South Dakota CNA cheat sheet

Normal adult resting respiratory rate is 12 to 20 breaths per minute; count for a full 60 seconds when the rhythm is irregular.

Normal adult resting pulse is 60 to 100 beats per minute; document rate, rhythm, and strength for every measurement.

Blood pressure categories: normal is below 120/80 mmHg; elevated is 120-129 over less than 80; stage 1 hypertension is 130-139 or 80-89 mmHg.

Normal oral temperature range is about 97.6 to 99.6 degrees Fahrenheit (36.5 to 37.5 Celsius).

An oxygen saturation below 90 percent on pulse oximetry is abnormal and is reported to the nurse with the resident's symptoms.

Intake and output conversion: 1 fluid ounce equals 30 milliliters; record all oral fluids, IV fluids, urine, emesis, and wound drainage.

Weigh a resident on the same scale, at the same time of day, with the same amount of clothing to make readings comparable.

During range-of-motion exercise, move each joint only to the point of resistance or pain and never force a joint.

Bath water is kept at 105 to 110 degrees Fahrenheit (about 40 to 43 Celsius) and is tested with a thermometer or the inner wrist before the resident enters.

In a bed bath, wash from cleanest to dirtiest: face and neck, then arms and chest, then legs, and the perineal area last.

For female perineal care, wipe from front to back, moving from the urethra toward the rectum, to reduce urinary tract infection risk.

For an uncircumcised male, retract the foreskin to clean the glans, then replace the foreskin over the glans after cleaning.

For an unresponsive resident, provide oral care with the head turned to the side and suction available; do not use water or toothpaste.

Do not cut the nails of a resident with diabetes or poor circulation; file them instead and report the need for trimming.

When dressing, put clothing on the weak or affected side first and remove it from that side last.

Reposition an immobile resident at least every 2 hours and keep skin clean and dry to help prevent pressure injuries.

Maslow's hierarchy is met in order: physiological needs, safety, love and belonging, esteem, then self-actualization.

The developmental task of older adulthood in Erikson's theory is integrity versus despair; life review and reminiscence support it.

Withdrawal, poor appetite, sleep changes, and hopelessness are signs of depression, not normal aging, and are reported to the nurse.

Offering choices about clothing, food, and activities supports autonomy and self-esteem.

Grief does not follow a fixed order; denial, anger, bargaining, depression, and acceptance may appear in any sequence.

When a resident is angry, stay calm, acknowledge the feeling, and avoid arguing; anger may signal pain, fear, or loss of control.

Changes in mood, appetite, or behavior are reported to the nurse because they may indicate pain, illness, or medication effects.

Introduce yourself by name and role at each contact and use the resident's preferred name.

Speak slowly with short sentences, and allow extra time for a response instead of answering for the resident.

For a resident with aphasia, use pictures, gestures, and simple questions, and never finish the resident's sentences.

For hearing loss, face the resident, get their attention, lower the pitch of your voice, and reduce background noise rather than shouting.

For vision loss, identify yourself on entry, describe sounds and actions, use clock-face directions, and keep items in consistent locations.

A qualified medical interpreter is used when the resident and staff do not share a language; family members are not a substitute.

Share resident information only with the care team and only as needed for care, consistent with HIPAA confidentiality rules.

Chart objectively: write what was observed and done, such as 'resident cried for five minutes,' not opinions like 'resident was sad.'

Alzheimer's disease is progressive; short-term memory is lost before long-term memory and established routines.

Validation therapy accepts the resident's reality instead of correcting a false belief, which reduces distress.

Redirect rather than argue during agitation: change the topic or activity and move the resident to a calmer setting.

Sundowning is increased confusion or agitation in late afternoon or evening; reduce stimulation and keep routines consistent.

For wandering, provide a safe environment, alert the nurse, and allow safe supervised walking; restraints are not used.

Use one-step directions, face the resident, and demonstrate the task rather than explaining it in detail.

A sudden change in cognition suggests delirium from infection, medication, or dehydration and is reported immediately.

Keep familiar objects, consistent caregivers, and a predictable daily routine to reduce confusion.

Federal OBRA law guarantees dignity, privacy, self-determination, and freedom from abuse and unnecessary restraints.

A resident may refuse any treatment or medication; accept and document the refusal and report it to the nurse without forcing care.

Knock, close doors and curtains, and keep resident information confidential to protect the right to privacy.

Residents may inspect and obtain copies of their own medical record within a reasonable time.

Residents may voice grievances without fear of retaliation; the facility must post and explain the grievance process.

Residents may choose their own physician, daily schedule, and activities and take part in care planning.

Restraints require a physician's order for a specific, time-limited reason, frequent monitoring, and periodic release; they are never used for staff convenience.

Transfer or discharge requires written notice with the reason, and chemical restraints require consent and monitoring.

Fire response is RACE: Rescue anyone in danger, Alarm, Contain the fire by closing doors, Extinguish or Evacuate as directed.

Fire extinguisher use is PASS: Pull the pin, Aim at the base of the fire, Squeeze the handle, Sweep from side to side.

Fall prevention includes a low bed, call light within reach, non-skid footwear, and clear pathways.

Never leave a resident unattended in a bathtub, shower, or on a toilet; stay within arm's reach.

Side rails or other devices used to restrict movement are restraints and require an order and monitoring.

Tag broken equipment out of service and report unsafe conditions immediately.

Use a gait belt for transfers, keep the resident close, and pivot with your feet rather than twisting your back.

Store cleaning chemicals locked and never in food or drink containers to prevent poisoning.

Hand hygiene is the single most important way to prevent infection; use soap and water or an alcohol-based rub.

Wash with soap and water for at least 20 seconds, and always use soap and water when hands are visibly soiled or after caring for a resident with C. difficile.

Standard precautions apply to every resident regardless of diagnosis; select gloves, gown, mask, and eye protection based on the task.

PPE order when putting on: gown, mask, goggles, then gloves; when removing: gloves, goggles, gown, then mask, with hand hygiene between steps.

Gloves do not replace hand hygiene; clean hands before donning and after removing gloves.

Droplet precautions require a private room and a mask for staff and visitors; the door may remain open.

Airborne precautions require a negative-pressure room with the door closed and an N95 respirator for tuberculosis, measles, and chickenpox.

Do not recap, bend, or break needles; drop them immediately into a puncture-resistant sharps container near the point of use.