Indiana CNA cheat sheet

Scope of practice is set by the state nurse practice act and facility policy; the aide performs only tasks he or she was trained and assigned to do, and reports requests for anything else to the charge nurse.

Chain of command: nurse aide → charge nurse/LPN → RN → director of nursing → administrator. Concerns go up the chain, starting with the charge nurse.

The nurse aide never gives medications, starts or inserts tubes, performs sterile procedures, makes a nursing assessment, or accepts telephone/verbal orders.

Report to the nurse immediately: any fall, skin breakdown, abnormal vital signs, bleeding, refusal of care, or sudden change in mental status.

Chart objective data that can be seen, measured, or counted ("ate 50% of lunch," "urine dark yellow"); do not chart opinions, guesses, or blame.

Resident rights include privacy, dignity, choice, refusal of treatment, freedom from abuse and restraint, access to records, and receiving visitors of the resident's choosing.

Suspected abuse, neglect, or misappropriation of property must be reported at once to the charge nurse and to the state agency as required; the aide is a mandatory reporter.

When a task is delegated, the nurse keeps accountability for the outcome; the aide may accept the task only if it falls within his or her training and may ask for clarification.

Protected health information is shared only with the care team for care purposes; discussing a resident in public areas or with unauthorized people is a violation of confidentiality.

Fall prevention setup: bed in lowest position, wheels locked, call light and personal items within reach, non-skid footwear, clear path, and side rails only as written in the care plan.

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

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

Oxygen safety: no smoking or open flame, no petroleum-based products, no electrical sparks; secure cylinders upright and post signage.

A restraint requires a physician's order, must be the least restrictive type, is released and monitored on a schedule, and is never used for punishment, convenience, or staffing shortage.

Body mechanics for lifting: bend at the knees, keep the back straight, hold the load close, use a wide base of support, do not twist; use a mechanical lift or get help when the resident cannot assist.

Ambulate on the resident's weaker side with a gait belt, non-skid shoes, and a clear path; stop and lower the resident to the floor if he or she begins to fall rather than catching the body.

Incident reports are factual, completed by staff, and are not filed in the resident's medical record or mentioned to the resident as a threat.

Turn and reposition a bedbound resident at least every 2 hours and inspect the skin at each turn for redness, warmth, or breakdown.

Range of motion: support the joint above and below, move only to the point of resistance or pain, never force a joint, and stop and report pain with motion.

Orthostatic hypotension is prevented by raising the head of the bed, dangling the legs at the bedside, and rising slowly before standing.

Dehydration signs are dark concentrated urine, dry mouth, poor skin turgor, and new confusion; encourage fluids unless a fluid restriction is ordered.

During meals sit the resident upright, offer small bites, alternate fluids, allow time to chew and swallow, and record the percentage of food eaten.

Contracture prevention uses proper alignment with pillows, hand rolls, and foot support as ordered, plus daily range of motion.

Offer toileting on a regular planned schedule and answer the call light promptly; these are the most effective continence measures.

Encourage self-care and dressing, grooming, and eating tasks the resident can still do, because performing tasks for the resident speeds loss of function.

Normal adult ranges: oral temperature 97.6–99.6 °F, pulse 60–100 beats/min, respirations 12–20 breaths/min, blood pressure under 120/80 mmHg; report values outside the resident's normal range.

Count the pulse for 30 seconds and multiply by 2 when regular; count a full 60 seconds when the rhythm is irregular.

Count respirations for 30 seconds and multiply by 2 (count a full minute if abnormal) without announcing it, so breathing stays natural.

Blood pressure: cuff on a bare arm at heart level; avoid an arm with an IV, a dialysis fistula, or on the side of a mastectomy or lymphedema.

Hand hygiene is performed before and after every resident contact, after glove removal, and after contact with blood or body fluids; gloves never replace handwashing.

Bathing order: wash the cleanest areas first (face, arms, chest, legs) and the perineal area last to avoid spreading microorganisms.

Perineal care is given front to back, wiping away from the urethra, to reduce urinary tract infection risk.

Dentures are brushed, rinsed, stored in a labeled cup of cool water when not worn, and never placed in hot water; natural teeth are brushed at least twice daily and after meals.

Record and report urine color, odor, amount, and frequency, and the color, consistency, and frequency of stools.

Signs of approaching death include Cheyne-Stokes respirations, mottled and cool extremities, decreasing urine output, loss of appetite, and increasing sleepiness.

Do not force food or fluids in an actively dying resident; provide mouth care, lip balm, and repositioning for comfort instead.

Post-mortem care: place the body supine, close the eyes, insert dentures, keep the body covered and clean, follow religious or cultural practices, and notify the nurse.

Kübler-Ross stages of grief are denial, anger, bargaining, depression, and acceptance; residents and families may move back and forth among them.

Hospice care focuses on comfort and quality of life rather than cure, with pain and symptom control as the priority.

Seizure first aid: protect the resident from injury, do not restrain or place anything in the mouth, time the seizure, and turn the resident onto the side afterward.

Report immediately any sudden chest pain, shortness of breath, one-sided weakness, facial droop, difficulty speaking, or abrupt change in level of consciousness.

Hypoglycemia signs are sweating, shakiness, hunger, confusion, and irritability; report at once and give a sugar source only as allowed by the care plan.

For a resident with dementia, approach from the front, use short simple sentences, allow time to respond, and do not argue with hallucinations or delusions.

Scope of practice

Chain of command reporting

Mandatory abuse reporting

Objective charting rule

Resident rights

Delegation accountability