CNA Test: Chapter 5 Notecards

What are 4 possible causes of delirium?

1. Infections 2. Disease 3. Fluid imbalances 4. Poor nutrition (Drugs and alcohol also)

1. Don't leave a confused resident alone 2. Stay calm, provide a quiet environment 3. Speak in a lower tone of voice clearly/slowly 4. Introduce yourself each time you see the resident 5. Remind the resident of their location, name, and the date (calendar can help) 6. Explain what you are going to do using simple instructions 7. Don't rush the resident 8. Talk to confused residents about plans for the day (keeping routine can help) 9. Encourage the use of eyeglasses and hearing aids, make sure they are clean/not damaged 10. Promote self care and independence 11. Report observations to the nurse

11 actions that an NA can take when helping care for a confused resident

Mr. Tennant sometimes gets depressed, especially in the evenings. Lisa knows that he loves classical music, so she starts playing it for him in the evenings a little before he usually starts feeling sad. He sorts through albums and places them in stacks. What type of therapy is being used?

Activity therapy

Mrs. Martin gets very upset every time she sees the president on television. She yells at the screen and tells everyone how poor a state our country is in. What AD behavior is this? How would an NA deal with it?

Agitation Try to remove triggers, keep routine constant, avoid frustrations, focus on a soothing/familiar activity, stay calm, use a low/soothing voice to speak to/reassure Mrs. Martin, place an arm around her shoulder or pat/stroke her arm

Blake, an NA, has been trying to give Mr. Collins, a resident with AD, a bath. Mr. Collins has become agitated and is asking Blake, "Who are you?" over and over again, although Blake has already identified himself twice. How would an NA respond?

Answer Mr. Collins' questions using the same words each time until he stops

Always bathe the resident at the same time every day, even if they are agitated

Bad idea

Do not attempt to groom the resident; people with Alzheimer's disease most likely do not care about their appearance

Bad idea

Do not encourage exercise, as this will make the resident more agitated

Bad idea

Do not encourage independence, as this can lead to aggressive behavior

Bad idea

If the resident is incontinent, do not give them fluids because it makes the problem worse

Bad idea

Serve new kinds of foods as often as possible to stimulate the resident

Bad idea

If a resident is frightened or anxious, the NA should

Check their body language so they do not appear tense or hurried

Mr. Montoya tells his NA that his wife has just called him on the phone. She is coming to pick him up, and they are going to dinner at the place they went on their first date. The NA knows that his wife has been dead for several years, and their favorite restaurant has long since closed down. What AD behavior is this? How would an NA deal with it?

Delusions Ignore harmless delusions, reassure Mr. Montoya who seems upset or worried, do not argue with Mr. Montoya who is imagining things, redirect Mr. Montoya to other activities/thoughts, be calm, and reassure Mr. Montoya that you are there to help

Ms. Desmond used to enjoy talking to people and reading, but lately she does not seem to enjoy anything. She sleeps most of the day and never talks to anyone unless she is asked to. What AD behavior is this? How would an NA deal with it?

Depression Report signs of depression to the nurse immediately, encourage independence/self care/activity, talk about moods/feelings if Ms. Desmond wishes, be a good listener, and encourage social interaction

Whenever Mr. Whitlock does not like what is being served for dinner, he bangs on the table with his fists and shouts about how much he hates his food. When people try to get him to stop, he only seems to grow louder. What AD behavior is this? How would an NA deal with it?

Disruptiveness Gain Mr. Whitlock's attention, be calm/friendly, gently direct Mr. Whitlock to a more private area, find out why the behavior is occurring (ask him about it), tell Mr. Whitlock of any changes in schedules/routines/environment in advance, involve Mr. Whitlock in developing routine activities/schedules, encourage Mr. Whitlock to join in independent activities that are safe, and focus on positive activities he may still be able to do (provides a diversion)

If a resident does not remember how to perform basic tasks, the NA should

Encourage the resident to do what they can

Diagnosing Alzheimer's disease is usually a simple procedure

False (difficult*)

Dementia is something that happens as every person gets older

False (doesn't happen*)

Men are more likely to have Alzheimer's disease than women

False (women*)

Break tasks down into simple steps, explaining 1 step at a time

Good idea

Check the skin regularly for signs of irritation

Good idea

Choose clothes that are simple to put on

Good idea

Follow Standard Precautions when caring for the resident

Good idea

Mark the bathroom with a sign or picture as a reminder of when to use it and where it is

Good idea

Put only 1 kind of food on the plate at a time

Good idea

Reward positive behavior with smiles and warm touches

Good idea

Schedule meals at the same time every day

Good idea

Serve finger foods if the resident tends to wander during meals

Good idea

Use nonslip mats, tub seats, and hand holds to ensure safety during bathing

Good idea

Use plain white dishes for serving food to residents with Alzheimer's disease

Good idea

Whenever a female resident comes into the television room, Mr. Radcliffe tells her that he loves her and starts removing his clothes. If she stays in the room long enough, he will ask her to take off her clothes too. What AD behavior is this? How would an NA deal with it?

Inappropriate sexual behavior Be professional when dealing with such behavior, do not overreact, be sensitive to the nature of the problem, try to distract Mr. Radcliffe, gently direct him to a private area, and tell the nurse

About 1 hour before dinner every night, Ms. Lordes starts walking up and down the hall as quickly as she can. She does not speak to or acknowledge anyone else while she is doing this. What AD behavior is this? How would an NA deal with it?

Pacing Remove causes when you can, give nutritious snacks, encourage an exercise routine, maintain a toileting schedule, let Ms. Lordes pace or wander in a safe/secure (locked) area, keep an eye on her, and suggest another activity such as going for a walk together

Mrs. Rowling loves the color red. She has a lot of red clothing that she enjoys wearing. Whenever she sees a piece of red clothing, even in another resident's room, she picks it up and takes it back to her room. What AD behavior is this? How would an NA deal with it?

Pillaging Label all personal belongings with the resident's name/room number, place a label/symbol/object on the resident's door, prepare the family so they are not upset when they find items that do not belong to their family member, ask the family to tell staff if they notice strange items in the room, and provide a rummage drawer

Mrs. Connor is in the first stage of Alzheimer's disease. Lately she has been having trouble remembering which month of the year it is. Lisa brings her a colorful calendar that has a different scene for each month to help her remember. What type of therapy is being used?

Reality orientation

Ms. Lee misses her husband, who has been dead for 10 years, very much. Lisa, an NA, who works with her, always asks about her life with her husband and what it was like. Ms. Lee seems to enjoy telling Lisa stories about what they did when they were young and how happy she was when they were together. What type of therapy is being used?

Reminiscence therapy

If a resident perseverates, this means they are

Repeating words, phrases, questions, or actions

When communicating with a resident with AD, the NA should

Speak slowly, using a lower tone of voice than normal

Mrs. Hays has been telling Blake a story about her niece. She is showing him a necklace that her niece had given her as a gift. She is having trouble remembering the word "necklace" and is getting upset. How would an NA respond?

Suggest the word if it doesn't upset Mrs. Hays

Mrs. Donne gets upset at about 9:00 every night. She repeatedly asks for snacks or drinks and refuses to go to bed. What AD behavior is this? How would an NA deal with it?

Sundowning Remove triggers, give snacks or encourage rest, avoid stressful situations during this time, limit activities/appointments/trips/visits, play soft music, set a bedtime routine (keep it), recognize when sundowning occurs, plan a calming activity just before, remove caffeine from diet, give a soothing back massage, distract Mrs. Donne with a simple/calm activity, and have a daily exercise routine

Mrs. Hays, a resident with AD, has awakened from her nap and does not recognize her room or anyone around her. How would an NA respond?

Tell Mrs. Hays where she is, who she is, and identify others in the room

Alzheimer's disease causes tangled nerve fibers and protein deposits to form in the brain, eventually causing dementia

True

Alzheimer's disease is a common cause of dementia

True

Dementia is the loss of mental abilities such as thinking, remembering, reasoning, and communicating

True

Each person with Alzheimer's disease will show different signs at different times

True

Encouraging residents with Alzheimer's disease to keep their minds and bodies active may help slow the disease

True

Most Alzheimer's disease victims will eventually need constant care

True

There is no cure for Alzheimer's disease

True

Blake is helping Mr. Collins get ready to go to dinner. Blake asks him to put his shoes on, but Mr. Collins does not understand what Blake wants him to do. How would an NA respond?

Use short words/sentences and hold up the shoes while saying "Lets put on your shoes."

Mr. Elking tells Lisa that he has a date with Rose, the pretty girl who lives across the street. He is going to take her dancing and out to a movie. Lisa knows that Rose lived in his neighborhood when he was a teenager and that he has not seen her for years. Lisa knows that Mr. Elking rarely gets out of bed. Instead of correcting him, Lisa asks him what kind of movie they are going to see and what he thinks he should wear. What type of therapy is being used?

Validation therapy

Mr. Noble is playing chess with a friend and becomes angry when he loses the game. He shoves his friend, and when the NA approaches them, he tells her he is going to hit her. What AD behavior is this? How would an NA deal with it?

Violent behavior Block blows but never hit back, step out of reach, call for help if needed, do not leave Mr. Noble alone, try to remove triggers, focus on a soothing/familiar activity, stay calm, use a low/soothing voice to speak to/reassure Mr. Noble, place an arm around his shoulder or pat/stroke his arm

Ms. Storey is walking around the facility asking everyone she meets what time it is. Even though she has been told several times, she still seems unsatisfied and keeps asking the question. What AD behavior is this? How would an NA deal with it?

Wandering and perseverating Remove causes when you can, give nutritious snacks, encourage an exercise routine, maintain a toileting schedule, let Ms. Storey wander in a safe/secure (locked) area, keep an eye on her, suggest another activity such as going for a walk together, answer questions each time they are asked, and use the same words each time