Idaho CNA cheat sheet

Normal adult resting respiratory rate is 12 to 20 breaths per minute; count for a full minute when the rate is abnormal or irregular.

Normal adult resting pulse is 60 to 100 beats per minute; report a new rate outside this range, an irregular rhythm, or a marked change from baseline.

Blood pressure categories: normal is less than 120/80 mmHg; stage 1 is 130-139 or 80-89 mmHg; stage 2 is 140 or higher or 90 or higher mmHg.

Oral temperature is about 36.5-37.5 C (97.7-99.5 F); axillary readings are slightly lower and rectal readings slightly higher.

Intake and output are recorded in milliliters; 1 ounce equals 30 mL, and all fluids, urine, emesis, and drainage are measured.

Weigh residents at the same time of day, usually morning, on the same scale, with the same amount of clothing; 1 kg equals 2.2 lb.

Pulse oximetry usually reads 95-100% on room air; report a reading below baseline or below 90%, or new shortness of breath.

Specimen containers are labeled at the bedside with resident name, date, time, and specimen type; gloves and hand hygiene are required.

Report immediately chest pain, difficulty breathing, sudden weakness, slurred speech, severe headache, bleeding, a fall, or a change in consciousness.

Oral care is provided at least twice daily and after meals; dentures are removed, rinsed, and stored in a labeled cup with water.

Bathing proceeds from cleanest to dirtiest: face and neck, arms, chest and abdomen, legs, back, then perineal area last.

Female perineal care is performed front to back with a separate washcloth; rinse and dry thoroughly.

Bedbound residents are repositioned at least every 2 hours; skin is checked at each turn and heels are kept off the mattress.

When dressing a resident with one weak side, dress the weak side first and undress the strong side first.

Nails are soaked, cut straight across, and filed; do not cut the nails of a resident with diabetes unless facility policy permits.

Shampooing protects the eyes and ears, uses warm water, and includes checking the scalp for redness or sores.

Toileting is offered at routine times, before and after meals, at bedtime, and whenever the resident requests.

Separate washcloths are used for the face and perineal area; water is changed when it becomes soiled.

Hand hygiene is performed before and after every resident contact, after glove removal, after body fluid contact, and between dirty and clean tasks.

Standard precautions apply to all residents and all blood, body fluids, secretions, excretions, nonintact skin, and mucous membranes.

Gloves do not replace handwashing; hand hygiene is performed after removing gloves.

PPE is put on in the order gown, mask, goggles, gloves and removed gloves first, then goggles, gown, and mask, with hand hygiene after.

Contact precautions are used for C. difficile and MRSA; droplet for influenza and pertussis; airborne for tuberculosis, measles, and varicella.

C. difficile requires soap-and-water handwashing because alcohol sanitizer does not reliably kill spores.

Shared equipment is disinfected between residents with a facility-approved disinfectant for the required contact time.

A needlestick or sharp injury is washed with soap and water, reported immediately, and managed under the facility exposure protocol.

Razors, toothbrushes, and other personal items are not shared between residents.

Fall prevention includes a low bed, locked brakes, call light within reach, non-skid footwear, and a clear path.

Restraints require a licensed provider's order; circulation, skin, and needs are checked at least every 15 minutes or per policy, and restraints are released regularly.

If a choking resident can cough forcefully, encourage coughing; if the resident cannot breathe, speak, or cough, activate emergency response and follow trained abdominal thrust or CPR protocol.

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

For bleeding, apply direct pressure with gloves; do not remove a soaked dressing, add more dressings on top.

During a seizure, protect the head, move objects away, do not restrain or put anything in the mouth, and time the seizure.

For fainting, lower the resident to the floor or chair, elevate the legs, check breathing, and notify the nurse.

Emergency calls state the location, resident condition, what happened, and the caller stays on the line until told to hang up.

Elevators are not used during a fire; use stairs and follow the evacuation route and assembly point.

Use the resident's preferred name, introduce yourself, and explain care before starting.

Speak slowly, face the resident, use short sentences, and do not shout unless hearing loss requires it.

Active listening includes repeating back information to confirm understanding.

For hearing impairment, reduce background noise, face the resident, and use written notes or an amplification device if needed.

For aphasia, allow time, use yes-or-no questions, gestures, and communication boards, and do not finish sentences unless asked.

Changes are reported to the nurse promptly; documentation records objective observations rather than opinions.

Resident information is discussed only with the care team and only the minimum necessary information is shared.

A trained interpreter is used when needed; a family member is not used as interpreter except in an emergency with resident agreement.

In conflict, stay calm, listen, acknowledge feelings, focus on the resident's needs, and involve the nurse or social worker.

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

A competent resident may refuse care; document the refusal, notify the nurse, and do not force or threaten care.

Residents participate in care planning and make choices about daily routines, within safety and facility policy.

Resident records are confidential and released only with authorization or as law requires.

Residents may voice grievances without retaliation.

Residents should be allowed to perform as much self-care as possible; setup and adaptive devices are provided rather than taking over.

Resident mail is not opened, read, or discarded without the resident's permission or a legal exception.

Residents have access to phone, visitors, and mail; restrictions follow facility policy and resident rights rules.

Resident money is not handled unless facility policy authorizes it; staff never borrow from or accept gifts from residents.

Depression signs include persistent sadness, loss of interest, appetite or sleep changes, fatigue, and withdrawal; these are reported to the nurse.

Anxiety is addressed with a calm manner, simple explanations, extra time, and reassurance.

Social interaction and activities are offered based on resident preference; withdrawal from previously enjoyed activities is reported.

Grief is met by listening and acknowledging feelings; signs of complicated grief are reported.

Suicidal statements or signs of substance withdrawal require immediate notification of the nurse.

New behavior changes may signal pain, infection, constipation, hunger, fear, or another unmet need and are reported rather than assumed intentional.

Cultural and religious beliefs and routines are respected in care delivery.

Delusions and hallucinations are not argued with; feelings are acknowledged and the resident is redirected to a safe familiar activity.

Privacy and dignity are maintained during emotional distress.

Dementia is progressive; abilities fluctuate, so routine and familiar cues are used.

Approach a resident with dementia from the front, use a calm tone, give one instruction at a time, and avoid arguing or correcting.

Validation acknowledges the resident's feelings rather than insisting on factual accuracy.

Sundowning is increased confusion or agitation in late afternoon or evening; noise and stimulation are reduced and calm routine and lighting provided.

For wandering, ensure a safe environment, alert the nurse, check identification, and redirect gently; the resident is not locked in a room.

Memory aids include labels, clocks, calendars, and pictures; items are kept in the same place.

Pain or illness may appear as agitation; new behavior is reported.

Restraints are not used for wandering or confusion unless ordered and monitored under facility policy.

Mealtimes use a quiet environment, familiar foods, cueing, and extra time.

Range-of-motion exercises are performed only as ordered; stop for pain, shortness of breath, or resistance, and support the joint.

Active range of motion is movement performed by the resident; passive range of motion is movement of the resident's joint by the caregiver.

Self-care is supported by setting up supplies, allowing time, and praising effort.

Ambulation uses a gait belt, non-skid shoes, and a clear path; the aide stands on the weak side and slightly behind.

Transfers lock wheels, raise the bed to the proper height, use a gait belt, and pivot the resident toward the strong side.

Positioning supports body alignment with pillows and avoids pressure on bony prominences.

Splints and braces are applied as ordered; skin and circulation are checked and removal follows the order.

Bladder training offers toileting on schedule and promotes fluids unless restricted.

Adaptive devices are used as directed by occupational or physical therapy to support independence in ADLs.

A nurse aide performs tasks within state certification and facility policy that are delegated by a licensed nurse; the aide does not diagnose, prescribe, or give medications unless specifically authorized.

Changes in condition, refusals, and errors are reported to the nurse promptly.

Abuse includes physical, sexual, emotional, financial abuse, neglect, and exploitation; suspected abuse is reported immediately to the nurse or administrator and the required state agency.

Nurse aides are mandatory reporters of suspected abuse and neglect.

HIPAA requires sharing only the minimum necessary information with the care team.

Documentation is objective, timely, and accurate; a written error is corrected with a single line, initials, date, and per policy, never by altering another person's record.

Staff do not accept gifts or money from residents or borrow from them.

Assault, battery, false imprisonment, and defamation are legal risks; consent is obtained before care.

When unsure about a task, the aide asks the nurse and follows the state nurse practice act and facility policy.