Arizona CNA cheat sheet

Wash hands before and after every resident contact and whenever gloves are removed; wear gloves when contact with blood, body fluids, or non-intact skin is likely.

Bath water is about 105°F (40-43°C); test it with the inner wrist or a thermometer, and never leave a resident alone in a tub or shower.

During a bed bath, wash from cleanest to dirtiest: face and neck, then arms and trunk, then legs, and the perineal area last.

Provide oral care at least twice daily and after meals; remove dentures, clean the gums, and store dentures in a labeled cup of water.

Turn and reposition an immobile resident at least every 2 hours; keep the bed in the lowest position with the wheels locked.

Dress the affected or weaker side first and undress that side last.

Perform range-of-motion exercises only through the joint's pain-free limit; stop and report if the resident reports pain.

Perform perineal care from front to back to reduce the risk of urinary tract infection.

Diabetic residents' toenails are trimmed only by a podiatrist or per facility policy; use an electric razor for residents taking anticoagulants.

Normal adult ranges: oral temperature 97.6-99.6°F (36.5-37.5°C), pulse 60-100 beats per minute, respirations 12-20 per minute, blood pressure below 120/80 mmHg.

Rectal temperatures read 0.5-1°F higher and axillary temperatures 0.5-1°F lower than an oral reading.

Count pulse and respirations for 30 seconds and multiply by 2 when the rhythm is regular; count a full minute when it is irregular.

Count respirations without announcing it, so the resident's breathing pattern does not change.

Blood pressure: place the cuff on the bare upper arm with its lower edge 1 inch above the brachial pulse, arm supported at heart level.

Report an oral temperature above 100°F (37.8°C) or a rectal temperature of 101°F (38.3°C) or higher.

Orthostatic hypotension is a drop of 20 mmHg systolic or 10 mmHg diastolic within 3 minutes of standing.

Pulse oximetry is normally 95-100%; report readings below 90% or a sudden drop.

1 ounce = 30 mL and 1 cup = 240 mL; record intake and output in milliliters.

RACE: Rescue anyone in danger, Alarm, Contain the fire by closing doors, then Extinguish or Evacuate.

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

Adult CPR: 30 compressions to 2 rescue breaths, 100-120 compressions per minute, depth at least 2 inches.

Never use water on an electrical or grease fire; use a class C or ABC extinguisher.

Seizure: ease the resident to the floor, protect the head, put nothing in the mouth, do not restrain, time the seizure, and turn the resident onto the side afterward.

Fall prevention: bed low and locked, call light within reach, non-skid footwear, clear pathways, and adequate lighting.

Restraints require a physician's order, the least restrictive device, checks every 15 minutes, and release with repositioning every 2 hours.

After a fall, do not move the resident; check for injury, stay with them, and call for the nurse.

Choking: abdominal thrusts for a conscious adult; if the resident becomes unconscious, lower them and begin CPR.

Hand hygiene is the single most effective way to prevent infection; wash with soap and water for at least 20 seconds.

Standard precautions apply to every resident regardless of diagnosis or known infection status.

Don PPE in this order: gown, mask, goggles, gloves. Remove: gloves, goggles, gown, mask; then perform hand hygiene.

Airborne precautions (tuberculosis, measles, varicella): N95 respirator and a negative-pressure room with the door closed.

Droplet precautions (influenza, pertussis): surgical mask. Contact precautions (MRSA, C. difficile, scabies): gown and gloves.

Use soap and water rather than alcohol rub for C. difficile, because alcohol does not kill the spores.

Never shake soiled linen; hold it away from the body and place it in the designated laundry bag.

Needlestick: wash with soap and water, report immediately, and follow the facility exposure control plan.

Do not share razors, toothbrushes, washcloths, or other personal items between residents.

Introduce yourself, use the resident's preferred name, and speak face to face at eye level.

Hearing loss: face the resident, lower the pitch of your voice, and reduce background noise; do not shout.

Aphasia: allow extra time, use yes/no questions, gestures, and pictures; never finish the resident's sentences.

Use a trained medical interpreter for residents with limited English; family members and children should not interpret medical information.

Document objectively: record what you see, hear, measure, and are told, without opinions or judgments.

Report a change in condition to the nurse promptly rather than waiting until the end of the shift.

Confidentiality: discuss residents only with the care team in private areas, never in hallways, elevators, or with other residents.

Active listening: face the resident, maintain eye contact, nod, and restate what you heard.

The federal Nursing Home Reform Act (OBRA 1987) established the Residents' Bill of Rights.

Residents have the right to dignity, privacy, respect, and freedom from abuse and neglect.

Residents may refuse treatment and must be informed of the consequences of that refusal.

Residents may voice grievances without retaliation and may contact the state long-term-care ombudsman.

Residents have the right to send and receive unopened mail and to make and receive private telephone calls.

Residents may keep personal possessions and manage their own finances, or voluntarily delegate that management.

Residents participate in their own care plan and choose activities, schedules, and their own physician.

Restraints may never be used for discipline, convenience, or coercion.

Abuse categories: physical, sexual, emotional/verbal, financial, neglect, and involuntary seclusion.

Any suspected abuse or neglect is reported immediately to the supervisor and per state law; suspicion alone is enough to report.

Assault is a threat to touch a resident without consent; battery is actual unauthorized touching; both are legal offenses.

False imprisonment is restricting a resident's movement without justification, such as locking a door.

HIPAA: share resident information only with the care team on a need-to-know basis.

Negligence is failing to give the care a reasonable person would give; malpractice is negligence by a professional.

Never accept gifts, money, or bequests from residents, and never witness a resident's will.

Perform only tasks within the CNA scope of practice that you were trained and authorized to perform.

Dementia is chronic, progressive, and typically affects short-term memory first; delirium is sudden, fluctuating, and often reversible.

Look for a physical cause of new confusion: infection, dehydration, pain, constipation, or a medication change.

Do not argue with delusions or hallucinations; acknowledge the feeling behind them and redirect.

Behavior is communication - agitation may signal pain, a full bladder, hunger, or overstimulation.

Depression signs: withdrawal, loss of interest, poor appetite, and sleep changes lasting 2 weeks or more.

Take any talk of suicide seriously, stay with the resident, remove harmful objects, and notify the nurse immediately.

Encourage independence and offer choices in ADLs to support self-esteem and function.

Wandering: provide a safe environment and an identification bracelet; restraints are not an acceptable intervention.

Adults need roughly 2000-2500 mL of fluid daily unless a fluid restriction is ordered.

Dysphagia: seat the resident upright at 90 degrees, give small bites, offer thickened liquids as ordered, and place food on the stronger side of the mouth.

Signs of aspiration: coughing or choking while eating, a wet voice, pocketing food, and watery eyes; stop feeding and report immediately.

NPO means nothing by mouth, including ice chips and water, unless specifically ordered.

Record intake and output in milliliters; 1 ounce = 30 mL and 1 cup = 240 mL.

Report weight loss of 5% or more in one month or 10% or more in six months.

Check the diet card against the tray before serving, and report meals the resident eats poorly.

Encourage fluids between meals and with medications to prevent dehydration and constipation.