Massachusetts 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

A normal adult oral temperature ranges from about 36.5 to 37.5 degrees Celsius (97.6 to 99.6 degrees Fahrenheit). Report readings outside this range or a change from the resident's usual baseline.

Normal adult pulse range

The normal resting adult pulse is 60 to 100 beats per minute. Count for 30 seconds and multiply by two, or count a full minute when the rhythm feels irregular.

Normal adult respiratory rate

A normal adult respiratory rate is 12 to 20 breaths per minute. Count for a full 60 seconds, preferably without telling the resident, because awareness can change the rate.

Normal adult blood pressure

Normal adult blood pressure is generally less than 120/80 mmHg. A reading of 130/80 mmHg or higher is classified as hypertension and should be reported to the nurse.

Orthostatic hypotension check

Measure blood pressure and pulse with the resident lying, then sitting, then standing one to three minutes apart. Report a drop of 20 mmHg systolic or 10 mmHg diastolic, or dizziness.

Apical pulse location

Listen with a stethoscope at the fifth intercostal space at the left midclavicular line and count for a full minute. It is used before digoxin and when a radial pulse is irregular.

Intake and output conversions

One ounce equals 30 milliliters and one cup equals 240 milliliters. Record all fluids taken by mouth and all urine, vomitus, or drainage output in milliliters on the intake and output record.

Denture care

Remove dentures at night, clean them with a denture brush and cleanser, and store them in a labeled, covered cup of water so they neither dry out, warp, nor get lost.

Bath water temperature

Bath water should be 100 to 105 degrees Fahrenheit (about 38 to 41 degrees Celsius). Test it with the inner wrist and keep the room warm so the resident does not become chilled.

Perineal care direction

Wash the perineal area from front to back, moving from the urethra toward the rectum, and use a separate washcloth for the perineum to reduce the risk of urinary tract infection.

Repositioning schedule

Turn and reposition an immobile resident at least every two hours, using a 30-degree lateral tilt, and keep the head of the bed at or below 30 degrees to reduce pressure injury risk.

Dressing the weak side

When dressing a resident with one-sided weakness, put the garment on the affected arm or leg first, then the unaffected side. When undressing, remove the unaffected side first.

Nail care with diabetes

Do not cut the fingernails or toenails of a resident who has diabetes or peripheral vascular disease. File them if permitted and report the need for nail trimming to the nurse.

Eye care direction

When washing the eyes during personal care, wipe from the inner corner next to the nose toward the outer corner, using a different part of the washcloth for each eye.

Handwashing duration

Wash hands with soap and running water for at least 15 to 20 seconds, covering all surfaces including under the nails, then dry with a paper towel and use it to turn off the faucet.

PPE removal order

Remove personal protective equipment in this order: gloves first, then goggles or face shield, then gown, and finally the mask or respirator, touching only the ties or straps.

R.A.C.E. fire response

R.A.C.E. stands for Rescue anyone in danger, Alarm or activate the fire alarm, Contain the fire by closing doors, and Extinguish or Evacuate according to the facility's emergency plan.

Adult CPR compression ratio

For adult CPR, give compressions at least two inches deep at a rate of 100 to 120 per minute, with a ratio of 30 compressions to 2 rescue breaths.

Fall prevention bed setup

Keep the bed in its lowest position with the brakes locked, the call light and personal items within reach, a night light on, and non-skid footwear on the resident.

C. difficile hand hygiene

After caring for a resident with Clostridioides difficile or norovirus, wash hands with soap and water rather than alcohol-based hand rub, because alcohol does not reliably kill these organisms.

SBAR report

SBAR is a structured handoff: Situation (what is happening now), Background (relevant history), Assessment (what you observe), and Recommendation (what you think should be done next).

Aphasia communication tips

For a resident with aphasia, ask yes-or-no questions, use picture or word boards, allow extra time to respond, and avoid finishing the resident's sentences or talking about them as if they are absent.

Hearing impairment communication

Face the resident, get their attention, reduce background noise, speak clearly at a normal volume, and avoid shouting or exaggerating lip movements, which distort speech and hinder lip reading.

Objective reporting

Report only what you observe or measure, such as 'the skin is red and warm' or 'ate 25 percent of lunch,' rather than opinions or guesses about the cause of a change.

Interpreter use

Use a qualified medical interpreter, not a family member or another resident, for consent, discharge teaching, or other sensitive information. Speak directly to the resident, not to the interpreter.

Confidentiality rule

Share resident health information only with care team members who need it to provide care. Do not discuss residents in hallways, elevators, or public areas, and never post about them online.

Right to refuse care

A competent resident may refuse any care or treatment. Accept the refusal without arguing, notify the nurse, document exactly what was refused, and offer acceptable alternatives.

Mandatory abuse reporting

Nursing assistants are mandated reporters. Report any suspected physical, sexual, or emotional abuse, neglect, or financial exploitation immediately to the charge nurse and per state law; do not investigate it yourself.

Long-term care ombudsman

The ombudsman is an independent advocate who investigates complaints about nursing home care and helps residents exercise their rights. The contact number must be posted where residents can see it.

Informed consent elements

Valid informed consent requires that the resident or legally authorized representative understand the nature of the treatment, its risks, benefits, and alternatives, and consent freely without pressure.

Privacy during care

Knock and wait before entering, close the door or curtain, and expose only the body part being cared for. Privacy is a resident right protected by facility policy and federal law.

Promoting independence

Let residents do as much of their own care as possible, even if it takes longer, and provide adaptive equipment such as grab bars, long-handled sponges, or button hooks to support self-care.