Louisiana CNA cheat sheet

Normal adult vital sign ranges: oral temperature 97.6-99.6 degrees F (36.5-37.5 C), pulse 60-100 beats per minute, respirations 12-20 breaths per minute, pulse oximetry 95-100 percent.

Hand hygiene: soap and water for at least 20 seconds when hands are visibly soiled or after contact with body fluids; alcohol-based rub is acceptable when hands are not visibly soiled.

Body mechanics: bend at knees and hips, keep the back straight, hold the load close to the body, feet shoulder-width apart, and never twist the trunk while lifting or moving a resident.

Transfer sequence with a gait belt: belt snug at the waist over clothing, underhand grip, stand on the resident's weaker side, and let the resident dangle at the bedside 1-2 minutes before standing to prevent orthostatic hypotension.

Reposition an immobile resident at least every 2 hours; use a 30-degree lateral position and pillows to keep bony prominences off the mattress.

A reddened area over a bony prominence that does not blanch when pressed is an early pressure injury: report it, keep pressure off it, and never massage the site.

Bathing order: face first (eyes cleaned from inner to outer canthus with a different part of the cloth for each eye), then arms, chest, abdomen, legs, back, and perineal area last.

Measurement conversions for intake and output: 1 ounce = 30 mL, 1 cup = 8 ounces = 240 mL, 1 mL = 1 cc; record intake and output in milliliters unless the form states otherwise.

Catheter care: cleanse the catheter from the meatus outward about 4 inches using a clean area of the cloth per stroke, and keep the drainage bag below the level of the bladder.

Maslow's hierarchy, from lowest to highest priority: physiological needs, safety and security, love and belonging, self-esteem, self-actualization. Physical needs are met before higher needs.

Kubler-Ross stages of grief: denial, anger, bargaining, depression, acceptance. Residents may move back and forth among stages rather than progressing in a fixed order.

Hearing deficit: face the resident, gain attention before speaking, speak slowly and clearly at a slightly lower pitch, reduce background noise, and do not shout.

Aphasia: allow extra response time, ask yes-or-no questions, use gestures and pictures, and do not finish the resident's sentences or talk about the resident as if they are absent.

Dementia: approach from the front at eye level, use a calm tone, keep routines consistent, redirect rather than argue, and do not correct every misstatement.

Report to the nurse: withdrawal, loss of appetite, changed sleep patterns, crying, hopeless statements, and loss of interest in grooming or activities, as these can signal depression.

A alert and oriented resident may refuse any care or treatment; honor the refusal, do not force care, and report the refusal and the stated reason to the nurse.

Restorative care principle: encourage residents to perform as much of their own ADLs as safety allows (washing the face, feeding, grooming) to preserve function and independence.

Respect cultural and spiritual needs: follow facility policy for dietary restrictions, arrange privacy for prayer or ritual, and notify the nurse or chaplain when a resident requests spiritual support.

Chain of command: the nurse aide takes direction from and reports to the licensed nurse (RN or LPN); the aide does not accept assignments from other unlicensed workers.

Scope of practice limits: nurse aides do not assess, diagnose, teach, administer medications, insert tubes, or perform sterile procedures. These are referred to the licensed nurse.

Report immediately: any change in condition, fall, injury, refusal of care, chest pain, difficulty breathing, abnormal vital signs, or suspected abuse or neglect.

Documentation standard: black ink, objective facts only, timed and dated, signed with name and title. Correct errors with a single line, the word error, initials, and date; never use whiteout.

Objective data are measurable observations (pulse 88, urine output 200 mL); subjective data are what the resident reports (I feel dizzy). Chart both accurately, attributing subjective statements to the resident.

HIPAA confidentiality: discuss resident information only with the care team, never in hallways, elevators, or with friends and family, and log off or lock computer screens.

OBRA Residents' Bill of Rights guarantees dignity, privacy, confidentiality, freedom from abuse and unnecessary restraint, choice, and the right to voice grievances without retaliation.

Suspect abuse or neglect: report immediately to the charge nurse or administrator; the aide is a mandatory reporter, and the facility then notifies the state survey agency as required by law.

Incident reports document unusual events such as falls; they contain facts only, no blame or opinions, and are not filed as part of the medical record.