AMCA NAC cheat sheet

Scope of practice: the nursing assistant performs delegated tasks under the supervision of a licensed nurse; assessment, care planning, and teaching are not delegated.

Vital sign normal adult ranges: oral temperature 97.6-99.6 F (36.5-37.5 C); pulse 60-100 beats/min; respirations 12-20 breaths/min; blood pressure under 120/80 mmHg.

Pulse sites: radial (routine), apical (count a full 60 seconds, used with irregular rhythm or digoxin), carotid (emergency only, never both sides at once).

Respiration counting: count for a full 60 seconds if abnormal; one breath = one inspiration plus one expiration; note depth, rhythm, and effort.

Weight measurement rules: same scale, same time of day, same clothing, and record in kilograms or pounds exactly as the facility policy specifies.

Intake and output: 1 ounce = 30 mL; 1 cup = 240 mL; 1 teaspoon = 5 mL; record all oral fluids, IV fluids, and measurable output.

Positioning terms: supine (flat on back), lateral (side-lying), prone (on abdomen), Fowler (head elevated 45-60 degrees), Sims (left side-lying with chest and hip forward).

Range-of-motion types: active (resident performs), passive (assistant moves the joint); stop if the resident reports pain and report to the nurse.

Fall prevention: bed in lowest position, brakes locked, side rails per policy, call light within reach, non-skid footwear, and frequent rounding.

Restraint rules: restraints require a physician order, are used only for a medical reason, and must be released, repositioned, and circulation checked at least every 2 hours.

Transfer safety: use a gait belt for ambulation and transfers, keep the resident close to your body, bend at the knees, and never lift with the back twisted.

Choking precautions: place residents with swallowing difficulty upright at 90 degrees during meals, feed slowly, and keep suction equipment available if ordered.

Skin breakdown prevention: reposition at least every 2 hours, keep skin clean and dry, and inspect bony prominences (sacrum, heels, hips) each shift.

Burn and scald prevention: check bath water temperature (about 105 F or per policy), never use heating pads on residents with decreased sensation, and keep hot liquids away from table edges.

Seizure care: lower the resident to the floor, protect the head, do not restrain or place anything in the mouth, time the seizure, and report duration over 5 minutes.

Incident reporting: report any fall, injury, medication error, or skin change to the nurse immediately and document objective facts only, never blame or opinion.

Standard precautions apply to all residents regardless of diagnosis: hand hygiene, gloves, gown, mask, eye protection based on anticipated exposure.

Hand hygiene is the single most effective infection control measure; wash with soap and water when hands are visibly soiled or after C. difficile care.

Alcohol-based hand rub is used when hands are not visibly soiled; rub for at least 20 seconds covering all surfaces until dry.

Glove rules: gloves do not replace hand hygiene; change gloves between residents and between dirty and clean tasks on the same resident.

Personal protective equipment order: don gown, mask, goggles, then gloves; remove gloves first, then goggles, gown, mask, and perform hand hygiene last.

Transmission-based precautions: contact (private room, gloves and gown), droplet (mask, private room), airborne (N95 respirator, negative pressure room).

Needlestick or body fluid exposure: wash the area with soap and water, report immediately, and follow facility post-exposure protocol; do not squeeze or scrub the site.

Sterile field rules: sterile items touch only sterile items; keep the field above waist level and never turn your back on it.

Documentation rules: record only objective, factual observations; chart immediately after care; never chart in advance or alter a record.

Late entries and errors: draw a single line through an error, write 'error,' initial and date it, and add a late entry noting the actual time of care.

Confidentiality: share resident information only with the care team on a need-to-know basis; do not discuss residents in public areas or on social media.

SBAR handoff: Situation, Background, Assessment, Recommendation, used to report changes in condition concisely to the nurse.

Reporting changes: report immediately any change in vital signs, mental status, pain, skin, intake/output, or behavior; the assistant does not diagnose.

Communication barriers: use a professional interpreter for limited-English residents, speak directly to the resident (not the interpreter), and avoid medical jargon.

Hearing and vision aids: face the resident when speaking, keep the tone low, ensure glasses and hearing aids are clean, working, and in place.

Resident rights: the resident has the right to refuse care, to privacy, to be informed, and to have concerns addressed; report refusals rather than forcing care.