New York CNA cheat sheet

Hand hygiene is required before and after every resident contact, after glove removal, and after contact with body fluids; gloves never replace handwashing.

During a bed bath, wash the face and neck first and the perineal area last; change bath water when it cools or becomes soiled.

Bath water is checked with the inner wrist and kept near 105 degrees F (40.5 degrees C); never leave a resident alone in a tub or on a toilet.

Dentures are removed with gauze or a washcloth to prevent slipping, cleaned over a basin filled with water, and stored in a labeled cup covered with water.

Occupied bed making: keep the far side rail up, roll the resident toward you, never pull the resident across the bed, and lower the bed when finished.

Intake/output conversions: 1 ounce = 30 mL and 1 cup = 240 mL; report urine output under 30 mL per hour or under 500 mL in 24 hours.

Radial pulse: count for 30 seconds and multiply by 2, or count a full minute if irregular; normal adult range is 60 to 100 beats per minute.

Dress the weak or affected arm first and undress it last; remove clothing from the strong side first.

Keep the Foley drainage bag below bladder level and off the floor, and do not let tubing loop below the level of the bag.

Standard precautions apply to every resident regardless of diagnosis or test results.

PPE order on: gown, mask, goggles, gloves. Order off: gloves, goggles, gown, mask, then hand hygiene.

Alcohol-based sanitizer with 60 to 95 percent alcohol is used when hands are not visibly soiled; soap and water for at least 20 seconds is used when soiled or after C. difficile exposure.

Fire response uses RACE (Rescue, Alarm, Contain, Extinguish or Evacuate); extinguisher use uses PASS (Pull, Aim, Squeeze, Sweep).

During a seizure: protect the head, move hazards away, do not restrain or place anything in the mouth, time the seizure, and turn the resident to the side afterward.

After a fall, do not lift or move the resident; stay with them, check for injury, and call for the nurse immediately.

Restraints require a physician's order, the least restrictive device, and periodic release with circulation checks per policy; they are never used for convenience or punishment.

Suspected tuberculosis requires airborne precautions with an N95 respirator; influenza requires droplet precautions.

Soiled linen is rolled dirty side inward, held away from the uniform, and never shaken or placed on the floor.

Positioning angles: Semi-Fowler's is about 30 degrees, Fowler's is 45 to 60 degrees, and high Fowler's is 60 to 90 degrees; residents sit upright for meals.

Keep the resident upright for at least 30 minutes after eating to reduce aspiration risk.

Most adults need 1500 to 2000 mL of fluid daily unless restricted; report intake under 500 mL per shift or dark, concentrated urine.

Reposition immobile residents at least every 2 hours and inspect bony prominences for redness or skin breakdown.

Logrolling: keep head, neck, and spine aligned, place a pillow between the knees, and turn the resident as one unit.

Passive range of motion: support the joint, move to the point of resistance, never force, and stop if the resident reports pain.

Apply a gait belt snugly over clothing at the waist; ambulate on the resident's weaker side and follow the ordered weight-bearing status (NWB, PWB, FWB).

Use a draw sheet and at least two staff to move a resident up in bed; never pull on the arms or shoulders.

Protein from eggs, fish, poultry, beans, and dairy supports tissue healing; vitamin C aids wound healing; fiber plus fluids prevents constipation.

A resident may refuse any care, treatment, or food; report the refusal to the nurse, document it, and retry later without arguing.

Knock, wait for permission, state your name and purpose, and use the resident's preferred name before entering.

Share protected health information only with the care team; do not discuss residents in hallways, elevators, or dining areas.

For aphasia, use short sentences, yes/no questions, pictures or gestures, and allow extra time for a response.

For hearing impairment, face the resident, reduce background noise, speak clearly at normal volume, and never shout or cover your mouth.

For vision impairment, announce yourself before touching and describe food locations using the clock method.

A valid DNR order means do not start CPR if breathing and heartbeat stop; continue comfort care and notify the nurse.

Report promptly to the nurse: changes in condition, new or worsening pain, refusals, injuries, and any suspected abuse or neglect.

The ombudsman advocates for residents and investigates complaints; residents may file grievances without fear of retaliation.