Kentucky CNA (SRNA) cheat sheet

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

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

Bath water is typically about 105°F (40–41°C); test the temperature, and never leave a resident alone in a tub or shower.

Dress the affected or weak side first, then the stronger side; when undressing, remove the stronger side first so the weak limb is protected.

For an unconscious resident, turn the head to the side, use suction or a moist swab for oral care, and never allow fluids to pool in the mouth.

Clean dentures over a basin of water or a folded towel to prevent breakage; remove them at night and store them in a labeled container with water.

Perform range of motion only to the point of resistance or pain; never force a joint, and stop and report if the resident reports pain.

Offer toileting at least every 2 hours, before and after meals, and at bedtime; answer call lights promptly.

Do not trim the nails of a resident with diabetes or poor circulation; report nail problems to the nurse instead.

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, SpO2 95–100%.

Count respirations for a full minute if the rhythm is irregular; keep fingers on the wrist as if still counting pulse so the resident does not alter breathing.

Take a radial pulse with the index and middle fingertips on the thumb side of the wrist; never use the thumb because it has its own pulse.

Wait about 15 minutes after smoking or after hot or cold fluids before taking an oral temperature.

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

Wear gloves whenever contact with blood, body fluids, mucous membranes, or non-intact skin may occur, and remove them before leaving the room.

Keep the bed in the lowest position with wheels locked and the call light within reach; raise side rails only as ordered.

Report immediately: change in level of consciousness, chest pain, difficulty breathing, temperature above 101°F, bleeding, or a sudden drop in blood pressure.

Restorative care aims to maintain or regain function by encouraging residents to do as much self-care as they safely can.

Reposition an immobile resident at least every 2 hours and use pillows or heel boots to keep bony areas off the mattress.

When ambulating with a cane, the resident holds it on the stronger side and moves the cane and weaker leg forward together, then steps with the stronger leg.

With a walker, the resident lifts and places the walker forward first, then steps into it; use a gait belt when assisting ambulation.

Apply splints and braces exactly as ordered, check the skin underneath for redness or breakdown, and report any problems.

Prevent contractures with regular range of motion exercises and proper body alignment in bed and chair.

Bladder and bowel retraining require a consistent toileting schedule; record results and report changes.

Encourage fluids and high-fiber foods to prevent constipation and support normal elimination.

Kubler-Ross stages of grief are denial, anger, bargaining, depression, and acceptance; not every person experiences every stage or in that order.

Report signs of depression such as withdrawal, loss of appetite, changed sleep patterns, crying, and loss of interest in activities.

Denial, regression, projection, and rationalization are common defense mechanisms; recognize them without arguing.

Do not argue with a confused resident; use a calm tone, simple words, and gentle redirection.

Offer choices whenever possible to promote autonomy and reduce feelings of helplessness.

Anger may be directed at staff; do not take it personally, stay calm, listen, and report persistent or escalating behavior.

Behaviors such as agitation or refusing care may signal pain, illness, or fear; report changes to the nurse.

Encourage social interaction and activities to reduce isolation and boredom.

Spirituality is broader than religion; it includes meaning, purpose, and connection, so care should support both without imposing personal beliefs.

Ask residents about cultural preferences for food, dress, hygiene, personal space, and the gender of the caregiver.

Honor dietary restrictions such as kosher, halal, or vegetarian diets; check the diet card before serving food.

Provide privacy and quiet during prayer, meditation, and religious rituals, and announce yourself before entering.

Report requests for clergy, religious items, or rituals to the nurse or activity director.

Cultures differ in comfort with eye contact, touch, and personal space; observe the resident's reactions and adjust care.

Never pressure a resident to accept your own religious beliefs or practices.

Use short, simple sentences, speak slowly and clearly, and avoid medical jargon.

With hearing loss: get the resident's attention, face them, reduce background noise, and speak at a normal volume without shouting or covering your mouth.

With aphasia: allow extra time, ask yes-or-no questions, and use gestures or picture boards; never finish the resident's sentences.

With vision loss: identify yourself on entering, announce what you are about to do, and keep frequently used items in the same place.

Write reports objectively-what you see, hear, and measure-including time, what happened, and what you did, rather than opinions.

Use reality orientation with a confused resident: calmly state who you are, where the resident is, and the day and time.

Do not discuss resident information in halls, elevators, or public areas; share it only with the care team.

If there is a language barrier, use a facility interpreter or translation service and speak directly to the resident, not to the interpreter.

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

A resident may refuse any care or treatment; accept the refusal, document it, and report it to the nurse rather than forcing care.

Residents may voice grievances without retaliation; staff must not punish or treat them differently for complaining.

Care, records, and conversations about a resident are confidential and are shared only with the care team.

Residents have the right to make their own choices about care, schedule, and activities, and staff should offer options rather than deciding for them.

Residents have the right to receive visitors, mail, and telephone calls, and to communicate freely.

Restraints may never be used for discipline, convenience, or coercion, and only with a physician's order.

A competent resident's wishes take priority over family preferences; report conflicts to the nurse.

Types of abuse include physical, sexual, verbal or emotional, financial, neglect, and involuntary seclusion.

Any suspicion of abuse or neglect must be reported immediately to the charge nurse and per state law and facility policy.

Assault is a threat to touch a person without consent; battery is actual unauthorized touching.

Negligence is failing to give the care a reasonable, similarly trained person would give, resulting in harm.

Restricting a resident's freedom of movement without justification constitutes false imprisonment.

Nurse aide registries record findings of abuse, neglect, or misappropriation of resident property, which can bar employment.

Never accept gifts or money, witness a will, or act as power of attorney for a resident.

Ethical practice includes honesty, maintaining competence, protecting confidentiality, and doing no harm.

Know and work within your job description; perform only tasks you have been trained and authorized to do.

Report changes in condition, refusals, injuries, and abnormal vital signs to the charge nurse promptly.

Nurse aides do not assess, administer medications, insert catheters, start IVs, or teach residents.

The chain of command is typically: nurse aide to charge nurse or LPN, then RN, then supervisor, then administrator.

If asked to perform a task that is untrained or unsafe, say so, ask the nurse, and report the concern.

Contribute observations to the care plan and team conferences; the nurse remains responsible for the plan of care.

Share resident information only with the care team to comply with confidentiality rules.

When unsure about a procedure or a resident's condition, ask the nurse rather than guessing.