DC CNA cheat sheet

Bath water should be about 105°F (40.5°C); test it on the inner wrist and wash the eyes from the inner to the outer corner.

Perineal care goes front to back - clean the urethral area before the anal area to reduce urinary tract infection risk.

Dress the weak or affected side first; when undressing, remove clothing from the strong side first.

For an unconscious resident, give oral care with the head turned to the side and suction available; never place fluids in the mouth.

Do not trim the toenails of residents with diabetes or poor circulation - report the need to the nurse.

Use an electric razor for residents on anticoagulants or with bleeding disorders.

Reposition the resident at least every 2 hours and inspect skin over bony prominences at each turn.

Never force a joint past the point of resistance or pain during range of motion.

Warm the bedpan rim and raise the head of the bed no more than about 30 degrees when the resident's condition allows.

Normal adult ranges: oral temperature 97.6–99.6°F, pulse 60–100 beats/min, respirations 12–20/min, SpO2 95–100%.

Take the radial pulse with two fingers, never the thumb, because the thumb has its own pulse.

Count respirations for 30 seconds and multiply by two while the resident still believes you are counting the pulse.

Position the BP cuff bladder with its lower edge about 1 inch above the antecubital space and directly over the brachial artery.

Weigh residents at the same time of day on the same scale, before breakfast and after voiding.

Clean-catch urine specimen: collect midstream into a sterile container and label with name, date, and time.

Stool specimens must not be contaminated with urine or toilet paper.

Keep the catheter drainage bag below bladder level and off the floor; perform catheter care front to back.

A sterile dressing change moves from clean to dirty; never touch or reach over the sterile field.

RACE = Rescue, Alarm, Contain, Extinguish/Evacuate. PASS = Pull, Aim, Squeeze, Sweep.

If a resident begins to fall, ease them to the floor while protecting the head; do not attempt to catch dead weight.

Seizure: protect the head, clear nearby objects, do not restrain, place nothing in the mouth, and time the seizure.

Hand hygiene with soap and water lasts at least 20 seconds; use alcohol rub only when hands are not visibly soiled.

Standard precautions apply to all blood, body fluids, secretions, excretions, and non-intact skin.

Remove PPE before leaving the resident's room and perform hand hygiene immediately afterward.

Keep the bed in the lowest position, wheels locked, call light within reach, and side rails per the care plan.

Restraints require a physician's order and must be released and checked at least every 15 minutes.

Report any needlestick or body-fluid exposure immediately and follow the facility post-exposure protocol.

Speak at eye level, face the resident, and use the resident's preferred name.

For aphasia, ask yes/no questions, allow time to answer, and use gestures or pictures; do not finish the resident's sentences.

For hearing loss, face the resident, reduce background noise, and speak at a slightly lower pitch; do not shout.

Report changes in condition to the nurse promptly, stating facts rather than opinions.

Document objectively: record what is observed or measured, quote statements, and sign and time each entry.

Discuss resident information only in private areas (HIPAA); no hallway, elevator, or cafeteria conversations.

Never promise to keep a secret about abuse, neglect, or harm - reporting is mandatory.

Use a qualified interpreter or language line and avoid medical jargon with residents and families.

Federal minimum nurse aide training is 75 hours, including at least 16 hours of supervised clinical practice.

Nurse aides do not administer medications, insert catheters, start tube feedings, or perform sterile procedures.

Chain of command: nurse aide → charge nurse/LPN → RN → director of nursing → administrator.

Report immediately: falls, injuries, skin breakdown, abnormal vital signs, refusal of care, and signs of abuse.

Assignments come from the nurse; a delegated task outside training or legal scope should be refused and reported.

Accept no money, gifts, or bequests from residents or their families.

Follow the facility job description and state nurse practice act; do not perform tasks for which you were not trained.

Residents have the right to refuse any treatment or care; inform the nurse and document the refusal.

OBRA (1987) guarantees privacy, dignity, freedom from abuse and restraint, and participation in care planning.

Knock and wait before entering, close doors and curtains during care, and keep resident information confidential.

Residents may voice grievances without retaliation and must be helped to file them.

Staff may not open a resident's mail, borrow belongings, or search possessions without policy authorization.

Suspected abuse, neglect, or misappropriation of property must be reported immediately to the charge nurse and administrator.

Resident funds must be held in trust and accounted for; staff may not borrow or 'hold' resident money.

Do not argue with a dementia resident's delusions or hallucinations; acknowledge the feeling and redirect gently.

Reality orientation suits mild confusion (clocks, calendars, stating name and day); validation therapy suits dementia.

Sundowning is late-day agitation; reduce noise and stimulation and keep routines and lighting consistent.

Never restrain a wanderer; provide safe walking areas and supervision, and report exit-seeking behavior.

Any statement about suicide or self-harm: stay with the resident and notify the nurse immediately.

Signs of depression include withdrawal, poor appetite, sleep changes, and loss of interest - report them.

Keep caregivers and routines consistent; introduce yourself and explain care before performing it.

Encourage independence in ADLs and allow extra time rather than completing the task for the resident.

Typical adult fluid need is about 1500–2000 mL per day unless restricted; offer fluids with meals and between meals.

Record all intake (oral, IV, tube) and all output (urine, emesis, drainage) in milliliters and report totals.

Dysphagia precautions: sit upright at 90 degrees, offer small bites, encourage a chin tuck, and use thickened liquids per orders.

Signs of aspiration include coughing, choking, a wet or gurgly voice, and cyanosis - stop feeding and report.

Dehydration signs: dark concentrated urine, dry mouth, poor skin turgor, confusion, and weight loss.

NPO means nothing by mouth: remove food and water from the room and provide mouth care.

For a resident who had a stroke, place food on the stronger, unaffected side of the mouth.

Residents with diabetes: follow the prescribed diet and report refusals or uneaten meals to the nurse.

Follow any fluid restriction exactly and report intake that exceeds the ordered limit.