CHHA cheat sheet

Bath or shower water must not exceed 105°F (40.5°C); test the temperature on your inner wrist before the client enters.

Dress the affected or weaker side first and undress the unaffected side first.

Turn and reposition an immobile client at least every 2 hours and inspect the skin over bony prominences for redness that does not blanch.

Perform range-of-motion exercises at least once daily, stopping at the point of resistance or pain; never force a joint.

Remove dentures at night, clean them, and store them in a labeled container covered with water.

Provide mouth care at least twice daily for clients who cannot do it themselves; brush natural teeth at least twice a day.

Offer the bedpan, urinal, or toilet every 2 hours, before and after meals, and at bedtime.

Do not trim the fingernails or toenails of a client with diabetes or poor circulation; report the need to the supervisor.

Use an electric razor for clients who take blood thinners or have a bleeding disorder.

Fire response follows RACE: Rescue, Alarm, Contain, Extinguish or Evacuate.

For a conscious choking adult, give abdominal thrusts; if the person becomes unresponsive, call 911 and begin CPR.

Cool a minor burn with running cool water for at least 20 minutes; never apply ice, butter, or ointments, and do not break blisters.

Seizure care: protect the head, move hazards away, do not restrain the client or put anything in the mouth, and turn the client onto the side afterward.

Stroke screening uses FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 911.

Control external bleeding with direct pressure through a clean cloth or gloved hand; add layers rather than removing soaked dressings.

Fall prevention: bed in the lowest position, wheels locked, call bell and personal items within reach, floor clear, night light on.

Oxygen safety: no smoking or open flame near the equipment, no petroleum-based products on the face or cannula, and cylinders secured upright.

In any emergency, call 911 first, give first aid within your training, then notify the supervisor and family per agency policy.

Hand hygiene is the single most effective way to prevent infection; wash with soap and water for at least 20 seconds.

Use an alcohol-based hand rub of at least 60% alcohol only when hands are not visibly soiled or contaminated with blood or body fluids.

Standard precautions apply to every client regardless of diagnosis or known infection status.

Donning PPE order: gown, mask or respirator, goggles or face shield, gloves.

Removing PPE order: gloves, goggles or face shield, gown, mask; hand hygiene follows immediately.

Never recap, bend, or break a used needle; place it directly into a puncture-resistant sharps container.

Hold soiled linen away from the body and never shake or sort it in the client's room.

The bloodborne pathogens of major concern are hepatitis B, hepatitis C, and HIV.

Clean and disinfect shared equipment and contaminated surfaces with an agency-approved product before use on another client.

Report any change in condition, whether physical, mental, or behavioral, to the supervisor promptly during the same shift.

Normal resting adult ranges: temperature 97.6–99.6°F, pulse 60–100 beats per minute, respirations 12–20 per minute, blood pressure near 120/80.

Document objectively: record what you saw, heard, measured, and did, plus the date and time; avoid judgments such as "uncooperative."

Correct a written error with a single line through it, the correction, your initials, and the date; never erase or use correction fluid.

Pain is whatever the client says it is; use the 0–10 scale or the Wong-Baker FACES scale for clients who cannot use numbers.

Report immediately: chest pain, severe shortness of breath, sudden weakness or slurred speech, a fall or injury, bleeding, fever above 101°F, or signs of abuse.

Signs of infection to report include redness, warmth, swelling, pus or drainage, fever, and increased pain.

Never document care before it is given, and never document care performed by another caregiver.

Open-ended questions gather more information than yes-or-no questions and are used when the client can elaborate.

For hearing loss: face the client, get their attention first, speak clearly at a normal volume, and reduce background noise; do not shout.

For aphasia: ask yes-or-no questions, allow extra time, and use gestures, pictures, or a communication board rather than finishing sentences.

With vision loss, identify yourself on entering, announce your purpose, and tell the client before you touch them.

Use a trained medical interpreter, not a family member or child, when language barriers affect consent or medical instructions.

For a client with dementia, use short sentences, one instruction at a time, and allow extra time for processing.

Nonverbal cues such as facial expression, tone, posture, and touch carry meaning; position yourself at the client's eye level.

Silence and active listening are communication tools; allow the client time to express feelings without interruption.

Offer fluids throughout the day, about 6 to 8 cups (1.5 to 2 L) for most adults, unless a fluid restriction is ordered.

Conversion rules: 1 ounce = 30 mL; 1 cup = 8 ounces = 240 mL.

Position a client with dysphagia upright at 90 degrees for meals and keep them upright for at least 30 minutes afterward.

Signs of aspiration include coughing, choking, a wet or gurgling voice, and a drop in oxygen saturation during meals.

Keep the refrigerator at 40°F or below and the freezer at 0°F or below; discard leftovers kept longer than 3 to 4 days.

Follow prescribed diets such as low-sodium, low-fat, diabetic, or mechanically altered, and report any deviation the client requests.

Offer small, frequent meals and encourage independence with adaptive utensils when appetite is poor.

Record the percentage of each meal eaten plus fluid intake and output; report intake below half a meal for two or more meals.

Client rights include dignity, privacy, personal choice, being informed, refusing treatment, and voicing grievances without retaliation.

A competent adult may refuse care; document the refusal, notify the supervisor, and never coerce or threaten.

HIPAA protects health information; never discuss a client in public, with neighbors, or on social media.

Report suspected abuse, neglect, or financial exploitation immediately to the supervisor or state hotline; aides are mandated reporters.

The long-term care ombudsman advocates for client rights and may be contacted by the client or family.

Advance directives include a living will and a durable power of attorney for health care; follow them as written and as agency policy directs.

Never accept gifts, money, or inclusion in a client's will; follow agency policy if a gift is offered.

Behavior is communication: check for an unmet need such as pain, hunger, toileting, fatigue, or overstimulation before responding to the behavior.

Do not argue with a delusion or hallucination; acknowledge the feeling and redirect to a safe topic or activity.

Use short sentences, one instruction at a time, and allow extra time for a response.

Sundowning is late-day agitation; reduce evening noise and stimulation and keep daily routines consistent.

For wandering: secure medications and keys, use an identification bracelet, and alert the supervisor; do not lock the client in alone.

A consistent daily routine with familiar objects and cues reduces agitation in dementia.

Answer repeated questions calmly each time rather than pointing out that the question was already answered.

Approach from the front at eye level and identify yourself; avoid sudden touch from behind.

Normal aging changes include thinner skin, reduced fat padding, lower thirst sensation, decreased renal function, and slower healing.

Presbyopia, cataracts, and high-frequency hearing loss are common age-related sensory changes.

Older adults have a blunted thirst response and lower total body water, so dehydration can occur without thirst.

Thermoregulation declines with age, raising the risk of hypothermia and heat stroke.

Erikson's final psychosocial stage is integrity versus despair, in which older adults review their life and seek meaning and acceptance.

Bone density and muscle mass decline with age, increasing the risk of falls and fractures.

Reduced saliva production and slower gastric motility contribute to dry mouth and constipation in older adults.

Range-of-motion and weight-bearing activity help preserve joint function and slow contractures and bone loss.