North Dakota CNA flashcards

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

Normal adult pulse range

The normal resting adult pulse is 60 to 100 beats per minute. Report a rate below 60 or above 100, an irregular rhythm, or a change from the resident's usual baseline.

Normal adult respiratory rate

An adult normally breathes 12 to 20 times per minute at rest. Count for a full minute and note depth, rhythm, and whether the resident uses effort to breathe.

One ounce in milliliters

One fluid ounce equals 30 milliliters. Nurse aides use this conversion when recording intake and output so the nurse can accurately track fluid balance.

Oral temperature restrictions

Oral temperatures are not taken on residents who are confused, unresponsive, coughing, or recovering from mouth surgery, because of choking and biting risk. Use another route as directed.

Log rolling a resident

Log rolling keeps the head, spine, and hips aligned while turning a resident, usually after spinal surgery. Two aides work together with the resident's arms crossed over the chest.

Turning schedule for immobile residents

Reposition an immobile resident at least every two hours, alternating sides and back, to relieve pressure and prevent pressure injuries. Report any reddened area that does not fade.

Range of motion limits

Move each joint slowly until resistance is felt and never force past pain. Support the joint above and below and stop if the resident reports discomfort.

Perineal care wash direction

Wash the perineal area from front to back, using a clean portion of the cloth for each stroke, to keep bacteria from the rectum away from the urinary opening.

Bathing order clean to dirty

During a bath, wash the cleanest areas first, such as the face, arms, and trunk, and save the perineal area and buttocks for last, changing water as needed.

Feeding a stroke survivor

Seat the resident upright, offer small bites, and place food on the unaffected side of the mouth. Watch for swallowing problems and pocketing of food, and stop if choking occurs.

Fowler's position angles

Semi-Fowler's is a 30- to 45-degree head elevation, and high Fowler's is 60 to 90 degrees. It improves breathing and is used for eating and tube feedings.

Safe lifting mechanics

Keep feet shoulder-width apart, bend at the hips and knees, hold the resident close to your body, and never twist while lifting. Point your toes in the direction of movement.

Maslow's hierarchy order

From bottom to top the levels are physiological needs, safety, love and belonging, esteem, and self-actualization. Lower needs are met first, so hunger or pain overrides social needs.

Kubler-Ross grief stages

The five stages are denial, anger, bargaining, depression, and acceptance. They are not strictly sequential, and a dying resident may move back and forth among them.

Sundowning

Sundowning is worsening confusion and agitation in late afternoon or evening, common in dementia. Reduce noise and stimulation, keep routines calm, and report changes to the nurse.

Validation therapy

When a resident with dementia states something untrue, validation accepts the feeling behind the statement instead of arguing about the facts, which reduces distress and conflict.

Therapeutic communication opener

Open-ended questions invite the resident to describe feelings and cannot be answered with yes or no. Restating and reflecting what you hear shows that you are listening.

Signs of depression in elders

Watch for withdrawal, sad or flat mood, appetite loss, sleep changes, and loss of interest in grooming or activities. Report these observations to the nurse for evaluation.

Defense mechanism: regression

Regression is returning to behavior from an earlier stage of life, such as an ill adult sucking a thumb or wanting a stuffed animal, as a way to cope with stress.

Resident's right to privacy

Knock and announce yourself before entering, close doors and curtains during care, and never discuss a resident's condition where others can hear. This preserves dignity and confidentiality.

Responding to anger

Stay calm, do not argue or take the anger personally, keep your voice low, and give the resident space while staying safe. Report repeated or escalating anger to the nurse.

Cultural care basics

Ask about food preferences, prayer times, and rituals around illness and death, and record them on the care plan. Never assume a resident's beliefs based on appearance.

Chain of command for aides

The nursing assistant reports to the licensed nurse supervising care, usually an RN or LPN. Report changes and concerns promptly rather than waiting for a break or shift end.

Nursing assistant scope of practice

Aides provide basic care such as bathing, feeding, mobility, and vital signs. They do not administer medications, insert tubes, perform sterile procedures, or provide medical teaching.

OBRA 1987 requirements

The Omnibus Budget Reconciliation Act of 1987 set federal standards requiring nurse aide training and competency evaluation and established residents' rights in nursing homes.

Reporting suspected abuse

Report suspected physical, sexual, emotional, or financial abuse or neglect to the charge nurse immediately; facility policy then requires reporting to the state agency. Aides are mandated reporters.

Incident report rules

An incident report documents an unusual event for the facility's risk management. Record objective facts in the resident's chart, but never mention the incident report in progress notes.

Correcting a documentation error

Draw a single line through the error, write 'error' and your initials, then record the correct information. Never erase, scribble out, or use correction fluid on a medical record.

Objective versus subjective charting

Objective data are measurable facts you observe, such as 'urine output 200 mL.' Subjective data are the resident's own statements and should be quoted rather than assumed.

Delegation and right to refuse

The nurse delegates tasks the aide is trained and permitted to perform. An aide must decline a task outside their training or scope and report the refusal to the nurse.

Resident's right to refuse care

A competent resident may refuse any care, including bathing or medication. Aides accept the refusal, never force care, and report it to the nurse promptly.

Standard precautions

Treat all blood and body fluids as infectious. Wear gloves for contact with them, wash hands after removing gloves, and use a mask and goggles when splashing is likely.