Maryland CNA flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Hand hygiene duration

Wash hands with soap and water for at least 20 seconds, covering all surfaces and under the nails; use alcohol-based rub when hands are not visibly soiled.

Normal adult oral temperature

Oral temperature for a healthy adult ranges from about 97.6 to 99.6 degrees Fahrenheit (36.5 to 37.5 Celsius); report a reading outside that range to the nurse.

Stage 1 pressure injury

Stage 1 pressure injury is intact skin with non-blanchable redness over a bony prominence; keep pressure off the area and report it, and never massage the site.

Turning schedule for immobility

Immobile residents are repositioned at least every two hours during the day and as ordered at night to prevent pressure injuries and skin breakdown.

Intake and output recording

Record all fluids taken by mouth, feeding tube, or IV and all urine, vomit, and drainage in milliliters; report urine output below 30 mL per hour.

Radial pulse counting rule

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

Passive range of motion limit

Move the joint slowly only until resistance or pain is felt, then stop; never force a joint past its limit and support the limb above and below.

Fecal impaction warning signs

Report no bowel movement for three or more days, abdominal swelling, or liquid stool leaking around a blockage; never give an enema without a nurse's order.

Maslow hierarchy order

Needs are met from the bottom up: oxygen, food, and water first, then safety, love and belonging, self-esteem, and finally self-actualization.

Kubler-Ross grief stages

The five stages of grief are denial, anger, bargaining, depression, and acceptance; residents may move back and forth between stages rather than in order.

Reality orientation technique

For a resident with mild confusion, calmly state the date, place, and person and use clocks, calendars, and good lighting to keep the person oriented.

Validation for dementia confusion

With dementia-related confusion, accept the resident's reality, respond to the feeling behind the words, and redirect rather than arguing about facts.

Resident right to refuse

A resident may refuse any care or food; do not force it, document the refusal, and tell the nurse so the refusal is reported.

Restraint release checks

Physical restraints require a doctor's order, must be the least restrictive device, and must be released with skin and circulation checks at least every 15 minutes.

Cause of new confusion

Sudden confusion often signals a physical problem such as a urinary tract infection, dehydration, low oxygen, constipation, or a new medication, so report it promptly.

Regression defense mechanism

Regression is returning to behavior from an earlier stage of life, such as an adult resident sucking a thumb or asking for a bottle when stressed.

CNA scope of practice

A nurse aide performs tasks delegated by a licensed nurse, such as bathing and vital signs, and does not assess, diagnose, or give medications unless specially certified.

Chain of command reporting

Report changes to the licensed nurse caring for the resident, who then reports to the charge nurse and physician; never contact the doctor directly unless policy allows.

Findings requiring immediate report

Chest pain, trouble breathing, a fall, unresponsiveness, new skin breakdown, or bleeding must be reported to the nurse at once, not saved for shift report.

Objective documentation rule

Write only what you see, hear, measure, or smell, using facts and exact quotes rather than opinions; sign, date, and time each entry in black ink.

Late entry charting

If an entry is written after the fact, add the current date and time and label it 'late entry' so the record stays accurate and honest.

HIPAA confidentiality rule

Resident health information may be shared only with the care team; never discuss residents in elevators, hallways, or with friends and family.

Mandatory abuse reporting

Report suspected abuse, neglect, or misappropriation of property immediately to the nurse and administrator; substantiated findings are placed on the state nurse aide registry.

Accepting gifts from residents

Do not accept money, gifts, or loans from residents or their families; explain the facility policy and report the offer to the supervisor.

Donning PPE order

Put on the gown first, then the mask, then goggles, and gloves last; gloves go over the gown cuffs to cover the wrists.

Removing PPE order

Remove gloves first, then goggles, then the gown, then the mask; perform hand hygiene immediately after the last item is removed.

Apical pulse location

Listen at the fifth intercostal space at the left midclavicular line with the diaphragm of the stethoscope and count for a full 60 seconds.

Blood pressure cuff placement

Place the cuff on the bare upper arm with the lower edge about one inch above the antecubital crease and the artery marker over the brachial artery.

Bed bath washing order

Wash the eyes first with inner-to-outer strokes, then the face, neck, arms, chest, abdomen, legs, back, and the perineal area last with fresh water.

Denture care steps

Line the sink or fill it with water to prevent breakage, hold the dentures with gauze, brush with denture cleanser, and store them in a labeled cup.

Catheter bag positioning

Keep the drainage bag below the level of the bladder and the tubing free of loops and kinks so urine flows by gravity and does not back up.

Feeding positioning rule

Raise the head of the bed to at least 90 degrees, or as high as the resident tolerates, and keep the resident upright for 30 minutes after eating.