Arkansas CNA cheat sheet

OBRA (1987) guarantees residents dignity, privacy, self-determination, and freedom from abuse and from physical or chemical restraint.

A resident may refuse any treatment, bath, medication, or meal; accept the refusal, offer again later, and report it to the charge nurse.

Restraints require a physician's order, the least restrictive device available, and release plus repositioning and circulation checks at least every 2 hours.

Suspected abuse, neglect, or exploitation must be reported immediately to the charge nurse and per state law, even when there is no proof.

Resident information is shared only with the care team and only in private; hallway, elevator, and dining-room discussion violates confidentiality.

Residents keep the right to their personal possessions and to manage their own money unless a legal guardian has been appointed.

Filing a grievance is a protected right with no retaliation; the CNA helps the resident reach the complaint process when asked.

Independence rule: assist only with the steps the resident cannot do, and offer choices in food, clothing, and daily schedule.

Fire response is RACE: Rescue anyone in danger, Alarm, Contain by closing doors, then Extinguish or Evacuate.

Extinguisher use is PASS: Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep side to side.

Fall prevention: bed in lowest position, wheels locked, call light within reach, non-skid footwear, clear path, frequent checks.

Never leave a resident unattended in a bathtub, on a toilet, or on a raised bed.

Seizure care: protect the head, do not restrain or place anything in the mouth, time the event, turn the resident on the side afterward.

Stroke screening is FAST: Face droop, Arm drift, Speech change, Time symptoms began.

Check scene safety, then responsiveness, then call for help before starting CPR; compressions at 100-120 per minute and about 2 inches deep.

Oxygen safety: no smoking or open flame, no petroleum-based products, cylinders upright and secured, never adjust the flow rate.

Choking: encourage coughing; if ineffective give abdominal thrusts; if unresponsive start CPR and activate the emergency response.

Bath water is about 105 degrees Fahrenheit (40 degrees Celsius) or below; verify with a thermometer and let the resident test it.

Perineal care goes front to back, using a clean area of the washcloth each stroke, to prevent urinary tract infection.

Oral care for an unconscious resident: moistened toothette only, head turned to the side, no water, suction available.

Clean dentures over a water-filled or towel-lined sink and store them in a labeled cup of water when out of the mouth.

Reposition immobile residents at least every 2 hours; keep skin clean, dry, and off reddened bony prominences.

Dress the affected (weak) side first and undress it last; the strong side does the work.

Do not cut the toenails of a diabetic or circulation-impaired resident; report the need to the nurse.

Use an electric razor for residents on blood thinners or with a bleeding risk.

NPO means nothing by mouth, including water and ice chips, unless a specific order allows it.

Normal adult ranges: oral temperature 97.6-99.6 degrees Fahrenheit, pulse 60-100 per minute, respirations 12-20 per minute, blood pressure under 120/80.

Regular radial pulse: count 30 seconds and multiply by 2; irregular pulse: count a full 60 seconds and note rhythm.

Count respirations for a full minute without telling the resident; note rate, depth, rhythm, and effort.

Blood pressure: cuff bladder about 40 percent of arm circumference, arm supported at heart level, deflate 2-3 mm Hg per second.

Report a systolic drop of 20 mm Hg or a diastolic drop of 10 mm Hg on standing, which indicates orthostatic hypotension.

Rectal temperatures read about 0.5-1 degree higher than oral and axillary reads lower; never use the rectal route with diarrhea or rectal surgery.

Oxygen saturation of 95 percent or higher is normal; report values below 90 percent or any drop with shortness of breath.

Intake and output: 1 ounce equals 30 mL; record all intake and output, including ice chips and IV fluids as ordered.

Weigh at the same time of day, on the same scale, in the same clothing, typically morning after voiding and before breakfast.

Hand hygiene is the single most effective infection-control measure: soap and water for at least 20 seconds, or alcohol rub when hands are not visibly soiled.

Use soap and water rather than alcohol rub after contact with C. difficile or norovirus and whenever hands are visibly dirty.

Standard precautions apply to every resident: gloves for body fluids, plus gown, mask, and eye protection when splashing is possible.

Remove PPE with gloves first and mask last, then perform hand hygiene immediately.

Documentation is objective: time, observed facts, care given, and resident response; no opinions, no blank spaces, no unapproved abbreviations.

Correct a charting error with a single line through it plus error, initials, and date; never erase or use correction fluid.

Report changes in condition to the charge nurse; the CNA does not diagnose or interpret findings.

Contact precautions require gown and gloves; droplet requires a mask; airborne requires an N95 respirator and a negative-pressure room.

Do not share resident care items; clean and disinfect shared equipment between residents.