuccessfully tried and a doctor orders to protect the resident from self or to protect others
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what is the difference between active and passive restraints
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active restraints are attached to the person's body such as a vest restraint
passive restraints are near, but not directly attached such as bed rails or wedge cushions |
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what are the different types of restraints
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vest restraint
wrists mitten belt/waist side rails geriatric chair with tray attached |
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what are the guidelines for restraint use
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remove every 2 hours for 10 minutes to toilet, hydrate, ambulate, give ROM
check every 15-30 minutes never tie to side rails tie in quick release tie (no knots check skin under restraints for pressure |
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how do you know if a restraint is not too tight or loose
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slip 2-3 fingers inside- if fingers wont fit (too tight) or whole hand slips in (too loose) readjust
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what are the links in the chain of infection?
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1.causative agent- such as bacteria or virus
2. reservoir- place for bug to live and grow 3. portal of exit- way for germ to get out of reservoir 4. method of transmission- how the germ is spread to others 5. portal of entry- how the germ gets in to next victim 6. susceptible host- person who is most at risk of getting the infection |
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what are the 3 types of reservoirs
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humans
vectors- animals, insects, birds fomites- objects such as a toilet seat or door knob |
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what are the 4 portals of exit
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1.Respiratory - could cough or sneeze germs out
2. Gastrointestinal- could vomit or have diarrhea 3. Circulatory - could get out through blood, vaginal secretions or semen 4. Skin- break in skin and drainage from a wound |
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what are the methods of transmission
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1. airborne- person breathes it in (TB)
2. direct contact- thru kissing or sex or hugging 3. indirect contact- through touching a contaminated object such as a toilet seat 4. droplets- touching secretions sneezed out, sharing eating utensils |
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what are the portals of entry
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skin- thru a cut or opening in the skin
respiratory- breathed in gastrointestinal- eat or drink it in |
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what makes a person more at risk for getting a contagious (communicable) infection
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1.they are very young or very old
2.their job 3. their lifestyle (IV drug user, unprotected sex) 4. living with chronic illnesses 5. already being immunosuppressed (like having IAIDS) |
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what are the guidelines for handwashing
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warm water
friction 15 seconds or more before and after direct contact hands held below elbows if inside of sink touch- restart stand away from sink wash wrist and fingernails too |
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what type of precautions are used for all residents and patients
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standard precautions- wear personal protective equipment (PPE) if exposure to blood or body fluids possible, clean, dry and store equipment, dispose of sharps properly
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what are the guidelines for a person with TB in airborne precautions
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private room
door closed at all times special mask (HEPA filter mask or N95 respirator mask) negative air pressure (all air vented outside of building from the room) |
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what are the signs and symptoms of TB
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coughing that produces bloody sputum
wt loss fatigue night sweats |
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what are the guidelines for glove use
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single pay of gloves for each task (change after bathing, before doing mouthcare)
don't wear if torn never worn outside of room never reused removed by turning inside out |
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what are the guidelines for body mechanics
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1. bend at the knees
2. hold load close to your body 3. pivot instead of twisting 4. synchronize movements by counting to 3 5. smooth movements, don't jerk 6. face your work 7. stand with feet wide apart 8. ask for help 9. don't reach overhead 10. push, pull or slide if you can |
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what are the strongest muscles of your body that should be used during work
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shoulders, upper arms and thighs
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what position is back lying
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supine
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what position is side lying
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lateral
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what position is lying on the left side with upper leg sharply flexed and lower arm behind the person
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Sims- used for enemas, rectal exams
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what position is lying on the stomach
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prone
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what position is feet higher than the head
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trendelenberg- used if person going into shock to increase blood flow to brain
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what position is sitting completely up with spine straight (90 degree angle)
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fowlers
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what is logrolling
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turning the person as a unit, to prevent injury to neck and spine
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what is dangling
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allowing the person to sit on the edge of the bed for a few minutes with legs dangling free (not on floor) to prevent orthostatic hypotension (a drop in BP which may cause fainting)
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what is standard equipment in a resident room
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bed (manual bed is operated by gatches or cranks)
bedside stand with drawers overbed table (used as CNA workspace and for meals) chair with arms wardrobe privacy curtain call bell |
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what are the 2 delivery systems for oxygen
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mask or nasal cannula
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what are the 3 types of beds you might make
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closed- when bed not in use- pillow covered by spread
open- top sheet and spread fanfolded to foot of bed occupied |
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what are the guidelines for bedmaking
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1. collect linen in order of use
2. place linen on clean dry surface (chair or overbed table) 3. don't fan sheets 4. make one side of bed at a time 5. raise bed to comfortable working height 6. make wrinkle free 7. wear gloves if visibly soiled or wet to strip bed (remove sheets) 8. don't bring in extra linen (considered contaminated and would have to be placed in soiled linen hamper) 9. don't let linen (clean or dirty) touch your uniform 10. no linen on the floor |
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what skills are performed during early AM care (before breakfast)
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wash hands and face
toilet or change diaper rinse mouth or rinse off dentures and place in place in fowler's position |
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what skills are performed with PM (bedtime) care
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wash hands and face
comb hair change in to bedclothes toilet back rub |
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how often is routine mouthcare performed
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BID- after breakfast and HS (at bedtime or hour of sleep
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what position is used for routine mouthcare
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person must be sitting up
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what residents may require special mouthcare, every 2 hours
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those who are unconscious, in a coma, very confused, NPO, tube feeders
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what position is used for special mouthcare
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person has head turned to side
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what are guidelines for denture care
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1.cleaned in cool water
2. stored in a labeled, covered denture cup filled with cool water 3. sink lined to protect from damage during cleaning |
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what are guidelines for bathing
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1, bath water temp 105-115
2. change water if too soapy, cold or dirty 3. wash from clean to dirty body parts 4. rinse well 5. pat skin dry 6. clean eyes from inner to outer 7. no soap on face 8. keep body covered |
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describe perineal care for male and female
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female- from front to back
male- in circular motion from urinary meatus (opening) towards scrotum; if uncircumcised, push back foreskin to clean and replace |
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how are fingernails filed
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straight across
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what is washed during a partial bath
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eyes
face hands axilla perineal area back |
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how is hair combed
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if untangled, from roots to ends
if tangled, from ends toward scalp comb in sections- long hair pulled up, pulled back |
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what are the guidelines for shaving
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hold skin taut
rinse blade often shave in direction of hair growth if on an anticoagulant- use electric razor dispose of razor in sharps container |
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what should you do if a man is nicked while being shaved
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apply direct pressure until bleeding stops and inform nurse
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describe dressing a resident with an affected arm or leg
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offer choice of clothing items
undress unaffected side put clean clothes on affected side |
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what is another term for urination
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voiding
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how is the fracture pan placed under a person
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the handle faces the foot of the bed
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where can a urinal be placed after use
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the man can hook it to the side rail- never on the overbed table, bedside stand or floor
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what are guidelines for a person with an indwelling urinary catheter
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1. bag must be kept below level of bladder
2. bag is attached to frame of bed 3. bag cannot touch floor 4. bag emptied at end of shift 5. catheter secured to body (inner thigh of woman or stomach for men) 6. clean catheter after BM or with bath- hold at insertion sight and clean 4 inches down catheter with soap and water) 7. keep catheter and tubing unkined |
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what is peristalsis
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alternating contractions and relaxation of intestinal muscles that moves feces through the large intestines to the rectum
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what are signs and symptoms of fecal impaction
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passage of liquid stool
stomach enlarged and crampy rectal bulging **must be removed by nurse or doctor by hand, with an enema in or in surgery |
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what is flatulence
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excessive formation of gas
(flatus is the passing of gas) |
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what are measures to remember when giving an enema
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1. cover bed with extra padding to keep dry
2. have toilet paper, commode or bedpan nearby 3. insert tubing 2-4 inches and hold in the rectum 4. encourage slow deep breaths if cramping 5. always show the nurse the return (what comes out) before flushing) |
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what is the difference between a colostomy and an ileostomy
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a colostomy will drain solid stool
an ileostomy will drain liquid stool (irritating to skin, can be expelled at any time and has more odor) |
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what are signs and symptoms of dysphagia
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pocketing food, drooling, spitting out food, coughing, food comes up through nose, eating slowly (especially solids)
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what are guidelines for preventing aspiration
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1. position upright
2. check for pocketing 3. alternate food and liquids 4. feed slow 5. leave sitting up for 1 hour after meals 6. support upper back, neck with pillows 7. give thickened liquids if ordered |
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how many ounces are equal to 1cc/ml
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30
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what fluids are included on output
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diarrhea
emesis wound drainage urine |
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what are guidelines for care of the resident with a feeding tube
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1. HOB raised when feeding going in
2. NPO- give mouthcare Q2h 3. keep tubing unkinked 4. report vomiting to nurse 5. reapply tape over bridge of nose as needed 6. secure tubing (to clothes or under a binder to prevent accidentally coming out) |
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How are contractures prevented
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Range of motion exercises
handrolls splints |
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How is footdrop prevented
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footboard at foot of bed, feet flush against it
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What position should the legs of a person who has had a hip replacement be kept in
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abduction
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what is the purpose of a bedcradle
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keeps the top linen from touching the lower body
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what are guidelines for ambulation
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1. nonskid footwear
2. CNA walks slightly behind to one side 3. hold gait belt with hands facing upward |
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how many hours of sleep do seniors require
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5-6 hours
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during what stage of sleep does dreaming occur
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during stage one of nonREM sleep (rapid eye movement_
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what is radiating pain
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pain that moves from site of tissue damage to nearby sites
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what is phantom pain
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pain experienced by amputees- is real!
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in what position might a person with COPD sleep
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orthopneic position or sitting up, leaning over an overbed table
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what should you note and report to the nurse if you are caring for a person receiving oxygen
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flow rate
whether humidifier bottle is bubbling or empty |
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what should you do if a residents food is cold
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get another tray or reheat in microwave
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what is the most accurate and least accurate way to measure body temp
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accurate- rectal
least accurate- axillary |
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what is the most important thing to remember about taking a rectal temp
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thermometer must be held in place
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what are guidelines for taking a radial pulse
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1. don't use your thumb
2. don't press too hard (blocks the pulsation) 3. note rate, rhythm, and force 4. keep fingers on pulse area to begin taking respirations |
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what is the normal range for pulse
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60 to 100
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what is the normal range for respirations
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12-20
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what is the medical term for a pulse greater than 100
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tachycardia
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why would urine be strained
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to collect kidney stones
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how would you measure height on a nonambulatory person
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using a tape measure from top of head to heel
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what tasks are performed by the CNA when a resident is transferred to another unit
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pack belongings and toiletries (wash basin, etc).
transport in w/c introduce to new staff and roommate wish the person well |
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what are possible causes of skin tears
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rushing when providing care
long fingernails or jewelry very fragile skin (put resident in long pants, and sleeves) sharp edges of equipment |
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how is shearing prevented
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keep HOB 30 degrees or less
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how is friction prevented
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1. light dusting of powder under areas where skin touches skin
2. use a drawsheet to move around in bed |
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what should you do if you see a red area on a resident's skin
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NEVER massage over it- report to nurse
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what are causes of skin breakdown or pressure ulcers
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1. immobility
2. incontinence 3. poor nutrition and hydration 4. decreased sensation of skin 5. friction 6. shearing 7. wrinkled sheets |
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what protective devices are used to prevent skin breakdown
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1. foam/air/mattresses
2. elbow and heel protectors 3. sheepskin/lambswool on bed 4. pillows foam wedges 5. bedcradles 6. gel pads in wheelchairs |
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what is the purpose of antiembolism or TED stockings
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to prevent blood clots from breaking free and traveling to the heart, lungs or brain
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what residents would benefit from enti-embolism stockings
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bedridden
post surgery residents those with circulatory or heart disorders |
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what are the guidelines for use of TED stockings
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1. put on before getting out of bed
2. keep wrinkle free and untwisted 3. removed every 8 hours or at bedtime 4. wash by hand and let air dry |
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what are the guidelines for hot or cold aplications
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1. never apply directly to skin
2. check every 5 minutes for signs of complications (such as blistering, burning) 3. never leave on for more than 15-20 minutes |
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what residents might benefit from a sitz bath
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residents with hemorrhoids, after vaginal childbirth or residents with genital herpes
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what are guidelines for care of the hearing aide
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1. remove during showers, shampoos and at bedtime
2. check battery daily- turn on, turn up, listen for loud whistle, then readjust volume 3. clean (follow manufacturers directions) 4. turn off at bedtime 5. report if lost immediately 6. always check sheets before removing from bed for hearing aide |
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how do you communicate with the hearing impaired
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1. gain attention (touch gently on arm)
2. face to face 3. sit in good lighting 4. don't cover your mouth or chew gum 5. use body language 6. write out important messages 7. use communication boards 8. use short sentences and simple words |
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what is the medical term for difficulty speaking
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dysphasia
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what are guidelines for communicating with the speech impaired
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1. ask person to repeat or rephrase statements as needed
2. be patient 3. don't finish person's sentences 4. if frustrated, ask him to write it down 5. use body language |
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what are risk factors for glaucoma
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1. african american
2. diabetes or hypertension 3. family history 4. over 60 years old |
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how is glaucoma treated
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no cure, only eyedrops to prevent further loss and blindness
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describe care of the artificial eye
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1. clean with mild soap and water
2. store in a lined container (to prevent scratching) filled with salt water 3. clean the socket with warm water or salt water and dry with washcloth or gauze 4. rinse eyeball before reinserting |
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which type of tumors have the ability to metastasize or spread
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malignant tumors spread to other areas, grow fast and are life-threatening
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how is cancer treated
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chemotherapy
radiation surgery |
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what are guidelines for cast care
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1. let dry completely (24 hours)
2. handle with open palms until dry 3. elevate arm or leg on pillow 4. never insert anything into cast 5. report odor, pain, drainage, swelling, cyanosis or redness of fingers/toes to nurse |
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what are guidelines for care of the person with traction
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1. keep body in good alignment
2. never place weights on floor or bed 3. use a fracture pan for toileting 4. encourage ROM exercise 5. never remove traction or change weights 6. prevent skin breakdown |
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what are guidelines for the person with a hip replacement
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1. no bending, no crossing legs
2. use an elevated toilet seat 3. keep legs abducted 4. use a high chair 5. turn to nonoperative side postop 6. apply elastic stockings as ordered |
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what are warning signs of a stroke
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sudden numbness or weakness of face, arm, leg on one side of body
confusion, dysphasia loss of balance severe headache |
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what are two bloodborne pathogens
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HIV and Hepatitis B
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how are HIV and hepatitis B spread
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1. moms to babies
2. blood transfusions 3. unprotected sex 4. sharing needles and syringes |
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what is a hallucination
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false sensory perception such as hearing voices, seeing dead people or feeling ants crawling over you
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what is a delusion
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false, fixed belief such as believing you can fly
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what does cognition involve
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ability to memorize, think, reason, understand, judgment, and behaviors
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what is dementia
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dementia is loss of cognitive function- poor memory, poor judgment, change in behaviors, poor reasoning
number one cause is alzheimer's disease |
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what is delirium
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sudden onset of extreme confusion, a medical emergency
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what are signs and symptoms of depression
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feelings of hopelessness, isolation, tearfulness, change in appetite and sleep patterns, lack of interest in self or others, thoughts of death- all for at least 2 weeks
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what are classic behaviors of people with AD
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wandering
pillaging hoarding agitation delusions hallucinations sundowning |
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how do people with AD communicate
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screaming
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what is sundowning and how is it managed
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restless, increased confusion and agitation during evening hours
give back rub, warm drink, finish activities and care early in day, calm quiet atmosphere, no exercise or activity near bedtime |
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what is the goal of rehab
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to restore a person to highest possible level of function
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what should you do if a person is having a seizure
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call for help
assist person to floor loosen clothing note time seizure starts move away furniture TURN HEAD TO SIDE support/protect head on your lap, pillow |
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what should you NOT do during a seizure
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try to stop movements
try to insert anything into the mouth |
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what position should someone be in if they are feeling faint
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head between knees or head as low as it can be
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what is a terminal illness
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an illness or injury for which there is no reasonable expectation of recovery- the person will die from the illness
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what is done to the body during postmortem care
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1. eyes closed
2. jaw closed 3. body straightened 4. body bathed 5. diaper applied 6. tied at wrists and ankles 7. dentures may be left in 8. leave wedding rings on, all other jewelry removed 9. toe tag on body 10. wrapped in shroud (plastic sheet) |
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what is the last sense to leave a dying person
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hearing
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what are 4 environmental causes of falls
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clutter poor lighting rugs |
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what should you do if a person is falling
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slide to floor down one of your legs, call for help, stay with person and do not touch him |
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what are 6 guidelines for restraint use
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check every 30 minutes don't tie in a knot tie to frame of bed slip2-3 fingers inside check for irritation/discoloration
|
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what are examples of passive restraints
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side rails, geriatric chair |
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what are types of active restraints
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wrists, vest, belt, mittens |
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how is the vest restraint applied
|
criss crossed in front |
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what are 5 complications of restraints
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incontinence, fractures, dehydration, skin breakdown |
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what should be done before performing the Heimlich maneuver
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ask person to cough and speak |
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what does RACE stand for in fire safety
|
a-activate the alarm c-close doors and windows e-extinguish if you can
|
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what does PASS stand for when using a fire extinguisher
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a- aim at base of flames s- squeeze handle s-sweep back and forth |
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what info is found in the MSDS manual
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how to store, dispose, handle a chemical and what to do if there is an accidental exposure |
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what are 6 guidelines for good body mechanics
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push or pull bend at the knees raise bed up pivot |
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what muscles should be used to lift and move a resident
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thigh, shoulder and upper arms |