North Carolina CNA key terms

Everyday self-care tasks a person performs to live independently, such as bathing, dressing, grooming, eating, toileting, and moving from place to place. Nurse aides often help residents with the ADLs they cannot complete alone.

The normal amount of movement a joint can make in each direction. Aides perform range-of-motion exercises by gently moving a resident's limbs through the motion they still have, which keeps joints flexible.

A permanent shortening of muscle or tendon that pulls a joint into a fixed, bent position. It develops when a limb stays still for long periods, so regular movement and careful positioning help prevent it.

Damage to skin and underlying tissue caused by unrelieved pressure, usually over bony areas such as the heels, hips, or tailbone. Repositioning, skin checks, and keeping skin clean and dry help prevent it.

A semi-sitting position in which the head of the bed is raised 45 to 60 degrees and the knees may be slightly bent. It helps with breathing, eating, and tube feedings.

Moving a resident as a unit by turning the whole body at once while keeping the spine aligned. It is used after back or neck surgery and requires at least two helpers to protect the spine.

Cleaning the genital and anal area, always wiping from front to back so germs are not carried toward the urinary opening. It is done during bathing and after toileting or incontinence to prevent infection and skin breakdown.

Cleaning hands with soap and water or an alcohol-based rub to remove germs. It is the single most effective way to prevent the spread of infection and is required before and after every resident contact.

Infection control practices used with every resident, every time, because any person may carry germs. They include hand hygiene, gloves, gowns, masks, safe handling of sharps, and proper cleaning of shared equipment.

Barrier items such as gloves, gowns, masks, and eye protection worn to keep germs from touching the aide's skin, clothing, or mucous membranes. PPE is removed carefully and discarded before leaving the room.

The six linked conditions needed for an infection to spread: a germ, a place to live, a way out, a way to travel, a way in, and a person who can be infected. Breaking any one link stops the spread.

Extra precautions used with residents known or suspected to have a contagious illness, based on how it spreads: contact, droplet, or airborne. They are used in addition to standard precautions and may include a private room and a sign on the door.

Any device or method that limits a person's freedom of movement or access to their own body, such as a vest, wrist strap, or a bed rail used as a barrier. Restraints require a doctor's order and are used only as a last resort.

A memory aid for fire response: Rescue anyone in immediate danger, sound the Alarm, Confine the fire by closing doors, and Extinguish small fires or Evacuate. Aides should know their facility's fire plan and nearest exits.

Quick inward and upward pushes just above the navel, used to clear a complete airway blockage in a conscious choking adult. The pushes force air up from the lungs to pop the object loose.

Measurements that show how well the body is working: temperature, pulse, respirations, blood pressure, and often oxygen saturation and pain. Changes are reported promptly to the nurse.

The heartbeat felt by pressing two fingers on the thumb side of the wrist. It is counted for 30 seconds and multiplied by two, or for a full minute when the rhythm feels irregular.

The force of blood against artery walls, recorded as two numbers: systolic, when the heart contracts, over diastolic, when the heart rests. It is measured with a cuff and reported right away if very high or very low.

One complete breath in and one breath out. Aides count breaths for 30 seconds and multiply by two, and they avoid telling the resident, because being watched can change the breathing rate.

A painless test using a clip on the fingertip that estimates how much oxygen the blood is carrying, shown as a percentage. A low reading is reported to the nurse.

A record of all fluids a resident drinks and receives and all fluids lost through urine, vomit, diarrhea, or drainage. Accurate measurement, usually in milliliters, helps the care team judge hydration.

A medical order meaning nothing by mouth, which includes no food, water, ice chips, or oral medications. The aide should remove water pitchers and gently remind the resident why they cannot eat or drink.

A sudden drop in blood pressure when a person stands up, causing dizziness, blurred vision, or fainting. Aides help prevent it by raising residents slowly and letting them sit with legs dangling first.

A planned, purposeful way of talking with a resident that supports physical and emotional well-being. It uses open questions, restating, and silence, and it always puts the resident's needs first.

Fully focusing on what a resident says, including tone and body language, without interrupting or planning a reply. Facing the person, nodding, and repeating key points show that you are paying attention.

Difficulty understanding or producing language caused by brain damage, often after a stroke. Thinking is usually intact, so aides should speak slowly, use simple words, and allow extra time for a response.

Understanding and sharing what another person is feeling without taking on their emotions yourself. Saying "that sounds hard" shows empathy, while false cheerfulness or "it could be worse" does not.

Messages sent without words, such as facial expressions, posture, tone of voice, touch, and eye contact. Aides should match their words and body language so the resident feels safe and respected.

The tasks and duties a nurse aide is legally allowed to perform under state law and facility policy. An aide must never do anything outside that scope and should ask the nurse when unsure.

The nurse's act of assigning a specific task to a nurse aide while keeping responsibility for the resident's overall care. The aide may accept or decline a task based on training and must report results back.

The line of authority in a facility, from the aide to the charge nurse, supervisor, and administrator. Following it means reporting concerns to the right person in the right order.

A state-maintained list of nurse aides who completed approved training and passed the competency exam. Being listed is required to work, and it records any findings of abuse, neglect, or misappropriation.

A federal law that protects the privacy and security of a person's health information. Aides must keep resident information confidential and share it only with those who need it to provide care.

The legally protected freedoms every nursing home resident has, such as privacy, dignity, choice, visitors, personal belongings, and freedom from abuse and restraint. Aides must honor these rights in everyday care.

A written document stating a person's wishes for medical care if they can no longer speak for themselves, such as a living will or health care power of attorney. Aides do not interpret it but report it to the nurse.

Failing to provide the care a resident needs, such as food, water, hygiene, safety, or medical attention, whether on purpose or by oversight. Aides must report suspected neglect immediately.

The legal duty of nurse aides and other caregivers to report suspected abuse, neglect, or exploitation of a resident to the nurse, administrator, or state agency promptly. Failing to report can bring penalties, and good-faith reporters are protected.

An independent advocate who investigates complaints made by or for nursing home residents and helps resolve problems with the facility. Residents may contact the ombudsman privately and without fear of retaliation.

A person's voluntary agreement to a treatment or procedure after being told about it, including the risks, benefits, and alternatives. Consent is obtained by the nurse or doctor, never by the aide.