Hawaii CNA flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Normal adult oral temperature

An adult oral temperature typically ranges from 97.6°F to 99.6°F, or 36.5°C to 37.5°C; report readings outside this range or a change from the resident's usual baseline.

Normal adult pulse rate

A normal adult resting pulse is 60 to 100 beats per minute; count for 30 seconds and multiply by two, or count for a full minute if the rhythm is irregular.

Normal adult respiratory rate

A normal adult respiratory rate is 12 to 20 breaths per minute; observe chest rise without telling the resident you are counting to avoid altering the rate.

Counting an irregular respiration

When a resident's breathing rhythm is irregular, count respirations for a full minute rather than 30 seconds so the rate and pattern are accurately recorded.

When to perform hand hygiene

Perform hand hygiene before and after every resident contact, after removing gloves, and whenever hands are visibly soiled; use soap and water for visible soil.

Intake-output metric conversions

One ounce equals 30 milliliters, one cup equals 240 milliliters, and one teaspoon equals 5 milliliters; record all intake and output in milliliters on the flow sheet.

Bed bath water temperature

Bed bath water should be about 105°F, or 40.5°C; test the water against your inner wrist before washing the resident and change it when it cools.

Perineal care cleaning direction

For female residents, wash the perineal area from front to back to prevent bacteria from the rectum from entering the urethra; use a clean washcloth for each stroke.

Dressing a resident with weakness

Put the garment on the affected arm or leg first, then the unaffected side; when undressing, remove the unaffected side first and the affected side last.

Oral care for unconscious resident

Turn the resident's head to the side, have suction ready, and use a toothbrush or swab without fluids; do not pour water into the mouth of an unconscious resident.

Denture care and storage

Remove dentures, brush them over a basin of water to prevent breakage, rinse them, and store them in a labeled cup of water when the resident is not wearing them.

Feeding a resident with dysphagia

Sit the resident upright at about 90 degrees, offer small bites, allow time to chew and swallow, and stop feeding if choking or gurgling occurs.

Maslow's hierarchy of needs

From bottom to top, Maslow's hierarchy is physiological needs, safety, love and belonging, esteem, and self-actualization; lower needs generally must be met before higher ones.

Therapeutic communication techniques

Open-ended questions, restating, reflecting, and silence encourage residents to express feelings; avoid false reassurance and asking 'why' questions that sound accusatory.

Kubler-Ross stages of grief

The five stages are denial, anger, bargaining, depression, and acceptance; residents may move back and forth among stages rather than through them in a fixed order.

Signs of depression to report

Persistent sadness, withdrawal from activities, appetite or sleep changes, and statements of hopelessness may indicate depression; report these observations to the nurse.

Defense mechanism: denial

Denial is refusing to accept a painful reality, such as a resident insisting that a serious diagnosis is wrong; recognize it without arguing and report ongoing distress.

Most common cause of dementia

Alzheimer's disease is the most common cause of dementia; it is irreversible and progressive, eventually affecting memory, communication, and all activities of daily living.

Communicating with cognitively impaired resident

Approach from the front at eye level, use a calm voice, short sentences, and one instruction at a time; allow extra time for the resident to respond.

Sundowning

Sundowning is increased restlessness, confusion, or agitation in the late afternoon or evening; reduce noise and activity and keep evening routines calm and predictable.

Wandering safety measures

Provide supervision, a safe environment, and identification such as a bracelet; do not use restraints as a substitute for supervision and redirect the resident gently.

Responding to repetitive questions

Answer the same question calmly each time, then redirect to another activity; do not argue, correct, or test the resident's memory, which can increase distress.

Range of motion frequency

Perform range-of-motion exercises two to three times daily with three to five repetitions per joint, unless the care plan gives different instructions; move slowly and gently.

When to stop range of motion

Stop a range-of-motion exercise if the resident reports pain or if the joint meets resistance; never force a joint, and report the finding to the nurse.

Cane use side

A cane is held on the resident's stronger side and moved forward at the same time as the weaker leg; this widens support and reduces fall risk.

Walker use sequence

The resident lifts and moves the walker forward first, then steps into it; the walker should be fitted so the hand grips are at wrist height when standing.

Repositioning immobile residents

Reposition an immobile resident at least every two hours, support the extremities in proper alignment, and inspect the skin for redness at each turn.

Source of resident rights

Resident rights are protected by the federal Nursing Home Reform Act, or OBRA, of 1987; these rights apply regardless of how the resident pays for care.

Mandatory abuse reporting

CNAs are mandatory reporters; report suspected abuse, neglect, or exploitation immediately to the nurse or administrator and follow facility policy for written documentation.

Restraint use requirements

Restraints require a physician's order for a specific condition, must be the least restrictive option, and must be released with repositioning at least every two hours.

Right to refuse treatment

A resident may refuse any treatment or care; document the refusal, inform the nurse, and explain the possible consequences without pressure or threats.

Confidentiality under HIPAA

Keep resident information confidential under HIPAA; discuss care only with the care team and only when needed, and do not share details with visitors or other residents.