Pennsylvania CNA cheat sheet

CNA scope: provides direct resident care under licensed-nurse supervision; does not perform assessment, diagnosis, treatment planning, or medication administration unless specifically authorized by state law and facility policy.

Chain of command: report resident changes, errors, injuries, and unsafe conditions to the licensed nurse promptly; follow facility escalation policy if the nurse is unavailable.

Resident rights include privacy, dignity, choice, refusal of care, access to personal belongings, communication, grievance filing, and freedom from abuse or neglect.

Mandatory reporting: suspected abuse, neglect, mistreatment, or misappropriation must be reported immediately to the supervisor and required state agency; the aide does not investigate.

Confidentiality: discuss resident information only with the care team for care purposes; do not share it with family, friends, or visitors without authorization.

Documentation rule: record objective, factual, timely information in the resident record; document care after it is provided and correct errors according to facility policy.

Workplace injury/exposure: wash the area, report immediately, and follow facility post-exposure protocol; needlestick injuries require prompt evaluation.

Professional boundaries: do not accept money or gifts, do not perform tasks outside training, and do not discuss resident information in public areas.

Fall prevention bundle: bed in low position, brakes locked, call light within reach, non-skid footwear, clear path, adequate lighting, and needed items within reach.

Restraint use requires a licensed provider order, least restrictive device, and frequent monitoring; check circulation and skin at least every 15 minutes and release/reposition at least every 2 hours per order/policy.

Fire response: RACE = Rescue persons in danger, Alarm, Contain fire/smoke, Extinguish or Evacuate; PASS = Pull, Aim, Squeeze, Sweep for extinguisher.

Body mechanics: keep feet shoulder-width apart, bend at knees and hips, hold load close, avoid twisting, and get help for heavy or unsteady loads.

Standard precautions apply to all residents: perform hand hygiene before and after contact, wear gloves for body fluids, and use gown/mask/eye protection when splashing is likely.

Oxygen safety: post no-smoking signs, keep flames and sparks away, avoid petroleum-based products on the face, and secure tubing to prevent tripping.

Seizure safety: protect the head, move dangerous objects away, do not restrain or place anything in the mouth, time the seizure, and turn the resident to the side after it ends.

Incident reports: complete factual documentation of what happened and what was observed; do not blame, speculate, or alter the medical record in place of an incident report.

Positioning schedule: reposition at least every 2 hours, align the body, support limbs, and relieve pressure over bony prominences; more frequent turning may be ordered.

Range of motion: support the joint above and below, move slowly to the point of resistance, stop if pain or resistance increases, and never force a joint.

Ambulation assistance: use a gait belt, stand on the resident's weaker side, keep the resident upright, and stop for dizziness, shortness of breath, or unsteady gait.

Pressure injury prevention: inspect skin at each turn, keep skin clean and dry, avoid massage over reddened areas, use pressure-relieving devices, and report nonblanching redness.

Hydration/nutrition: offer fluids unless restricted, record intake, observe swallowing, and report coughing, choking, pocketing, or a wet/gurgling voice after swallowing.

Bowel/bladder function: provide scheduled toileting and privacy, encourage normal positioning and activity, and report constipation, diarrhea, incontinence, or burning.

Sleep promotion: reduce noise and light, cluster care, maintain bedtime routines, and report new confusion or daytime sleepiness.

Independence promotion: encourage self-care within the care plan, provide adaptive devices, allow extra time, and assist only with tasks the resident cannot complete safely.

Hand hygiene is the primary infection-control measure; use soap and water when hands are visibly soiled or after C. difficile exposure, and alcohol-based rub otherwise.

Oral care: brush teeth and gums at least twice daily, clean dentures over a basin or towel, rinse dentures before insertion, and provide mouth care for unconscious residents per policy.

Perineal care: wash front to back, use a clean washcloth for each stroke, rinse and dry thoroughly, and report unusual odor, discharge, or skin breakdown.

Vital signs: oral temperature about 98.6°F, adult pulse 60-100/min, respirations 12-20/min, and blood pressure often near 120/80 mmHg; report values outside ordered parameters.

Intake/output: 1 ounce = 30 mL, 1 cup = 240 mL, and 1 mL = 1 cc; record all fluids taken and urine/vomit/drainage output as ordered.

Specimen collection: use clean technique for urine or stool specimens, label the container at the bedside, transport promptly, and document collection time.

Occupied bed making: ensure privacy, lock bed wheels, raise bed to working height, avoid pulling the resident, and place soiled linens in the proper container.

Dressing changes: observe drainage amount/color/odor, keep the dressing dry, do not remove a provider-ordered dressing unless instructed, and report increasing pain or redness.

Hypoglycemia signs include shakiness, sweating, hunger, confusion, and irritability; report immediately and follow facility protocol for glucose monitoring or treatment.

Stroke recognition uses FAST: Face drooping, Arm weakness, Speech difficulty, Time to call emergency services; do not give food or drink.

COPD care: position upright or tripod, encourage pursed-lip breathing as taught, conserve energy, and give oxygen only at the ordered flow rate.

Dementia care: maintain routines, use short simple sentences, redirect instead of arguing, and report sudden changes in behavior or function.

Heart failure monitoring: report rapid weight gain, worsening edema, shortness of breath, or new cough; weigh at the same time with similar clothing as ordered.

Post-operative care: encourage coughing/deep breathing and splinting, early ambulation as ordered, and report fever, wound drainage, or calf pain.

Terminal care: provide comfort measures, mouth care, repositioning, and emotional support; report pain or breathing changes to the nurse.

Infection/sepsis signs: fever, chills, rapid pulse, confusion, low blood pressure, or foul drainage require prompt nurse notification.