Physical Care Skills
Core concepts
Physical care skills are the hands-on tasks that keep residents clean, safe, nourished, mobile, and comfortable. Hand hygiene and standard precautions frame every task: wash hands before and after resident contact, wear gloves for body fluids, and follow facility policy for PPE. Know body mechanics-wide base, bend knees, keep the load close, pivot rather than twist-and use a gait belt for transfers unless contraindicated. Positioning and alignment, range-of-motion exercises, and frequent repositioning (typically every two hours for at-risk residents) help prevent pressure injuries; never massage a reddened area. Vital signs, height and weight, intake and output, and specimen collection are observation tasks: measure accurately, report abnormal values, and never interpret or treat. Nutrition and hydration care includes feeding safely-sit the resident upright, offer small bites, watch for choking-and following thickened-liquid or aspiration precautions. Elimination care includes bedpan and urinal assistance, incontinence care, catheter care (cleaning, not inserting), and ostomy bag emptying per policy.
Traps
Questions often test scope: a CNA does not insert catheters, give medications, adjust oxygen, or perform sterile dressing changes. 'First action' items usually hinge on safety or hand hygiene. Watch for 'best response' items where reporting a change to the nurse outranks charting it later, and for hot or cold applications on residents with poor sensation or circulation.
Worked example
You count a regular radial pulse. Count respirations for 30 seconds and multiply by 2-but if the rhythm is irregular, count a full minute. Never announce that you are counting breathing; residents alter it.
Rule of thumb
If a value or finding is abnormal, recheck safely and report it; do not decide what it means.