Ohio CNA (formerly STNA) cheat sheet

Nurse aides perform delegated ADLs and basic nursing tasks under a licensed nurse's supervision; assessment, teaching, and sterile procedures are outside the aide's scope.

OBRA 1987 requires nurse aide training and competency evaluation and established the nursing home Residents' Bill of Rights.

Residents' rights include dignity, privacy, choice, freedom from abuse and neglect, and access to their own records.

Suspected abuse, neglect, or exploitation must be reported immediately to the charge nurse and per state mandated-reporting rules.

Aides may not accept gifts, tips, or money from residents or families and must report any offers.

A resident may refuse care or treatment; the aide documents the refusal and informs the nurse rather than forcing care.

HIPAA limits sharing resident information to care-team members with a need to know.

Restraints require a physician order, the least restrictive device, and release with repositioning at least every 2 hours.

Speak face-to-face at eye level, use the resident's preferred name, and reduce background noise.

For hearing loss, lower voice pitch and speak clearly; shouting raises pitch and worsens understanding.

For aphasia, allow extra time, use yes/no questions and pictures, and avoid finishing the resident's sentences.

For vision loss, identify yourself, announce before touching, and use the clock-face method to describe food placement.

Report objective findings, such as 'skin red at the sacrum,' rather than opinions or guesses.

Therapeutic techniques include open-ended questions, restating, reflecting, silence, and clarifying.

Avoid 'why' questions, false reassurance, and medical jargon with confused or anxious residents.

Answer call lights promptly and keep the call device within reach; report requests outside aide scope to the nurse.

Fire response uses RACE: Rescue, Alarm, Contain (close doors), Extinguish or Evacuate.

Fire extinguisher use is PASS: Pull pin, Aim at base, Squeeze handle, Sweep.

Fall prevention: bed in low position, wheels locked, call light in reach, non-skid footwear, and a clear path.

Adult CPR ratio is 30 compressions to 2 breaths at 100-120 compressions per minute, depth about 2 inches.

During a seizure, protect the head, do not restrain, place nothing in the mouth, time it, and turn the resident on the side afterward.

Never leave a resident alone in a bathtub, on a toilet, or with hot liquids.

Know the facility's emergency codes, evacuation routes, and how to call for help before an emergency occurs.

Report all incidents and falls, even when the resident appears uninjured.

Perform hand hygiene before and after every resident contact and after removing gloves.

Soap-and-water handwashing lasts at least 20 seconds; alcohol-based rub at least 15 seconds.

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

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

Removing PPE: gloves first, then goggles, gown, and mask last, with hand hygiene afterward.

Contact precautions require gown and gloves; droplet requires a mask; airborne requires an N95 and negative-pressure room.

Gloves are changed between tasks and between residents and never replace hand hygiene.

Bag soiled linen at the point of use, never shake it, and never place it on the floor.

Test bath water at 100-105 degrees Fahrenheit (37-40 degrees Celsius) before the resident enters.

Wash from clean to dirty: face and eyes first, perineum last; wipe eyes from inner to outer corner.

Perform perineal care front to back to reduce urinary tract infection risk.

Provide privacy by closing the door or curtain and exposing only the area being washed.

Dress the weak or affected side first, then the strong side; undress the strong side first.

Inspect bony prominences for redness that does not blanch and report it to the nurse.

Remove dentures and clean them; store them in a labeled container in water when not in the mouth.

Do not cut the nails of a resident with diabetes or poor circulation; report to the nurse.

Use an electric razor for shaving; never use a straight razor on a resident.

Normal adult ranges: oral temperature 97.6-99.6 degrees Fahrenheit, pulse 60-100 beats per minute, respirations 12-20 per minute.

Normal adult blood pressure is below 120/80 mm Hg; SpO2 is typically 95% or higher.

Count a regular pulse for 30 seconds and multiply by two; count an irregular pulse for a full 60 seconds.

Count respirations for 30 or 60 seconds without telling the resident, since awareness alters breathing.

Place the BP cuff one inch above the antecubital space; avoid an arm with an IV, dialysis fistula, or mastectomy.

Wait 15 minutes after hot or cold drinks or smoking before taking an oral temperature.

Rectal temperatures are avoided with diarrhea or rectal surgery; axillary readings are least accurate.

Ask the resident to rate pain on a 0-10 scale and observe facial expressions and guarding.

Report any vital sign outside the normal range to the licensed nurse promptly.

Encourage fluids every 1-2 hours unless the resident has a fluid restriction order.

For dysphagia, position upright at 90 degrees, offer small bites, and check for food pocketing.

Follow the ordered liquid consistency; never thicken or thin liquids without an order.

NPO means nothing by mouth; provide oral care and report thirst or food requests to the nurse.

Signs of aspiration include coughing, choking, a wet voice, and fever.

Signs of dehydration include dry mouth, dark urine, decreased output, and new confusion.

Record the percentage of each meal eaten and report intake below 50% or a poor appetite.

Respect cultural, religious, and personal food preferences within the prescribed diet.

Normal adult urine output is at least 30 mL per hour; report lower output or dark, cloudy, or bloody urine.

Keep the catheter bag below bladder level, the tubing unkinked, and never pull on the catheter.

Clean the perineum front to back after toileting and when changing incontinence briefs.

Change wet or soiled briefs promptly to prevent skin breakdown and infection.

Warm a bedpan before use, provide privacy, and stay with the resident if balance is poor.

Report no bowel movement for three days, abdominal pain, or black, tarry stools.

Offer a toileting schedule and adequate fluids to reduce incontinence episodes.

Document bowel movements and urine output accurately on the intake/output record.

Restorative care encourages residents to perform their own ADLs and use ordered devices.

Never do for a resident what the resident can safely do alone.

Range of motion may be active, active-assistive, or passive; move slowly and stop if pain occurs.

Check skin before and after applying a splint or brace and follow the wearing schedule.

Praise effort and progress to build confidence and maintain function.

Report any decline in the resident's ability to perform ADLs to the nurse or therapist.

Follow the care plan's restorative goals consistently across shifts.

Use a wide base of support, bend the knees, keep the load close, and avoid twisting.

Raise the bed to working height for care and lower it before leaving the resident.

Apply a gait belt for ambulation and stand on the resident's weak side.

With a walker, the resident moves the walker first, then the weak leg, then the strong leg.

A cane is held on the strong side to widen support.

Log-roll residents with spinal precautions to keep the spine aligned.

Reposition immobile residents at least every 2 hours and use a 30-degree lateral position.

Lock bed and wheelchair wheels before any transfer, and use a mechanical lift when ordered.

Dementia care uses short, simple sentences, one step at a time, and a consistent routine.

Do not argue with delusions or hallucinations; acknowledge the feeling and redirect.

Sundowning is increased confusion in late afternoon or evening; reduce noise and stimulation.

Behavior is communication; look for pain, hunger, toileting, or fear as triggers.

Report signs of depression such as withdrawal, poor appetite, or sleep changes.

For suicidal statements, stay with the resident and notify the nurse immediately.

Avoid baby talk and maintain adult dignity in all interactions.