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34 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Initial Steps |
1. Ask nurse about resident's needs, abilities and limitations, if necessary and gather necessary supplies 2. Knock and identify yourself before entering resident's room. Wait for permission to enter the resident's room 3. Greet resident by name per resident preference 4. Identify yourself by name and title 5. Explain what you will be doing; encourage resident to help as able 6. Gather supplies and check equipment 7. Close curtains, drapes and doors. Keep resident covered, expose only area of resident's body necessary to complete procedure 8. Wash your hands 9. Wear gloves as indicated by Standard Precautions 10. Use proper body mechanics. Raise bed to appropriate height and lower side rails (if raised) |
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Final Steps |
1. Remove gloves, if applicable, and wash your hands 2. Be certain resident is comfortable and in good body alignment. Use proper body mechanics 3. Lower bed height and position side rails (if used) as appropriate 4. Place call light and water within resident's reach 5. Ask resident if anything else is needed 6. Thank resident 7. Remove supplies and clean equipment according to facility procedure 8. Open curtains, drapes and door according to resident's wishes 9. Perform a visual safety check of resident and environment 10. Report unexpected findings to nurse 11. Document procedures according to facility procedure |
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Choking |
1. Call for nurse and stay with resident 2. Ask if resident can speak or cough 3. If not able to speak or cough, move behind resident and slide arms under resident's armpits 4. Place your fist with thumb side against abdomen midway between waist and ribcage 5. Grasp your fist with your other hand 6. Press your fist into abdomen with quick inward and upward thrust 7. Repeat until object is expelled 8. Assist with document |
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Seizures |
1. Call for nurse and stay with resident 2. Place padding under head and move furniture away from resident 3. Do not restrain resident or place anything in mouth, assist nurse with placing resident on his/her side 4. Loosen resident's clothing especially around neck 5. Note duration of seizure and areas involved |
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What are you looking for when you check your gloves? |
I'm looking for rips, tears and discoloration |
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Fire |
1. Remove resident from area of immediate danger 2. Activate fire alarm 3. Close doors and windows to contain fire 4. Extinguish fire with fire extinguisher if possible 5. Follow all facility policies |
R.A.C.E |
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Fire Extinguisher |
1. Pull the pin 2. Aim at the base of the fire 3. Squeeze the handle 4. Sweep back and forth at the base of fire |
P.A.S.S |
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Falling or Fainting |
1. Call for nurse and stay with resident 2. Check if resident is breathing 3. Do not move resident. Leave in same position until the nurse examines in resident 4. Talk to resident in calm and supportive manner 5. Apply direct pressure to any bleeding area with a clean piece of linen 6. Take pulse and respiration 7. Assist nurse as directed. Check resident frequently according to facility policy and procedures. Assist in documentation |
Call and stay, check, do not & leave, talk, apply, take, assist & check & assist |
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Do not take oral temperature for a resident who is _____, uses _______, or who is _______/_______ |
Unconscious, oxygen, confused/disoriented |
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Oral temperature (Electronic) |
1. Remove thermometer from storage/battery charger 2. Do initial steps 3. Position resident comfortably in bed or chair 4. Put on disposable sheath and place thermometer under the tongue and to one side, press button to activate the thermometer 5. The resident should be directed to breathe through their nose 6. Instruct resident to hold thermometer in mouth with lips closed. Assist as necessary 7. Leave thermometer in place until signal is heard, indicating the temperature has been obtained 8. Read the temperature reading on the face of the electronic device, remove the thermometer, discard the sheath, and record the reading 9. Do final steps 10. Return thermometer to storage/battery charger 11. Report unusual reading to nurse |
Remove, do, position, put on & press, the resident, instruct & assist, leave, read & remove & discard & record, do, return, report |
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When is axillary temperature taken? |
Often taken when inappropriate to take an oral temperature; particularly if resident is confused and combative |
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Axillary temperature |
1. Remove thermometer from storage/battery charger 2. Do initial steps 3. Position resident comfortably in bed or chair 4. Put on disposable sheath, remove resident's arm from sleeve of gown, wipe armpit and ensure it is dry. Hold thermometer in place with end in center of armpit and fold resident's arm over chest 5. Press button to activate the thermometer 6. Hold thermometer in place until signal is heard, indicating the temperature has been obtained 7. Read the temperature reading on the face of the electronic device, remove the thermometer, discard the sheath, and record the reading 8. Assist the resident to return arm through sleeve of clothing/gown 9. Do final steps 10. Return thermometer to storage/battery charger 11. Report unusual reading to nurse |
Remove, do, position, put on & remove & hold & fold, press, hold, read & remove & discard & record, assist, do, return, report |
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Pulse and respiration |
1. Do initial steps 2. Place resident's hand on comfortable surface 3. Feel for pulse above wrist on thumb side with tips of first three fingers 4. Count beats for 60 second, noting rate, rhythm and force 5. Continue position as if feeling for pulse. Count each rise and fall of chest as one respiration 6. Count respirations for 60 seconds noting rate, regularity and sound 7. Record pulse and respiration rates 7. Record pulse and respiration rates8. Report unusual findings to nurse9. Do final steps 7. Record pulse and respiration rates8. Report unusual findings to nurse9. Do final steps 7. Record pulse and respiration rates8. Report unusual findings to nurse9. Do final steps 8. Report unusual findings to nurse 9. Do final steps |
Do, place, feel, count, continue, count, record, report, do |
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Blood pressure |
1. Do initial steps 2. Clean earpieces in diaphragm of stethoscope with an antiseptic wipe 3. Uncover resident's arm to shoulder 4. Rest resident's arm, level with heart, palm upward on comfortable surface 5. Wrap proper sized sphygmomanometer cuff around upper unaffected arm approximately 1-2 inches above elbow 6. Put earpieces of stethoscope in ears 7. Place diaphragm of stethoscope over brachial artery at elbow 8. Close valve on bulb. If blood pressure is known, inflate cuff to 20 mm/hg above the usual reading. If blood pressure is unknown, inflate cuff to 160 mm/hg 9. Slowly open valve on bulb 10. Watch gauge and listen for sound of pulse 11. Note gauge reading at first pulse sound 12. Note gauge reading when pulse sound disappears 13. Completely deflate and remove cuff 14. Accurately record systolic and diastolic readings 15. Do final steps 16. Report unusual readings to nurse |
Do, clean, uncover, rest, wrap, put, place, close & if & if, slowly, watch, note, note, completely, accurately, do, report |
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Height |
1. Do initial steps 2. Using standing balance scale: Assist the resident onto the scale, facing away from the scale. Ask the resident to stand straight. Raise the rod to a level above the resident's head. Lower the height measurement device until it rests flat on the resident's head 3. When a resident is unable to stand: Flatten the bed and place resident in supine position. Place a mark on the sheet at the top of the head and another at the bottom of the feet. Measure the distance 4. If the resident is unable to lay flat due to contractures: Utilize a tape measure and beginning at the top of the head, follow the curves of the spine and legs, measuring to the base of the heel 5. Accurately record resident's height 6. Do final steps |
Do, using & assist & ask & raise & lower, when & flatten & place & measure, if & utilize, accurately, do |
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Weight |
1. Do initial steps 2. Balance scale 3. Depending on scale used, assist resident to stand on platform or sit in chair with feet on footrest or transport wheelchair onto scale and lock brakes 4. When using a standard scale –lower weight to fifty pound mark that causes arms to drop. Move it back to previous mark. Move upper weight to pound mark that balances pointer in middle of square. Add lower and upper marks. When using a digital scale – press weigh button. Wait until numbers remain constant 5. Subtract weight of wheelchair from total weight, if applicable 6. Accurately record resident's weight 7. Do final steps 8. Report unusual reading to nurse |
Do, balance, depending, when & move & move & add & when & wait, subtract, accurately, do, report |
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Assist resident to move to head of bed |
1. Do initial steps. Ask another CNA to assist you if needed 2. Lower head of bed and lean pillow against head board. Adjust bed height as needed 3. Ask resident to bend knees, put feet flat on mattress 4. Place one arm under resident's shoulder blades and the other arm under resident's thighs. If a draw sheet or pad is under resident, 2 caregivers should grasp the sheet or pad firmly, with trunk centered between hands 5. Ask resident to push with feet on count of three 6. Place pillow under resident's head 7. Do final steps |
Do & ask, lower & adjust, ask, place & if, ask, place, do |
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Supine position |
1. Do initial steps 2. Lower head of bed 3. Move resident to head of bed if necessary 4. Position resident flat on back with legs slightly apart 5. Align resident's shoulder and hips 6. Use supportive padding and/or float heels, if necessary 7. Do final steps |
Do, lower, move position, align, use, do |
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Lateral position |
1. Do initial steps 2. Place resident in supine position 3. Move resident to side of bed closest to you 4. Cross resident's arms over chest 5. Slightly bend knee of nearest leg to you or cross nearest leg over farthest leg at ankle 6. Place your hands under resident's shoulder blade and buttock. Turn residents away from you onto side 7. Place supportive padding behind back, between knees and ankles and under top arm 8. Do initial steps |
Do, place, move, cross, slightly, place, place, do |
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Fowler's position |
1. Do initial steps 2. Move resident to supine position 3. Elevate head of bed 45 to 60 degrees 4. Use supportive padding if necessary 5. Do final steps |
Do, move, elevate, use, do |
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Semi-fowler's position |
1. Do initial steps 2. Move resident to supine position 3. Elevate head of bed 30 to 45 degrees 4. Use supportive padding if necessary |
Do, move, elevate, use |
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Sit on edge of bed |
1. Do initial steps 2. Adjust bed height to lowest position 3. Move resident to side of bed closest to you 4. Raise head of bed to sitting position, if necessary 5. Place one arm under resident's shoulder blades and the other arm under resident's thigh 6. On count of three, slowly turn resident into sitting position with legs dangling over side of bed 7. Allow time for resident to become steady. Check for dizziness 8. Assist resident to put on shoes or slippers 9. Move resident to edge of bed so feet are flat on floor 10. Do initial |
Do, adjust, move, raise, place, on count, allow, assist, move, do |
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Using a gait belt to assist with ambulation |
1. Do initial steps 2. Assist resident to sit on edge of bed. Encourage resident to sit for a few seconds to become steady. Check for dizziness 3. Place belt around resident's waist with the buckle in front (on top of resident's clothes) and adjust to a snug fit ensuring that you can get your hands under the belt. Position one hand on the belt at the resident's side and the other hand at the resident's back 4. Assist the resident to stand on count of three 5. Allow resident to gain balance. Ask the resident if dizzy 6. Stand to side and slightly behind resident while continuing to hold onto belt 7. Walk at resident's pace 8. Return resident to chair or bed and remove belt 9. Do final steps |
Do, assist & check, place & position, assist, allow & ask, stand, walk, return, do |
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Transfer to chair |
1. Do initial steps 2. Place chair on resident's unaffected side. Brace firmly against side of bed 3. Assist resident to sit on edge of bed. Encourage resident to sit for a few seconds to become steady. Check for dizziness 4. Stand in front of resident and apply gait belt around resident's abdomen 5. Grasp the gait belt securely on both sides of the resident 6. Ask resident to place his hands on your upper arms 7. On the count of three, help resident into standing position by straightening your knees 8. Allow resident to gain balance, check for dizziness 9. Move your feet 18 inches apart and slowly turn resident 10. Lower resident into chair by bending your knees and leaning forward 11. Align resident's body and position for rests. Remove gait belt 12. Do final steps |
Do, place & brace, assist & encourage & check, stand, grasp, ask, on count, allow, move, lower, align, do |
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Transfer to wheelchair |
1. Do initial steps 2. Place wheelchair on resident's unaffected side. Brace firmly against side of bed with wheels locked and foot rests out of way 3. Assist resident to sit on edge of bed. Encourage resident to sit for a few seconds to become steady. Check for dizziness 4. Stand in front of resident and apply gait belt around the resident's abdomen 5. Grasp the gait belt securely on both sides of the resident 6. Ask resident to place his hands on your upper arms 7. On count of three, help resident into standing position by straightening your knees. Stand toe to toe with resident 8. Allow resident to gain balance, check for dizziness 9. Move your feet to shoulder width apart and slowly turn resident 10. Lower resident into wheelchair by bending your knees and leaning forward 11. Align resident's body and position foot rests. Remove gait belt 12. Unlock wheels. Transport resident forward through open doorway after checking for traffic 13. Transport resident up to closed door, open door and back wheelchair through doorway 14. Take resident to destination and lock wheelchair 15. Do final steps |
Do, place & brace, assist & encourage & check, stand, grasp, ask, on count, allow, move, lower, align, unlock & transport, transport, take, do |
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Walking |
1. Do initial steps 2. Assist resident to sit on edge of bed. Encourage resident to sit for a few seconds to become steady. Check for dizziness 3. Assist resident to stand on count of three 4. Allow resident to gain balance, check for dizziness 5. Stand to side and slightly behind resident 6. Walk at resident's pace 7. Do final steps |
Do, assist & encourage & do, assist, allow, stand, walk, do |
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Assist with walker |
1. Do initial steps 2. Assist resident to sit on edge of bed 3. Place walker in front of resident as close to the bed as possible 4. Have resident grasp both arms of walker 5. Brace leg of walker with your foot and place your hand on top of walker 6. Assist resident to stand on count of three, check for balance and dizziness 7. Stand to side and slightly behind resident 8. Have resident move walker ahead 6-10 inches, then step up to walker moving the weak or injured leg forward to the middle of the walker while pushing down on the handles of the walker, and then bringing the unaffected leg forward whenever with the weak/injured leg 9. Do final steps |
Do, assist, place, have, brace, assist, stand, have & then step & and then bringing, do |
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Assist with cane |
1. Do initial steps 2. Check the cane for presence of rubber tip(s) 3. Assist resident to sit on edge of bed 4. Assist resident to stand on count of three 5. Allow resident to gain balance. Check for dizziness 6. Have resident place cane approximately 4 inches to the side of his/her stronger/unaffected foot. The height of the cane should be level with resident's hip. 7. Stand to the affected side and slightly behind resident 8. Have resident move cane forward about 4-6 inches, step forward with weak (affected) leg to a position even with the cane. Then have resident move strong leg forward and beyond the weak leg and cane. Repeat the sequence 9. Do initial steps |
Do, check, assist, assist, allow, have & the height, stand, have & then have, do |
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Shower/shampoo |
1. Do initial steps 2. Clean/disinfect shower area and shower chair as per facility policy. Prep the bathing area per facility policy. Gather supplies and take them into the shower area 3. Help resident remove clothing. Provide resident privacy 4. Turn on water and have resident check water 5. Assist resident into shower via wheelchair. Lock wheels of shower chair and transfer resident to shower chair. Use safety belt to secure resident stability, if indicated. Never take your eyes off the resident or turn your back to the resident while in the shower *Shampoo* 6. Give resident a washcloth to cover his/her eyes during the shampoo, if he/she desires. Place cotton balls in resident's ears if desired 7. Wet the resident's hair 8. Put a small amount of shampoo into the palm of your hand and work into the resident's hair and scalp using fingertips 9. Rinse the resident's hair thoroughly 10. Use a conditioner if the resident desires you to do so 11. Let resident wash as much as possible, starting with face. Assist as needed to wash and rinse the entire body going from head to toe. Use a separate washcloth to cleanse the perineal area last 12. Turn off the water. Cover resident with bath blanket 13. Remove the cotton balls from the resident's ears, if utilized 14. Towel dry the resident's hair, neck and ears 15. Give resident towel and assist to pat dry. Ensure to thoroughly pat dry under breasts, between skin folds, in the perineal area and between toes 16. Ensure floor area is dry and non-slip device is in place. Assist resident out of shower. 17. Use a dryer on the resident's hair, if desired 18. Apply lotion to skin, help resident dress, comb hair and return to room 19. Do final steps. Report skin abnormalities to the nurse |
Do, clean/disinfect & prep & gather, help, turn, assist & use & never, *Shampoo Give, wet, put, rinse, use, let & assist & use, turn, remove, towel, give, ensure, use, apply, do & report |
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Bed bath/perineal care |
1. Do initial steps 2. Offer resident urinal or bedpan 3. Provide resident privacy 4. Fill bath basin with warm water and have resident check water temperature for comfort, if able 5. Put on gloves 6. Fold washcloth and wet 7. Gently wash eye from inner corner to outer corner, using a different part of cloth to wash other eye 8. Wet washcloth and apply soap, if requested. Wash, rinse and part dry face, neck, ears and behind ears 9. Remove resident's gown 10. Place towel under far arm 11. Wash, rinse and pat dry hand, arm, shoulders and underarm 12. Repeat steps with other arm 13. Place towel over chest and abdomen. Lower bath blanket to waist 14. Lift towel and wash, rinse and pat dry chest and abdomen 15. Pull up bath blanket and remove towel 16. Uncover and place towel under far leg 17. Wash, rinse and pat dry leg and foot. Be sure to wash, rinse and dry well between the toes 18. Repeat with other leg and foot 19. Change bath water and gloves, wash hands and use clean gloves and towel 20. Assist resident to spread legs and lift knees, if possible 21. Wet and soap folded washcloth *Catheter care* 22. If resident has catheter, check for leakage, secretions or irritation. Gently wipe four inches of catheter from meatus out *Perineal care* 23. Wipe from front to back and from center of perineum to thighs. If washcloth is visibly soiled, change cloths -For females- • Separate labia. Wash urethral area first • Wash between and outside labia in downward strokes, alternating from side to side and moving outward to thighs. Use different part of washcloth for each stroke -For males- • Pull back foreskin if male is uncircumcised. Wash and rinse the tip of penis using circular motion beginning with urethra • Continue washing down the penis to the scrotum and inner thighs. Rinse off soap and dry. Return foreskin over the tip of the penis **** 24. Change water in basin. Wash hands and change gloves. With a clean washcloth, rinse area thoroughly in the same direction as when washing 25. Gently pat area dry with towel in same direction as when washing 26. Assist resident to lateral position, facing away from you 27. Wet and soap washcloth 28. Clean anal area from front and back. Rinse and pat dry thoroughly 29. Change bath water and gloves. Use clean washcloth and towel 30. Wash, rinse and pat dry from neck to buttocks 31. Return to supine position 32. Wash hands and change gloves 33. Help resident put on clean gown 34. Do final steps 35. Report and reddened areas, abrasions or bruises to the nurse |
Do, offer, provide, fill, put, fold, gently, wet & wash, remove, place, wash, repeat, place & lower, lift, pull, uncover, wash & be sure, repeat, change & use, assist, wet *Catheter care* If resident has *Perineal care* Wipe -For females- Separate & wash, wash between & use -For males- Pull & wash, continue & rinse & return **** Change & wash, gently, assist, wet, clean, change, wash, return, wash, help, do, report |
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How many wash rags and dry towels do you need for a bed bath? |
6 wash rags and 6 dry towels |
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Back rub |
1. Do initial steps 2. Place resident in lateral position with neck/back toward you 3. Expose back and shoulders 4. Rub lotion between your hands 5. Make long, firm strokes along spine from buttocks to shoulders. Make circular strokes down on shoulders, upper arms and back to buttocks 6. Repeat for at least 3-5 minutes 7. Gently pat off excess lotion with towel. Cover and position as resident requests 8. Do final steps |
Do, place, expose, rub, make & make, repeat, gently & cover, do |
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Bed shampoo |
1. Do initial steps 2. Gently comb and brush resident's hair 3. Provide the resident privacy 4. Remove resident's gown or pajama top. Place a towel around resident's neck and shoulders. Lower head of bed 5. Have resident check temperature of water to be used for comfort, if able 6. Place bed shampoo basin under resident's head according to manufacture's instructions 7. Place wash basin on chair to catch water flowing from shampoo basin 8. Pour water carefully over resident's hair 9. Lather hair with shampoo using fingertips. Rinse thoroughly. Apply conditioner to resident's hair if requested. Rinse thoroughly 10. Squeeze excess water from hair. Towel dry hair 11. Replace gown or pajama hair. Towel dry hair 12. Comb and brush resident's hair. Dry hair with dryer if resident wishes 13. Do final steps |
Do, gently, provide, remove & place & lower, have resident, place bed, place wash, pour water, lather & rinse & apply, squeeze, replace, comb, do |
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Oral care for the alert and oriented resident |
1. Do initial steps. Check. |
Do, raise, put, drape, wet, first brush, hold, ask, if requested, check & check, remove, remove, do |
