Chapter 1: The Nursing Assistant in Long-Term Care
What are 10 examples of ADLs?
1) bathing 2) caring for skin, fingernails, and hair 3) eating 4) drinking 5) caring for the mouth and teeth 6) dressing 7) walking 8) transferring 9) eliminating 10) communicating
Which 4 tasks do nursing assistants NOT do?
1) give medications 2) insert or remove tubes 3) give tube feedings 4) change sterile dressings
What are the 10 qualities good nursing assistants have?
1) patient and understanding 2) honest and trustworthy 3) conscientious 4) enthusiastic 5) courteous and respectful 6) empathetic 7) dependable and responsible 8) humble 9) tolerant 10) unprejudiced
What 4 types of needs does holistic care entail?
1) physical 2) social 3) emotional 4) spiritual
What are the Five Rights of Delegation?
1. Right Task 2. Right Circumstance 3. Right Person 4. Right Direction/Communication 5. Right Supervision/Evaluation
How many hours of training does Oregon require for nursing assistants?
155 total
What is "acute care"?
24-hour skilled care given in hospitals and ambulatory surgical centers for short-term, immediate illnesses or injuries
What is "long-term care"?
24-hour skilled care provided in long-term care facilities for people with ongoing conditions
How many parts does Medicare have?
4 (A,B,C,D)
What federal agency runs Medicare and Medicaid?
The Centers for Medicare & Medicaid Services (CMS), within the United States Department of Health and Human Services
What are "allergies"?
a condition in which the body's immune response is triggered after exposure to a substance called an allergen; reactions such as sneezing, difficulty breathing, and skin issues may result
What is a "policy"?
a course of action to be followed every time a certain situation occurs
What is the National Center for Complementary and Integrative Health (NCCIH)?
a federal agency that conducts and supports scientific research about the safety and effectiveness of different therapies to improve health/health care
What is "Medicare"?
a federal health insurance program for people who are 65 or older, have certain disabilities or permanent kidney failure, or are ill and cannot work
What is "liability"?
a legal term that means a person can be held responsible for harming someone else
What is a physician assistant (PA)?
a licensed health professional who works under a doctor's supervision, performing medical duties such as diagnosing diseases/illnesses, prescribing treatments/medication; has a master's degree
What is an occupational therapist (OT or OTD)?
a licensed health professional who works with people who need help adapting to disabilities and performing their ADLs; develops treatment plans and can order assistive devices; has a master's or doctoral degree
What is a "registered nurse (RN)"?
a licensed nurse who assesses residents, creates care plans, monitors progress, provides skilled nursing care, administers treatments and medications, and supervises the care given by nursing assistants and other members of the care team
What is a "licensed practical nurse (LPN)" or "licensed vocational nurse (LVN)"?
a licensed nurse who provides skilled nursing care and gives treatments and medications
What is "Medicaid"?
a medical assistance program for people who have low incomes, as well as for people with disabilities
What is "primary nursing"?
a method of nursing care in which the registered nurse provides much of the daily care to residents
What is a "procedure"?
a method or way of doing something
What is a "team leader"?
a nurse in charge of a group of residents for one shift of duty
What is a "charge nurse"?
a nurse responsible for a team of healthcare workers
What is a "resident"?
a person living in a long-term care facility
What is "rehabilitation"?
a program of care given by specialists, such as physical therapists, to restore or improve function after an illness or injury
What is an advanced practice nurse (APRN)?
a registered nurse who has completed training at the postgraduate level (master's or doctoral); can make diagnoses and prescribe treatment
What is "person-centered care"?
a type of care that places the emphasis on the person needing care and his or her individuality and capabilities
What is a "first impression"?
a way of classifying or categorizing someone or something at the first meeting
What are the benefits of primary nursing?
allows for a closer relationship between the nurse and the residents; consistency and continuity of care abound
What does Part C of Medicare do?
allows provide health insurance companies to provide Medicare benefits
What is the "Joint Commission"?
an independent, not-for-profit organization that evaluates and accredits different types of healthcare facilities
What is "continuity of care"?
an ongoing coordination of a resident's care over time, during which the care team regularly exchanges information and works toward shared goals
Define "accountable."
answerable for one's actions
When in class, skills, and clinical, how should you introduce yourself?
as a STUDENT nursing assistant
Are the residents of long-term care facilities or assisted living facilities generally more independent?
assisted living facilities
How often must an organization undergo a comprehensive survey process to receive accreditation from the Joint Commission?
at least every three years
What does "empathetic" mean?
being able to identify with and understand the feelings of others
What are "adult day services"?
care for people who need some assistance or supervision during certain hours, but who do not live in the facility where care is given
What is "subacute care"?
care given in hospitals or in long-term care facilities for people who need less care for an acute (sudden onset, short-term) illness or injury but more than for a chronic (long-term) illness
What is "outpatient care"?
care given to people who have had treatments, procedures, or surgeries and need short-term skilled care
What does Part A of Medicare help pay for?
care in a hospital or skilled nursing facility or care from a home health agency or hospice
What is "holistic care"?
care that involves the whole person
What is "intergenerational care"?
caring for children and the elderly in the same setting
What are "activities of daily living (ADLs)"?
daily personal care tasks
What does "trustworthy" mean?
deserving the trust of others
What group of people stays the longest in long-term care?
developmentally disabled folks
What does Part B of Medicare help pay for?
doctor services and other medical services and equipment
What is one of a nursing assistant's most important duties?
documenting observations
What is Medicaid funded by?
federal and state governments
What is a "care team"?
group of people with different kinds of education and experience who provide resident care
What does "conscientious" mean?
guided by a sense of right and wrong; principled
What is "home health care"?
health care that is provided in a person's home
What is "hospice care"?
holistic, compassionate care for people who have approximately six months or less to live
When surveyors visit a facility, what do they study and observe?
how well the staff cares for residents, focusing on how residents' needs are being met; they interview residents and families and observe the staff's interactions with residents and the care given; they review resident charts and observe meals
What does "cite" mean?
in a long-term care facility, to find a problem through a survey
What are "surveys"?
inspections of long-term care facilities that are performed periodically by the state agency that licenses facilities, in order to help ensure that long-term care facilities are following regulations
Approximately how long do people in hospice care have left to live?
less than six months
What type of healthcare setting does the textbook focus on?
long-term care for elderly residents
What does "chronic" mean?
long-term or long-lasting
What is "skilled care"?
medically necessary care given by a skilled nurse or therapist
What does Part D of Medicare help pay for?
medications prescribed for treatment
What is "team nursing"?
method of nursing care in which a nurse acts as a leader of a group of people giving care
What is "functional nursing"?
method of nursing care that involves assigning specific tasks to each team member for a large number of residents
Are nursing assistants allowed to change sterile dressings?
no
Are nursing assistants allowed to give medications?
no
Are nursing assistants allowed to insert or remove tubes?
no
Can a nursing assistant use their personal phone in residents' rooms or in resident care areas?
no
Can nursing assistants accept tips or gifts from residents, their families, or other visitors?
no
Can nursing assistants wear artificial nails?
no
Do residents in assisted living facilities usually need skilled care?
no
Should nursing assistants wear or use scented items?
no
Are healthcare facilities required to participate in the Joint Commission's survey process?
no; it's voluntary
Who will usually be the NA's immediate supervisor?
nurse
What are other common terms for long-term care facilities?
nursing homes, skilled nursing facilities, rehabilitation centers, extended care facilities
What is the "sandwich generation"?
people responsible for the care of both their children and aging relatives
What is a "nursing assistant (NA)"?
person who performs assigned nursing tasks and gives personal care
What are some examples of chronic conditions?
physical disabilities, heart disease, recovery from stroke
What does "courteous" mean?
polite, kind, and considerate
What is "assisted living"?
residences for people who do not need 24-hour skilled care, but who do require some help with daily care
What are some members of the care team?
resident, resident's family, nurse, advanced practice nurse (APRN), physician or doctor (MD or DO), physician assistant (PA), physical therapist (PT or DPT), occupational therapist (OT or OTD), speech-language pathologist (SLP), registered dietician nutritionist (RDN), respiratory therapist (RT), activities director, medical social worker (MSW), nursing assistant (NA)
When a surveyor asks an NA a question she does not know the answer to, how should she respond?
she should respond honestly that she does not know, but that she will find out the information, and then find out shortly and tell the surveyor
What are "assistive devices"?
special equipment that helps a person who is ill or disabled perform activities of daily living
What is one drawback of functional nursing?
staff may not have enough time to accurately observe each resident, and changes in a resident's condition may be overlooked
What is a "diagnosis"?
the identification of disease or condition by its signs and symptoms and through test results
What is, most often, the main reason for admission into long-term care facilities?
the lack of ability to care for oneself and the lack of a support system
What is a "length of stay"?
the number of days a person stays in a healthcare facility
What is a "chain of command"?
the order of authority within a facility
What is "animal-assisted therapy (AAT)"?
the practice of bringing pets into a facility or home to provide stimulation and companionship
Who is the most important member of the care team?
the resident
Why might someone attend adult day services?
the sandwich generation is often unable to spend enough time at home, so if no one can care for an elderly relative at home or if a person needs a break from caregiving, adult day services is an option
What is "dementia"?
the serious loss of mental abilities, such as thinking, remembering, reasoning, and communicating
What is "professionalism"?
the use of proper standards of behavior at work and in work-related settings
What makes nursing assistants some of the most important team members?
they have the most direct contact with residents; if a resident's health changes from day to day, NAs will often be the first ones to notice this change
What is "delegation"?
transferring responsibility to a person for a specific task
How long does hospice care stay available?
until the patient dies
Who makes up the majority of residents in long-term care facilities--men or women?
women
Are nursing assistants allowed to measure intake and output?
yes
Are nursing assistants allowed to take blood pressure?
yes
