Providing Specialized Care for Residents with Changes in Health
Recognize and report
The nurse aide is the eyes and ears of the team. Report immediately: a change in consciousness, new shortness of breath, chest pain, fever, vomiting, bleeding, refusal of food or fluids, very low urine output, or a vital sign outside the ordered range. You observe and report; the nurse assesses and decides. Write exactly what you saw and when.
Common changes
Hypoglycemia can look like shakiness, sweating, confusion, and hunger - report it and get the nurse; do not give food unless the care plan says to. Stroke signs are face droop, arm drift, and slurred speech, sometimes with sudden severe headache; note the time symptoms began. In older adults, infection may show up only as new confusion or a fall. Dehydration appears as dark urine, dry mouth, and dizziness. For a pressure injury, describe location, size, color, and drainage - only a nurse stages it.
Equipment and therapies
Do not adjust oxygen flow rates or silence alarms. Keep tubing unkinked and oxygen away from heat and petroleum products. For tube feedings, elevate the head of the bed and stop and report if the resident coughs or vomits. With a catheter, keep the bag below the bladder and off the floor, and report cloudy urine or burning. For an IV, report redness, swelling, or pain at the site and never change the rate.
Comfort and end of life
Treat pain as real: report it, reposition, and use comfort measures. When a resident is dying, give frequent mouth care, keep them clean and comfortable, and support the family. After death, follow facility policy and provide postmortem care with dignity.
Traps
Wrong answers have the aide guess the cause, change a setting, or wait until the end of the shift. A sudden change means report now.
Rule of thumb
When in doubt, report it and write it down - objectively and immediately.