CNA Exam 2 (ch 4-6)

Perseveration

The repetition of words, phrases, questions, or actions Be patient and don't try to silence or stop the resident. Answer questions each time they're asked using the same words each time

Inspiration

brathing in

Specific Immunity

protects against a particular disease that is invading the body at a given time

Music Therapy

uses music to acomplish specific goals, form of sensory stimulation. Hearing famjiliar songs can cause a response in people with dementia who do not respond well or at all to other treatments

Hygiene

ways to keep the body clean and healthy

Sundowning

when a person gets restless and agitated in the late afternoon, evening, or night Avoid stressful situations during this time (don't schedule appointments during this time, limit visits) Set a bedtime routine and keep it

Contracture

when the muscle or tendon shortens, becomes inflexible, and freezes in position.

If resident wants to say something but cannot

-Encourage resident to point, gesture, or act it out -offer comfort with a smile if resident is upset

if resident forgets or shows memory loss

-Repeat yourself, using the same words. If a resident does not understand a word, try a different one. -Do not stop a resident who is preseverating (repeating words/phrases)

Urinary Tract Infection (UTI)

A bacterial infection that affects the urinary tract. UTIs are more common in women due to the difference in length of their urethras. In addition, the female urethra is located directly in front of the vagina and anus. It is closer to potential sources of bacteria. After elimination, wipe from front to back to prevent infection. Encourage plenty of fluids. Drinking water and other liquids help to prevent UTIs Taking showers, rather than baths, helps to prevent UTIs

Parkinson's Disease

A progressive and incurable disease. Causes stooped posture and a shuffling gait

Agitation

A trigger is a situation that leads to agitation Remove triggers, redirect attention

Communication Guidelines for a resident with AD

Approach from the front, do not startle, identify yourself, speak slowly and using a calm voice, repeat yourself using the same words each time, use signs or pictures or gestures, break complex tasks into smaller tasks

HIV and AIDS Guidelines

Aquired Immunodeficiency Syndrom (AIDS) is a disease caused by the human immunodeficiency virus (HIV). HIV attacks the body's immune system Residents wirh infections of the mouth may need food that is low in acid and neither cold nore hot. Spicy seaosnings should be removed. Warm water rinses help with painful mouth A person who has nausea or vomiting should eat small. frequent meals and should eat slowly. The person should avoid high-far and spicy foods and eat a soft, bland diet. Residents who have mild diarrhea may have smmall, frequent meals that are low in fat, fiber, and milk products. Numbness, tingling, and pain in the feet and legs are usually treated with medications. Wearing loose, soft slippers may be helpful

Gastroesophageal Reflux DIsease (GERD)

Backflow of contents from the stomach to the esophagus Heartburn and GERD are usually treated with medication. Serving the evening meal three to four hours before bedtime may help. The resident should not lie down until at least two to three hours after eating. Extra pillows should be used to keep the body more upright during sleep. Serving the largest meal of the day at lunchtime, serving several smaller meals throughout the dya, and reducing fats-food, fattty foods, and spicy foods may also help

Delusions

Believes things that are not true Reassure a resident who seems agitated or worried Do not argue with a resident who is imagining things Redirect the resident to other activities or thoughts

Urinary System

Composed of two kidneys, two ureters, one urinary bladder, a single urethra, and a meatus Normal changes of aging: The ability of kidneys to filter blood decreases, bladder mucle tone weakens, the bladder holds less urine, which causes more frequent urination, the bladder may not be empty completely, causing a greater risk of infection. NA should encourage fluids and offer frequent trips to the bathroom

Guidelines to helping residents perform ADLs

Develop a routine and stick to it Promote self-care

Guidelines for Confusion include:

Do not leave a confused patient alone Stay calm. Provide a quiet environment.

When a resident shows inappropriate social behavior

Don't take it personally, resident may only be reacting to frustration or other stress, stay calm and be reassuring, remove triggers

Guidelines for hip replacement

Dress the affected (weak) side first

If the resident has problems with elimination

Encourage fluids Mark bathroom with sign or picture Develop "bathroom times" based on resident's needs

If a resident has problems with nutrition

Encourage nutritious food choices Have meals at regular times each day Serve familiar, appetizing foods Keep the task of eating simple -->If a resident is restless, try smaller, more frequent meals -->Finger foods work best -->Cut up foods into bite size peices Do not serve steaming or very hot foods/drinks Use a simple place setting with single eating utensil. Remove other items from the table. Plain plates without patterns or colors work best Put only one item of food on the plate at a time

If a resident has problems with grooming/dressing

Encourage resident to pick out clothes to wear, simplify by giving a few options Make sure clothing is clean and appropriate Lay out clothes in order in which they are put on. Chose clothes that are simple to put on Break the task down into simple steps. Introduce one step at a time. Do not rush the resident.

Violent Behavior

Frustration or overstimulation may trigger violence Try to remove triggers Block blows but never hit back

Respiratory System

Includes the nose, mouth, trachea, lungds, bronchi, and bronchioles. The functions include bringing oxygen into the blood and and eliminating carbon dioxide produced as the body uses oxygen.

Possible causes of Delirium include:

Infections Disease Fluid Imbalance Poor Nutrition Drug/ Alcohol use

Endrocrine System

Made up of glands in different areas of the body Hormones

Circulatory System

Made up of the heart, blood vessels, and blood. The heart pumps blood vessels to the cells. The blood carries food, oxygen, and other substances cells need to function properly. Supplies food, oxygen, and hormones to cells.

Reproductive System

Made up of the reproductive organs. Allows for human beings to reproduce, or create new human life.

Normal chnages of aging in women

Menstruation ends, a decrease in estrogen that leads to loss of calcium, vaginal walls become drier and thinner

Muculoskeletal System

Muscles work together to move the body. The skeleton of the human body has 206 bones. Two bones meet at a joint. Muscles provide movement of body parts to maintain posture and produce heat.

Guidelines for CVA (stroke)

Never refer to the weaker sude as the "bad side". Do not talk about the "bad" leg or arm. Use the term weaker or involved to refer to the side with paralysis When helpting with transfers or wlaking, always use a transfer belt for safety. Stand on the weaker side. Lead with the stronger side. Dress the weaker side first. Undress the stronger side first

PWB

Partial weight-bearing

Immune System

Protects the body from disease-causing bacteria, viruses, and microorganisms. Two types of protection: specific immunity and nonspecific immunity

Chronic Obstructive Pulmonary Disease (COPD) Guidelines

Residents with COPD have trouble breathing, especially with getting air out of the lungs. Help residents sit uprights or lean forward. Offer pillow for support.

Hoarding and Rummaging

Rummaging- going through drawers, closets, or personal items that belong to oneself or others Hoarding- collecting and putting things away in a guarded area Not to be considered stealing, do not tell family their loved one is stealing from others Label personal items, put labels on the resident's door to help locate his room Provide a rummaging drawer (a drawer of items that are safe for the resident to take with them)

If a resident has problems with bathing

Schedule bathing when the resident is least agitated Be organized, have all supplies ready to go

When a resident shows inappropriate sexual behavior

Stay calm, do not overreact as this may reinforce the behavior, direct resident to a private area

Head & Spinal Cord Injury Guidelines

The effects of spinal cord injuries depend on the force of impact and location of the injury. The higher the injury, the greater the loss of function. Allow as much independence as possible with ADLs Assist residents to change positions at least every two hours to prevent pressure injuries.

Sense Organs of the Body

The eyes, ears, nose, tongue, and skin are the body's major sense organs. They are part of the nervous system because they recieve impulses from the environment Normal changes of aging: Sense of tatse, smell, and touch decrease

Integumentary Systsem

The skin is a sense organ. It feels heat, cold, pain, touch, and pressure. Normal changes of aging include: skin being thinner, drier, and more fragile; it becomes damaged more easily. Bed linens should be kep wrinkle-free. The NA should not cut the resident's toe nails. The NA should encourage fluid intake.

Gastrointestinal System

Three functions: digest, absorb, and eliminate Observe and Report constipation Fluids and nutitious, appealing meals should be encouraged. NAs should allow time to eat and make the melatime enjoyable.

Guidleines for knee replacement

To prevent blood clots, apply special stockings as ordered. Antiembolic stockings are a type of special stocking. They aid in circulation.

Most common type of diabetes

Type 2

Some causes of Confusion include:

UTI Dehydration Fever Infection

Myocardial Infarction (MI/ Heart Attack) Guidelines

When blood flow to the heart is blocked oxygen and nutrients fail to reach the cells in that area. When waste products are not removed the muscle cells die. After an MI, cardiac rehabilitation is ususally ordered, this can consist of the following: A diet low in saturated fats and sodium and rich in fruits, vegetables, and whole grains. A regular excercise program. Avoiding cold temperatures.

Guidelines for Hypertension

When blood pressure is consistently 130/80 or higher, a person is diagnosed as having hypertensions HTN, or high blood pressure. Can develop at any age. Signs and symptoms are not always obvious, especially in the early stages. Often it is only discovered when BP is measured by a helathcare provider. "The Silent Killer" Treated with medicine Can lead to serious problems such as CVA, heart attack, kidney disease, or blindness, Treatment to control is vital. The resident may take medicine that lowers BP. They may take diuretics: medications that reduce fluid in the body and increase the need to urinate.

Congestive Heart Failure (CHF) Guidelines

When one or both sides of the heart stop pumping blood properly, it is called CHF Assist the resident as needed with getting to the toilet or commode. Medications help remove excess fluids. This means more trips to the bathroom. Answer call lights promptly. Encourage residents to follow diet orders or restrictions. A low-sodium diet or restrictions may be ordered.

Angina (pectoris) Guidelines

When the heart muscle that is not getting enough oxygen causes chest pain, pressure, or discomfort. Pain is usually described as pressure or tightness. Residents who have angina may keep nitroglycerin on hand to use as symptoms arise. To maintain potency, the nitroglycerin bottle should be kept tightly closed. NAs are not allowed to give any medication unless they have had specific training

Lymph

a clear yellowish fluid that carries disease-fighting cells called lymphocytes

Osteoporosis

a condition in which bones lose density. This causes them to become porous and brittle. Brittle bones break easily.

Dementia

a general term that refers to a serious loss of mental abilities such as thinking, remembering, reasoning, and communicating Common causes: Alzheimer's Disease, Lewy Body Dementia, Parkinson's Disease, Huntington's Disease

Cancer

a general term used to describe a disease in which abdominal cells grow in an uncontrolled way. Can cause great pain, especially In the late stages. Watch for signs of pain. Report them to the nurse. Help with comfort measures, such as repositioning and providing conversation, music, or reading materials. Report pain if it feels uncontrolled. Give back rubs for comfort and to increase circulation. Reposition patients who are weak or immobile every two hours. Check the skin often to help prevent pressure injuries. Keep the skin dry and clean. Use lotion on dry or delicate skin. Do not apply lotion to areas receiving radiation therapy. Help residents brush their teeth regularly. You can help by using a soft-bristled toothbrush, rinsing with baking soda and water, or using a prescribed rinse. Do not use a commercial mouthwash

Tumor

a group of abnormally growing cells

Guidelines for Multiple Sclerosis (MS)

a progressive disease. it affects the central nervous system. Be patient with self-care and movement Give the residents time to communicate Prevent falls

Delirium

a state of severe confusion that occurs suddenly and is usually temporary

Signs and Symptoms of Delirium include:

agitation, anger, irritability disorientation problems with speech

Rheumatoid Arthritis is an

autoimmune disease

If a resident doesn't remember how to perform basic tasks

break each activity into simple steps

Expiration

breathing out

Malignant Tumor

cancerous

Hormones

chemical substances created by the body that control numerous body functions

Benign Tumor

considered noncancerous

Dyspnea

difficulty breathing

Reminiscence Therapy

encouraging residents to remember and talk about the past

Sleep Disturbances

exposure to light and dark can help establish restful sleep patterns

An autoimmune illness causes the body's

immune system to attck normal tissue in the body

Validation Therapy

letting residents believe they live in the past or in imaginary circumstances Validating means giving value or approving Make no attempt to reorient resident to actual circumstances

Alzheimer's Disease (AD)

most common cause of demintia in the elderly; causes tanngled nerve fibers and protein depositsto form in the brain The only sure way to determine AD at this time is by autopsy AD generally progresses in stages: in each stage the symptoms become worse Each person with AD will shpw different symptoms at different times Skills a person has used over a lifetime are usually kept longer

Atrophy

occurs when muscle wastes away, decreases in size, and becomes weak.

Diabetes

occurs when the pancreas produces too little insulin or does not properly use insulin Signs and symptoms include: excessive thirst, excessive hunger, and frequent urination Proper foot care is vitally important for people with diabetes. Give foot care as directed. Diabetes causes poor circulation so any injury would be hard to heal and could escalate quickly. The goals of diabetic foot care are to check for irritation or sores, to promote blood circulation, and to prevent infection. Encourage residents to wear comfortable, supportive, well-fitting shoes that do not hurt their feet. Shoes made of material that breathes help to prevent moisture buildup. Residents should not go barefoot. Socks should be made of material that absorbs sweat and is not too tight. NAs should not clip resident's toenails, only a doctor or nurse can do that

Pacing and Wandering

pacing: walking back and forth in the same area wandering: walking aimlessly Causes: hunger, disorientation, incontinence or need to use bathroom, too much daytime napping Remove causes when possible, redirect attention to something the resident enjoys Mark rooms with signs or pictures (to avoid residents going into rooms then shouldn't go in to)

Grooming

practices like caring for fingernails and hair

Nonspecific Immunity

protects the body from disease in general

If resident insists on doing something that is unsafe or not allowed

redirect activities toward something else

If resident repeatedly asks to go home

redirect or guide conversation and/ or the resident's activities to something he enjoys

Lymphatic System

removes excess fluid, and waste products from the body's tissues. It also helps the immune system fight infection

Hallucinations

sees, hears, smells, tastes, or feels things that are not there

The female urethra is ____ than the male urethrea. This is one of th reasons why...

shorter; the female bladder is more likely to become infected by bacteria

If a resident is frightened/ anxious

speak slowly in a low, calm voice speak in a quiet area without distractions always descirbe what you're going to do use simple words and short sentences check your body language making sure you're not tense or hurried

If resident has trouble finding words

suggest a word that shounds correct, but do not correct incorrect words as words become more difficult, smiling, toughing, and hugging can help show care and concern

Ostomy

surgically create an opening NAs should give careful skin care and empty and clean or replace the ostomy pouch whenever stool is eliminated

Cognition

the ability to think logically and clearly

Nervous System

the control and message center of the body. It controls and coordinates all body functions. The nervouse system also senses and interprests information from outside the human body. Includes: the brain, spinal cord, and nerves throughout the body.

Menopause

the end of menstration (a normal sign of aging)

Anterior (ventral)

the front of the body or body part

Urinary Incontinence

the inability to control the bladder, which leads to an involuntary loss of urine not a normal part of aging. NAs should always report incontinence Offer a bedpan, urinal, commod, or trip to the bathroom often. Follow elimination schedules on the care plan. Keep residents clean, dry, and free from odor Use absorbent pads under bed linen for residents who are incontinent Some residents wear disposable pads or briefs. Change wet briefs immediately. Do not refer to an incontinence brief as a "diaper"

Confusion

the inability to think clearly and logically

Cataract

the lens of the eye, which is normally clear, becomes cloudy.

Cognitive Impairment

the loss of ability to think logically and clearly

Homeostasis

the name for the condition in which all of the body's systems are balanced and working at their best

Glaucoma

the pressure in the eye increases.

Elopement

to leave the facility without permission, unsupervised, or unnoticed

Medial

toward the midline of the body

If the resident is verbally abusive or uses bad language

try not to take it personal try to ignore the language redirect attention to something else

If resident hallucinates

try to redirect or ignore it

If a resident has lost most verbal skills

use nonverbal skills People with AD will still understand touch, smiles, and laghter for much longer

If resident seems not to understand basic instructions

use signs, pictures, gestures, or written words. combining verbal and nonverbal communication is helpful

Activity Therapy

uses activities that the resident enjoys to prevent boredom and frustration Is useful in MOST stages of AD Activities promote mental exercise