CHPNA flashcards
CHPNA · Build recall with a focused review session.
32 cards. Read the term and the definition here. The deck at the top of this page is optional.
- Hospice eligibility prognosis
- A physician certifies that the patient's prognosis is 6 months or less if the disease runs its expected course; certification is renewed at each benefit period.
- Interdisciplinary team (IDT)
- The hospice care team of physician, nurse, social worker, chaplain, therapies, and nursing assistant that meets at least every 14 days to review and update care plans.
- Nursing assistant scope
- Providing personal care, mobility, nutrition assistance, and observation within the plan of care, while reporting changes to the supervising nurse rather than making clinical decisions.
- Hospice vs palliative care
- Palliative care may begin at diagnosis alongside curative treatment; hospice requires the patient to forgo curative treatment for the terminal diagnosis.
- Four levels of hospice care
- Routine home care, continuous care, inpatient respite care, and general inpatient care; the level changes based on the patient's needs and setting.
- Open-ended question
- A question that invites a full response rather than a yes or no, such as asking the patient to describe how they are feeling today.
- Teach-back method
- Asking the patient or family to restate information in their own words to confirm understanding, especially when health literacy or language is a concern.
- Qualified medical interpreter
- A trained interpreter used for consent and care discussions instead of family members, particularly children, to ensure accuracy and confidentiality.
- Patient-defined family
- In patient and family-centered care, the patient decides who counts as family and who may be included in care discussions and decisions.
- Perineal care direction
- Cleanse from front to back to reduce the risk of introducing bacteria into the urinary tract and causing infection.
- Dressing rule for weak side
- Dress the affected or weak side first and undress it last, which makes dressing easier and safer for patients with one-sided weakness.
- Oral care frequency
- Provide oral care at least twice daily and after meals; remove, clean, and store dentures in a labeled container.
- Signs of aspiration
- Coughing, choking, or a wet gurgling voice during or after eating or drinking; stop feeding, reposition upright, and report to the nurse.
- Mealtime positioning
- Position the patient upright, about 90 degrees, during meals and for 30 minutes afterward to reduce the risk of aspiration.
- End-of-life anorexia
- A natural decline in appetite and intake near death; artificial nutrition and hydration may not improve comfort and are a family decision with the team.
- Repositioning interval
- Turn and reposition immobile patients at least every 2 hours to reduce the risk of pressure injury over bony prominences.
- Common pressure injury sites
- Bony prominences: the sacrum, heels, hips, shoulders, elbows, and back of the head are most vulnerable to pressure injury.
- Heel offloading
- Keeping the heels elevated off the mattress with pillows or devices to prevent pressure injuries on the heels.
- Pressure injury staging
- Stages 1 through 4 describe depth from non-blanchable redness to full-thickness tissue loss; unstageable and deep tissue injuries are classified separately.
- Behavioral pain scale
- A pain assessment tool using facial expression, body movement, and vocalization for patients who cannot self-report their pain.
- Expected opioid side effect
- Constipation is an expected opioid side effect and is managed preventively; sedation and respiratory depression are monitored and reported.
- Dyspnea comfort measures
- Upright positioning, a fan or cool air, and relaxation techniques can ease breathlessness; new or worsening dyspnea is reported to the nurse.
- Therapeutic presence
- Being fully attentive and available to the patient; silence and active listening can be supportive interventions in themselves.
- Spiritual referral
- Referring spiritual questions and rituals to the chaplain or the patient's own faith leader rather than imposing personal beliefs.
- Caregiver burden
- The physical and emotional strain on family caregivers; recognizing it and including caregivers in support is part of hospice care.
- Terminal secretions (death rattle)
- Pooling of secretions causing noisy breathing near death; it is generally not distressing to the patient, and repositioning may help.
- Signs of approaching death
- Decreased intake, increased sleep, cool mottled extremities, irregular breathing, and terminal secretions indicate the final hours are near.
- Post-mortem care
- After verifying death and notifying the nurse, position the body, close eyes and mouth, and honor religious, cultural, and family wishes.
- Hand hygiene with C. difficile
- Use soap and water rather than alcohol-based rub when hands are visibly soiled or after caring for a patient with C. difficile, because alcohol does not kill spores.
- RACE fire response
- Rescue anyone in danger, Alarm, Contain the fire, and Extinguish or Evacuate, following agency policy and emergency response.
- Objective documentation
- Recording what was observed and done rather than opinions or judgments, written at the time care is given and never pre-charted.
- Mandatory abuse reporting
- Suspected abuse, neglect, or exploitation must be reported immediately per state law and agency policy, even without proof.