Vermont CNA (LNA) flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Scope of LNA practice

A nurse aide performs delegated tasks such as bathing, feeding, ambulation, and vital signs under the direction of a licensed nurse; assessment, diagnosis, and medication administration are outside basic scope.

Chain of command reporting

The nurse aide reports observations and changes to the charge nurse first; the charge nurse reports to the RN or director of nursing, so concerns move up this chain rather than to other aides.

Delegation and right to refuse

A nurse may delegate tasks the aide is trained for; the aide should decline and ask for clarification when a task is outside training, unsafe, or unclear, and report the refusal to the nurse.

Communicating with aphasic resident

Speak slowly with short sentences, ask one question at a time, allow extra time to respond, and use gestures or picture boards; do not finish the resident's sentences or pretend to understand.

Hearing loss communication

Face the resident, get attention before speaking, lower voice pitch rather than shout, reduce background noise, and use written notes or gestures if needed; hearing aids should be clean and turned on.

Objective versus subjective reporting

Objective information is what you see, hear, smell, or measure, such as dark foul-smelling urine; subjective is what the resident says, such as feeling dizzy, and both are reported to the nurse.

Nonverbal communication

Facial expression, posture, tone of voice, and touch carry meaning; a resident's grimace, clenched fists, or withdrawal may signal pain or fear even when no words are spoken.

Standard precautions

Use gloves when touching blood, body fluids, mucous membranes, or non-intact skin, and perform hand hygiene before and after every resident contact; gloves do not replace handwashing.

RACE fire response

RACE stands for Rescue anyone in danger, Alarm by pulling the fire alarm or calling the code, Contain the fire by closing doors, and Extinguish or Evacuate as directed by facility policy.

Seizure first aid

Do not restrain the resident or place anything in the mouth; protect the head, move hazards away, time the seizure, and after it ends turn the resident on the side and report.

C. difficile hand hygiene

Alcohol-based hand rub does not kill C. difficile spores, so wash hands with soap and water after caring for a resident with a C. difficile infection, and wear gloves and gown.

Resident right to refuse

A competent resident may refuse care or treatment; the aide stops, informs the nurse, documents the refusal, and never forces or threatens the resident, because refusal is not automatically grounds for discipline.

Mandatory abuse reporting

Nurse aides must report suspected physical, emotional, or sexual abuse, neglect, and misappropriation of property immediately to the charge nurse and administrator, and Vermont law also requires reporting to the state.

Restraint use rules

Physical or chemical restraints require a licensed prescriber's order, must be the least restrictive option, and are never used for convenience or discipline; the resident is released, repositioned, and checked per order.

Bath water temperature

Use water at about 105 degrees Fahrenheit (about 40.6 degrees Celsius) for a bed bath, test it with a thermometer or on your inner wrist, and never leave the resident alone in the tub or shower.

Perineal care sequence

Wash the perineal area from front to back, using a separate part of the washcloth for each stroke, and wash the anal area last to prevent spreading bacteria toward the urethra.

Dressing weak side first

When dressing a resident with a weak side, put the garment on the affected arm or leg first and remove it from the unaffected side first; this makes dressing easier and safer.

Eye care direction

Clean the eye from the inner canthus near the nose toward the outer canthus, use a different area of the cloth for each eye, and never use the same cloth on both eyes.

Dysphagia feeding precautions

Sit the resident upright at 90 degrees, offer small bites, cue to chew and swallow, check for food pocketed in the cheek, and keep the resident upright for at least 30 minutes after eating.

Signs of aspiration

Coughing or choking during eating, a wet or gurgling voice, difficulty breathing, cyanosis, or a new fever may indicate aspiration; stop feeding and report to the nurse immediately.

Intake and output conversion

One ounce equals 30 milliliters, so a 4-ounce glass of juice is 120 mL; record all oral fluids, IV fluids, and urine output, and report urine output below 30 mL per hour.

Catheter bag position

Keep the drainage bag below the level of the bladder and off the floor, keep tubing free of kinks and loops, and empty the bag at least every 8 hours or when it is two-thirds full.

Bowel pattern reporting

Normal bowel patterns vary by resident, but report no bowel movement for three days, diarrhea, blood or mucus in stool, or complaints of abdominal pain or distension to the nurse.

Incontinence skin care

Change wet or soiled briefs promptly, clean the skin gently with mild soap and water, pat dry, and apply a barrier cream if ordered; report any reddened or broken skin areas.

Repositioning schedule

Turn and reposition an immobile resident at least every two hours, more often if the care plan says so, use pillows to support body alignment, and document each position change.

Gait belt transfer steps

Lock the bed or chair wheels, lower the bed, apply the gait belt snugly around the waist, stand on the resident's weaker side, and pivot on the count of three while keeping your back straight.

Mechanical lift safety

Two staff members operate a mechanical lift; check the sling and straps before use, attach them correctly, raise the resident only as high as needed, and never leave the resident suspended unattended.

Passive versus active ROM

In passive range of motion the aide moves the resident's joint through its range, while in active range of motion the resident performs the movement; stop if the resident reports pain and report it.

Supporting joints during ROM

Support the joint above and below the area being moved, move slowly to the point of resistance but not beyond pain, and never force a joint; report swelling, redness, or limited movement.

Normal adult vital sign ranges

Typical adult ranges are temperature 97.6 to 99.6 degrees Fahrenheit orally, pulse 60 to 100 beats per minute, respirations 12 to 20 per minute, and blood pressure below 120/80 mmHg.

Counting an irregular pulse

If the radial pulse is irregular, count it for a full minute rather than 30 seconds and multiply by two; also note the rhythm and report irregularity or rates below 60 or above 100.

Orthostatic blood pressure

Measure blood pressure and pulse with the resident lying, then sitting, then standing; a drop of 20 mmHg systolic or 10 mmHg diastolic with symptoms suggests orthostatic hypotension and is reported.