Washington CNA flashcards

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

Bath water temperature

Use water about 105°F (40.5°C) for a bed bath unless the care plan states otherwise; test it with your inner wrist and keep the resident covered to prevent chilling.

Washing order for bathing

Wash from cleanest to dirtiest: face and neck first, then arms, chest, abdomen, legs, back, and perineum last, using a different part of the washcloth for each stroke.

Dressing the weak side

Dress a resident with one-sided weakness by putting the garment on the affected arm or leg first, and undress the affected side last, to protect the weak limb.

Gait belt placement

Place the gait belt snugly around the resident's waist over clothing so two fingers slide underneath; it is never placed over bare skin, ribs, or a fresh abdominal incision.

Ambulation assistance position

Stand on the resident's weaker side and slightly behind, holding the gait belt, watching the feet and the path ahead; the resident should never hold your neck or shoulder.

Oral care when unconscious

Turn the resident to the side, keep suction ready, use only a small amount of solution on a swab, and never place fingers or liquids in an unconscious person's mouth.

Feeding a resident with dysphagia

Sit the resident upright at 90 degrees or as high as tolerated, give small bites, allow time to chew and swallow, and check the mouth for pocketed food afterward.

Radial pulse counting

Count the radial pulse for 30 seconds and multiply by two; if the rhythm is irregular, count for a full minute and report the rate and irregularity to the nurse.

Counting respirations

Count respirations for 30 seconds and double the number, or a full minute if abnormal, by watching chest rise without telling the resident, because awareness changes the rate.

Blood pressure cuff placement

Place the cuff on the bare upper arm with its lower edge about 1 inch above the antecubital space, and inflate 30 mmHg above the point where the pulse disappears.

Apical-radial pulse deficit

Two staff count simultaneously for a full minute, one at the apex and one at the radial; the apical count minus the radial count is the deficit, which is reported to the nurse.

Hand hygiene duration

Scrub with soap and water for at least 20 seconds, or rub with alcohol-based sanitizer for at least 15 seconds, before and after every resident contact and after removing gloves.

Standard precautions

These apply to every resident regardless of diagnosis: wear gloves for blood, body fluids, mucous membranes, or broken skin, and add gown, mask, and eyewear if splashing is likely.

Normal adult vital signs

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

Active range of motion

Exercises in which the resident moves each joint independently without help; the aide supervises, encourages full movement, and never forces a joint past the point of pain.

Passive range of motion

Exercises in which the aide moves the resident's joint through its range while the resident relaxes; support the limb above and below the joint and stop at resistance or pain.

Cane held on strong side

A resident with one weak leg holds the cane on the stronger side, moves the cane forward together with the weak leg, and then steps forward with the strong leg.

Contracture prevention

Prevent tightening of muscles and joints by supporting the body in alignment, performing range-of-motion exercises as ordered, and applying splints or positioning devices exactly as directed.

Bladder retraining schedule

Offer the toilet at set intervals such as every two hours, keep fluid intake adequate, praise success, and record incontinent episodes so the nurse can adjust the plan.

Walker step sequence

Move the walker forward a short distance, step the weak leg into it, then bring the strong leg forward; the resident must be able to bear weight and stand safely.

Reality orientation

For a resident with confusion, give calm, simple, repeated cues about the date, place, and your name, and use clocks, calendars, and labels to reduce disorientation.

Validation for dementia

Instead of correcting a resident who has dementia, acknowledge the feeling behind the statement, respond to the emotion, and gently redirect the resident to a safe activity.

Communicating through aphasia

Speak slowly in short sentences, ask yes-or-no questions, allow plenty of time to answer, and avoid finishing the resident's sentences unless the resident asks for help.

Resident rights

Every resident has the right to privacy, dignity, confidentiality, choice, personal belongings, visitors, and refusal of care; the aide protects these rights and reports violations.

Restraint monitoring requirements

Restraints need a provider order and the least restrictive device, with monitoring at least every 15 minutes; the device is released, the limb exercised, and circulation checked at least every 2 hours.

Behavior as communication

Agitation, hitting, or yelling often signals an unmet need such as pain, fear, hunger, or a full bladder; look for the cause and report it rather than arguing with the resident.

CNA scope of practice

The aide performs tasks delegated through the care plan, does not assess, teach, give medications, or perform sterile procedures, and reports changes rather than deciding care.

Chain of command

Report observations and problems to the charge nurse or licensed nurse responsible for the resident; an aide never accepts orders directly from a physician or other provider.

Objective charting

Document only what you saw, heard, measured, and did, using facts and direct quotes rather than opinions; chart promptly and never chart care that was not given.

Incident report rule

Complete a facility incident report for any accident or error and give it to the charge nurse, and do not record the existence of the incident report in the resident's medical record.

HIPAA confidentiality

Share resident information only with staff involved in that resident's care and only in private areas; never discuss residents in hallways, elevators, or with uninvolved family members.

Mandatory abuse reporting

Nursing assistants are mandated reporters; suspected physical, sexual, emotional, or financial abuse, neglect, or misappropriation of property must be reported immediately to the charge nurse and administrator.