CNA Ch. 15-25

measuring and recording fluid intake

-all liquid person drinks, food primarily liquid (soup, ice cream, popsicle -usually measures in mL or cc (equal to each other) 1 oz = 30 mL/30 cc -observe and record how much fluid at each meal, between, add all together

musculoskeletal conditions

-arthritis -osteoporosis -hip fracture

how to release pain, assist mobility, and promote independence for person with arthritis

-ask person about pain and report to nurse (medication) -understand pain and help movement to. make less painful -If taking pain medication, plan care after taken and has less pain -assist with warm soaks or heat therapy -encourage warm clothing (keep joints warm) -encourage exercise (range of motion to keep joints flexible) don't do if joint if painful of swollen -encourage person to use assistive devices -help person with joint replacement surgery (avoid certain positions, assist with mobility)

urinary tract infections (UTI)

-bacteria in urinary tract system -In kidneys, uterus, bladder, urethra -easy for women, feces contaminate urinary tract (wipe front to back) -male, clean urethra outward and use clean part of washcloth every pass -catheter users at high risk -Incomplete emptying of bladder (enlarged prostate gland) pressure on urethra, hard to urinate -make sure person gets enough fluids, give enough time to empty bladder, try to position body upright when using bedpan

hip fracture

-break in bone on upper thigh, below hip joint -usually treated with surgery (repaired or replaced) -weeks to months of physical therapy -help person reposition according to care plan -encourage person to help (trapeze) -use abduction pillow, raised toilet, sit on straight backed chair) -encourage movement and restore mobility -know correct way to support person during transferring (physical therapy tips) -encourage person to practice skills learned in physical therapy and monitor technique and proper use of assistive device -give emotional support, listen to concerns, practice empathy, provide encouragement

normal feces

-brown -soft -formed -distinctive odor

temporary transfer

-care for acute medical condition -bed hold may be placed in nursing home to reserve spot for resident to return -pack clothing and belongings person will need -ask nurse for guidance of what should be sent with person -help person bathe, dress, and keep accessories to minimum -In nursing home, valuable items may be put in safe or secure area till return

care for people with incontinence

-change soiled clothing promptly, good perineal care, avoid embarrassment -dry skin and give good skincare (skin breakdown)

providing catheter care

-cleaning perineal area and tubing extending from body -at least once daily or when becomes soiled

stool specimens

-collected using commode hat or bedpan -give person notice (less frequent) -remind person not to urinate or put toilet paper in commode hat or bedpan

fats

-concentrated energy source - helps feeling satisfied, makes food taste better, helps better absorb some vitamins, keeps warm, protects internal organs -small amount needed each day (better healthy than unhealthy) -healthy fat: olive oil, canola oil, peanut oil -unhealthy fat: butter, margarine, lard, fat from red meat

reporting urination and defecation

-describe usual frequency each day and time in-between voiding -time person usually has bowel movement, and how frequent (usually 2-3 times a day)

osteoporosis

-disease resulting in loss of bone tissue (fragile and prone to breaking) -mostly in order women (25% older women over 65) -gradual loss of minerals (calcium) change in hormones (estrogen), diet low in calcium or vitamin D, lack of weight bearing exercise -In spine can cause fractures and changes in spinal bones (rounded upper back, painful posture) tire easily and fear or walking -takes long time for bone to heal

thickened liquids

-easier for person to swallow (stroke) can be thickened to different consistencies -nectar: thin, runny syrup -honey consistency: drizzles down slowly -pudding consistency: very thick, must be eaten with spoon

emptying urine drainage bag (when to report)

-emptied at end of each shift -whenever it becomes full -do not contaminate end of drainage tube -report if cloudy or foul smelling urine -change in Amt of urine -change in color of urine -pain or discomfort from catheter -blood, redness, swelling, discharge at urethral opening -urine not flowing freely through drainage tube and into bag -catheter has come out

familiarize person to new surroundings

-explain facility policies, schedules, visiting hours -show how call signal works and ask person to demonstrate understanding to you -demonstrate how to adjust the bed, raise and lower and over bed table -make sure person knows how to use other equipment (TV, phone) -If person wishes to go on tour, introduce to other staff and residents -help person get comfortable in room and give call signal -ask if person needs anything -wash hands and tell person you will return -when duties finished, report to nurse, include observations about physical condition and emotional status in report to nurse

factors influencing pain

-family and culture: pain without complaint is encouraged -previous experience of pain: previous experience of pain leads more toleration -emotional state: anxiety, worry, emotional upset difficult to handle pain -cognitive status: may not be able to find the words to say they are in pain, person may remember time they were in pain but they are not actually in pain

condom catheter

-for man incontinent of urine -condom-like device, tubing, drainage bag -leg bag strapped to thigh -bag must be emptied frequently -remove condom once daily to clean skin (apply new) -make sure skin is dry so adhesive will stick -unroll completely -check person frequently to make it is not on too tight -report to nurse if see swelling, color change (remove condom and report to nurse)

bowel or bladder training programs / Scheduled toileting programs

-for person with incontinence to train muscles to control elimination -promote urination and defecation at predictable times -follow schedule through the night -program may not work with person with confusion or dementia because they can not recognize the urge to go -based of assessment of elimination patterns -as CNA, gather data about elimination (might document weather person voids in toilet/bedpan/urinal

discharge

-formal release of person from healthcare setting

diarrhea

-frequent passage of watery, loose feces -foul smelling accompanied with cramping -Infection, food poisoning, medical condition, medication, treatment -usually passes on its own -sometimes given clear liquid diet -sometimes medication given -If not pass, may become dehydrated -understand discomfort -respond promptly for help to bathroom -give good perineal care and be gentle with skin (may be sore) -may need to use transmission based precautions (C diff) wear gown and gloves, wash hands with soap and water, use bleach to clean hard surfaces

as CNA, ensure fluids by:

-frequently offer liquid they like at the temperature they like -encourage the person to drink plenty fluids with each meal -frequently provide pitcher of clean fresh water, encourage person to drink every time enter room -make sure clean drinking glass or cup is within reach, refill glass if person can not do it (plastic straw or water bottle with screw on lid and straw -If person frequently refuses beverages, check with nurse and see if can offer fluid-rich foods instead (ice cream, popsicles, gelatin, fruit)

measuring urine output

-graduate (measuring from portable commode, bedpan, urinal) -commode (placed over toilet, markings on side measure) -catheter (empty bag into graduate)

how to make person and family feel comfortable during admission

-greet with smile and preferred name -get to know person as individual, ask abt. fam members and personal preferences -welcome information family provides, care techniques -Include person that in conversations that concern them -before leaving, ask if he person needs anything -tell person and family hoe to reach you if they need assistance, let person know you will be making frequent checks on them

constipation

-hard, dry feces that is hard to eliminate -feces processes too slowly and less water filled -can be influenced by immobility, inadequate food intake, not enough fiber, disruptions in normal bowel elimination pattern, changes in diet, aging, medications -uncomfortable and irritable -laxative may be prescribed or enema

proteins

-help body build tissue and muscle, good source of energy -meat, poultry, fish, beans, eggs, dairy

how to help person with osteoporosis

-help exercise comfortably -use transfer bely and use carefully -keep walking areas clear of tripping hazards -follow care measures precisely -be aware of visual range, put objects where person can see and ensure safety when walking, talk in sight of view) -take caution of respiratory difficulties, spine curvature not allow full expansion of lungs, report problems to nurse -report new pain, loss of function or swelling

assisting person to use toilet

-help person put on robe and slippers before going to bathroom -If staying with person in bathroom, keep hand on them and turn your back if possible -If leaving room, make sure call light and tp are within reach and reassure that you'll be nearby for help (check on person every 5 min) -when ready, put on gloves and assist with wiping -help person stand up and adjust clothing -let them wash their hands before leaving the bathroom

assisting with enema

-helps remove feces in bowel with fluid placed in rectum -know what type of enema was ordered and hoe many times the person is allowed to receive it -If person complains of pain, stop immediately and wit for it to go away (reassure them to take deep breaths and if pain not stop, tell nurse) -commercial prepared enema (pre-filled plastic bottles with tip to be inserted into anus -can be administered with enema bag and tubing (warm tap water and small amp of mild soap) -make sure at 105 degrees

tain tolerance

-highest level of discomfort person is willing to experience before relieving

discharge planning

-identifying ongoing care and needs of person and making arrangements for these to be met when person leaves facility -begins when person admitted and keeps going throughout stay -communicate information about person's needs to other healthcare team members or paperwork telling preferences, habits, vital signs, and medications

assisting with discharges

-if condition has improved and no longer needs care, needs better setting for their condition -follow discharge planning -help gather all personal belongings and put in suitcase -check against personal inventory list to ensure nothing us lost -provide comfort and reassurance -help transportation to exit, tell how much you enjoyed helping and wish person well -Introduce person to ambulance crew and help move into ambulance -double check paperwork and belongs are in vehicle with person -report nurse completion of discharge, verify they were safely transferred to vehicle and any other observations (tearful, daughter anxious) -strip bed, remove supplies and equipment, wash hands -report to nurse room is ready for terminal cleaning

promoting rest and sleep

-important for physical and emotional help -7-9 hours each night -quality as important as time -body restores self, without sleep, body is at risk of fatigue, weight gain, increased BP, increased risk of cardiovascular disease, infections, decreased healing -be observant of pain, report to nurse -be aware normal bed time and rise time, try to maintain routine -maintain bedtime routine (bath, read) -promote physical activity during the day -avoid too many naps -create restful environment (wrinkle free linens, good temperature, minimize noise, close curtains and blinds, if need to care during night, turn on as little light as possible)

incontinence

-inability to control release or urine or feces (temporary or permanent) -when permanent, leading cause of admission to long-term-care facility -factors that lead to incontinence: structural changes (decrease in muscle tone and elasticity, UTI), certain medications, confusion or dementia, arthritis, brain/spinal cord/ nerve damage, weakness of muscles

products for managing incontinence

-incontinence pads (absorbent pads inside underwear to absorb urine and pull away from skin) -Incontinence briefs (instead of pads, worn as underwear, keeps skin dry, used according to care plan, change promptly and give perineal care to prevent skin breakdown) -extended wear brief (absorb large amount of urine) -condom catheter

how to make a meal positive and pleasurable

-involve person in meal decisions, what and where -support rituals (giving thanks) -promote dignity and self-esteem -help person enjoy company of others -present meal attractively (like own home environment) -pleasant, clean, relaxing eating environment created for them -do not rush the person, let them take their time

arthritis

-joints become inflamed, swollen, stiff, painful -osteoarthritis: smooth tissue around bones becomes rough and wears away (friction on bones when person moves) remaining tissue swells

chronic pain (associated conditions)

-lasts more than 6 months -constant or intermittent -mild to severe -arthritis (osteoarthritis, rheumatoid arthritis) -osteoperosis (bones become weak and brittle, fractures are painful) -peripheral artery disease (blood blockage to legs, pain, skin ulcers, tissue death) -amputation (surgical removal of whole limb, phantom pain the originated from removed body part) -cancer (pain caused by disease or treatment, growing tumor, medical tests and treatment -gastroesophageal reflux disease (GERD): stomach acid to esophagus, irritates esophageal lining, burning sensation from stomach, chest, to throat

terminal cleaning

-let nurse know when you finished stripping the room and ready for disinfecting room and equipment for new person

when and how to report pain

-location of pain: specific as possible, may have to watch for behavioral cues -characteristics of pain: burning or tingling, dull or achy -Intensity of pain: level of pain, mild, moderate, severe; scale 1-10 (FLACC scale: fece, legs, activity, cry, consolability) (PAINAD: pain assessment in advanced dementia) -frequency of pain: constant, intermittent, occasional, seldom, daily

hw to help promote normal elimination

-maintain person's normal elimination pattern (change of routine can lead to constipation or incontinence) -encourage adequate fluid intake (regular urination and keep feces soft) -encourage exercisse and foods high in fiber (helps bowel movement and keep feces moist) -privide privacy -promote comfort (don't rush the person, make sure they are warm

preparing person for meal

-make sure comfortable, and allow bathroom time and hand washing before meal -provide mouth care (food tastes better, make sure dentures clean and in place) -help person with glasses or hearing aid -make comfortable, pleasant eating environment (make sure room is neat and free of odors, good lighting) -position person for eating, many go from bed --> wheelchair --> dining chair (help person with head up and hips at 90 degrees, if in chair, make sure feet flat on foot and elbows or forearms are allowed on table for support -If person wants to protect their clothes from spills, help with clothing protector (avoid calling it a bib to keep dignity)

looking after persons belongings

-may need to fill out personal belongings inventory sheet -when reporting, do not use labels that describe the price of the item (don't use gold, silver, say yellow metal with clear stone, if watch, write brand name on envelope) -encourage person to send valuables home or may arrange for them to be locked up in facility safe -give inventory sheet to nurse -In nursing home, label clothing -help person put belongings away and help decorate room with personal items brought

Helping person eat with vision disabilities

-may need to locate where foods are on table or plate (describe life clock face) -cut up anything that needs cutting -open containers -describe location of eating utensils -check on person to see if the overlooked food (provide assistance)

graduate

-measuring from portable commode, bedpan, urinal -pitcher-like measuring device

how to relieve pain

-medication -comfort measures -hot or cold application (check with nurse for temp and duration, check skin every 5 min, wait one hour before re-applying) -observe response to medication -distraction: take mind off pain -repositioning: increase comfort level (ensure good body alignment) -back rub: check with nurse to make sure allowed,

assisting with transfers

-needs change -request to transfer -any move might have emotional impact on person, talk about their feeling and reassure the person -help person pack belongings -after washing hands and greet, tell you are there to help with transfer -pack personal care equipment (wash basin, bed pan, personal belongings) -wash hands and let person say goodbye to roommate -If permitted, ask nurse for papers that must go with person receiving unit nurse if they received report of person's condition and if they are ready for transfer -move person and possessions into new room and report arrival to receiving nurse and other relevant information (she needs you to face her directly when speaking) -Introduce nurse ro patient or resident -may stay and assist new nurse assistant with tasks to help person get settled into new environment -talk to person, explain how you enjoyed helping them and wish them well for their future -after returning, report to nurse that transfer was complete -prepare room for arrival of another person (remove left equipment, remove dirty linens, wash hands) -If you are reviewing nurse assistant, act as if new admission

NPO status

-nil per os = nothing by mouth -not even water by mouth per specific period of time (usually several hours before procedure that involve anesthesia, aspiration may cause pneumonia during anesthesia) -provide frequent mouth care -be sensitive to person's discomfort -encourage visitors to enjoy food outside of room

reasons why person may not report pain, how to recognize it

-not wanting to be a bother -fearful of meaning of pain -not wanting to worry others -cultural, social pressure to be stoic and strong -concern about side effects of pain medications -fear of losing control -fear of developing dependency at addiction to pain medication -ask person if they are in pain -nonverbal expressions

pain medications, dependence and addiction

-opioids, narcotics block pain receptors in CNS -addiction has mental basis as well as physical, seek drug at all cost, ability to function is decreased without drug

signs and symptoms of UTI (when to report)

-pain or burning when urinating -frequent need to urinate -ability to pass small amount or urine while still feeling the need to go -cloudy, dark yellow, foul-smelling urine -mucous (cloudy) or blood in urine -fever -unusual Behavior. person with dementia (leaning to one side) -changes in mental status -report to nurse immediately -report when urine cloudy, unusual color, odor -urination more frequently, urgency to urinate -pain or difficulty urinating

normal urine

-pale to deep yellow -slight odor -clear -darker in morning with harsher smell

transfer

-person moved from one side of facility to other -ensure belongings are moved safely -may need to communicate care to people in other facility

caring for person with ostomy appliance

-person no longer able to pass feces through rectum or anus -opening in abdominal wall, stoma created -feces go through stoma to pouch -person with bladder removed has ostomy appliance for urine elimination -help change appliance and clean skin around stoma (kept clean ,dry)

Factors that can affect what and how person eats

-personal taste: preference -allergies and intolerances: unpleasant/life threatening reactions to certain food -culture and religion: influenced by social customs, culture, religious practices, viability of ingredients (what foods can be eaten and when) no red meat on Fridays, no meat and dairy on same plate (vegan, vegetarian) -Budget: make make choices depending on what they can afford -willingness/availability to cook: lack of time, interest, strength, sills needed to cook -appetite: medications, emotional factors, can make appetite increase or decrease (anorexia, can cause nausea, pain, medication side effects, depression, loss of sense of taste and smell)

admission

-persons formal entry into healthcare setting -find if person has special needs you need to prepare -gather equipment and supplies for admission and bring to person's room (water pitcher, emesis basin, wash basin, cup, bedpan, washcloth, towel, gown and toiletries) -obtain any forms for admission -open bed or surgical bed -be prepared to take vital signs and height and weight as required -escort person to their room -greet self and explain role to help person feel welcome and at ease -explain what is happening, what is going to happen so person knows what to expect -wash hands, check ID and Photo -remove pre-existing medical bands -Ask what the person likes to be called (refrain to call by first name unless they request) -Introduce person to roommates and ask about basic needs before admission process (bathroom, hungry, thirsty, rest) -report what you learn to nurse, important to add to care plan (time of wake up, time get out of bed, naps?, bath or shower, what time do you bathe, what activities do they enjoy, what can I help with in daily routines, food preference or diet)

pain threshold

-point at which person be comes aware of pain

measuring and recording vital signs, weight, and height

-preform in warm, unhurried manner and help person relax and feel better about healthcare setting

handling catheter tubing and urine drainage bag

-prevent tubing from pulling on urethra (secure tubing with tape or catheter strap on inner aspect of tip thigh; make loop of excess tubing and secure to bed linens; attach drainage bag to bed frame (not side rail), if in wheelchair, put on back of chair lower than persons bladder; when helping repositioning or transferring, unclip tubing secured to beds and move drainage bag before moving person) -maintain free flow of urine to drainage bag (make sure tubing is free of kinks and person lot lying or sitting on it) -lower risk of infection (keep drainage bag lower than bladder and tubing, do not disconnect tubing from drainage bag, keep them from touching the floor)

skin conditions

-rashes -wounds -pressure injuries

mineral and vitamins

-regulate body function and form tissue and cells -minerals: iron, calcium, potassium, sodium, iodine -vitamins: vitamins A, B, C, D, E, K -whole grains, fruit, vegetables, lean meat, dairy

When to report bowel problems

-report when feces loose or very dry -foul smelling or unusual color -changes in elimination pattern -episodes of incontinence (if unusual)

monitoring food intake

-required to estimate and record amount of food eaten at each meal (rough %) -usually report to nurse if eaten less than 70% of food -may be required to record each percentage of each food served (50% pork chop, 50% mixed vegetables, 100% mashed potatoes -report lack of appetite, sudden change of appetite, difficulty chewing or swallowing, difficulty/frustration using assistive devices, refusal to eat therapeutic diet of decreased food intake, food intake less than 70% meal

collecting urine

-routine urine specimen: have person void directly into specimen container, or pour urine from urinal, bedpan, commode, drainage bag -clean catch (midstream) urine specimen: when person thought to have infection (UTI) before voiding, clean urethra, starts to void, stop, collect void (avoid contamination of urine sample with microbes other than those causing infection -24-hour specimen: collected over 24 hours; have person empty bladder (discard, note time), for next 24 hours, collect urine and transfer to specimen container (label and store according to policy)

indwelling urinary catheter

-small tube through urethra to bladder -small ball at en to hold in place -urine drained to drainage bag (leg bag or large drainage bag) -leg bag must be kept lower than the bladder -used when person has medical condition or injury preventing bladder emptying -before, during, after some surgeries -Incontinent of urine with pressure injury (infected if urine contact) -no sensation to urinate, nerve or lower-body paralysis

different types of therapeutic diet

-soft, mechanical, puree: mashed for, shopped very small, or blended to smooth consistency -liquid diet: clear liquid diet (broth, gelatin, tea, clear carbonated sodas, clear juice), full liquid diet (fruit juices, strained soup, ice cream, milk and thinned cooked cereal (usually only one or two days) -sodium-restricted diet: sodium lowers for individual with high BP, kidney disease, heart disease, no added salt and foods naturally high in sodium (lunch meat, cured meat, pickles, cheese) may use salt substitute -carbohydrate-controlled or diabetic diet: for people with diabetes, based on activity and nutrition needs, carbs, fat, protein adjusted, spaced through day to keep blood glucose steady -calorie-restricted diet: diet with 1200, 1500, 18000, or 2000 calories/day needed to control weight, may recommend multivitamin and mineral supplements for diet 1,200 of fewer (NCS: no concentrates sweets --> candy, cookies) -heart healthy diet: foods naturally low in sodium and unhealthy fats, lean mean, low-fat/non-fat dairy, fruits, vegetables, whole grains) frying avoided -high protein diet: per people who don't eat enough protein or who need extra to rebuild tissue

acute pain

-sudden response to injury or illness or surgery -usually lasts 6 months and gets better over time

carbohydrates

-supply glucose to body, most basic form of energy -whole grains (whole wheat bread, brown rice, oatmeal, fruits, vegetables), fiber (lowers risk of heart disease and diabetes) -less nutritious forms: white bread, table sugar, white rice, white pasta

testing urine

-test for substances by using chemical infused strip into urine sample, colors compared to chart

assistive devices for eating

-trouble getting food on utensil: plate guard (raised rim something to push food against; have person hold piece f bread to push food against), scoop dish (rounded side something to push food against) sport (spear and scoop food) -plate slips or moves: suction base (holds plate securely to table, can put moist washcloth under plate to avoid slippage) -person has trouble grasping utensil: built-up handle utensil (larger handle is easier to hold; use foam, rubber, leather to build handle or regular utensil) vertical/horizontal self-handle utensils (handle slips over palm so person doesn't have to grasp it) utensil holder (holder over palm, easier to grasp) universal cuff (strap fastened to hand, utensil put in strap) -person has trouble keeping food on utensil because of shakiness/weakness (swivel fork/spoon, end stays level when shaking, rest elbow on soft-spongey surface, help steady hand as needed) -person only able to use one hand to cut food: rocker knife (person rocks sharp edge of knife back and forth to cut food) -person has trouble drinking without spilling liquid: modified drinking cup (handles make it easier to grasp, cover and spout keep liquid from spilling) commercial straw holder (holder goes across rim to hold straw in place; secure plastic wrap over rim of cup with rubber band, poke hole through hold in plastic wrap -person has limited movement and can not reach mouth: extension utensil (handle extends to make it easier to bring for to mouth)

Assisting person with bedpan or urinal

-used for person who can not get out f bed t eliminate -man uses urinal and bedpan, woman bedpan for both urination and void -unnatural for person to do it in bed, difficult for person -penis place inside urinal -bedpan positioned under butt (standard, narrow end pointing feet and fracture, thinner, wedge shaped for person who can't roll too much, narrow end facing head) -check on person every 5 min -help remove as soon as done -let person clean hands with soap and water, hand wipes or hand sanitizer

assisting person with portable commode

-used for person who needs little assistance but not able to walk distance to bathroom -collection container can be removed for emptying and cleaning

intermittent catheterization

-using a straight catheter -used to empty bladder at regular intervals -useful for people with lower body paralysis -out of scope of care to insert catheter

fecal impaction

-when constipation not relieved, more severe -bowel almost completely blocked up, person uncomfortable, abdomen swelling -person may pass small amt. watery liquid (not bowel movement) -use enema, if doesn't work, nurse or doctor have to scoop out piece by piece (disimpaction)

fluid balance

-when fluid intake equals output -unequal balance leads to dehydration (too little fluid) or edema (too much fluid, can be noticed by swelling feet, fingers, ankles, report to nurse)

straining urine

-when person has kidney stones -when using commode, bedpan, urinal, place disposable strainer, gauze over rim of graduate and pour urine into graduate (stones left over), put strainer or cause in specimen container and dispose of urine

meal supplement

-when person not eating well or losing weight -similar to milkshake, high in calories, fat, protein -given with mean, between meal, as snack -serve at specific time with proper temperature, if declined, report to nurse

colostomy

-when when large intestine or colon is part of stoma

abduction pillow

-while lying on back, keeps legs spread

intravenous therapy (when to report)

admin of fluid through catheter in vein on back of hand or in arm -sometimes medications put through this tubing as well -report if disconnected IV line, leaking of IV tubing, wet/loose dressing on IV line, empty fluid bag, pain/swelling/bleeding/ redness at IV side

aspiration

breathing of fluid or other foreign material into lungs

dehydration (symptoms when to report)

can be from vomiting, diarrhea, fever, severe blood loss -person may not drink as much because of immobility of want to take less trips to the bathroom and lower risk of incontinence -as urine becomes more concentrated, bladder becomes irritated and increase urge to urinate -report when confusion, skin turgor, small amp. dark colored urine, constipation, drowsiness, very dry skin or chapped lips, elevated temperature

chronic conditions

do not resolve with time (diabetes and arthritis) -aften affect ability to do ADL,s and IADLs (instrumental activities of daily living)

diet

food and drinks consumed

IADL (instrumental activities of daily living)

higher levels of activity -shopping for food -preparing meals -managing medications -person may be agitated having to deal with condition day to day and losing independence -show empathy and recognize abilities

acute condition

illness happened suddenly and tested short amount of time

baseline

initial vital sign measurements to determine point of reference

urine (urination)

liquid body waste -kidneys filter blood (remove waste and excess fluid)

anorexia

loss of appetite -pain, nausea, medication side effects, depression, loss of sense of taste or smell

Opioids

narcotics that block pain receptors in CNS -body becomes dependent if used for a long time (improves bodies functioning)

stoma

opening in abdominal wall

laxative

oral medication for bowel movement

nutrition

process of consuming and using nutrients

dietitian

professional with specialized knowledge and training in nutrition -usually consulted with person having a diet with special needs

skin turgor

skin doesn't return to normal shape when gently squeezed or pinched

feces (voiding, defecation, having a bowel movement)

solid body waste -digesting food (usable times absorbed, unusable eliminated)

enema

solution put in rectum to help elimination

therapeutic diet

special diet ordered for person to maintain and regain health, ordered by healthcare provider, planned by nutritionist -as CNA, know what type of diet it is, why it is necessary -encourage person to follow diet

nutrients

substances body needs to grow, maintain, and stay healthy -can get from vitamin and mineral supplements or diet

enteral nutrition (when to report)

tube feeding through stomach or intestines -If only for few days (nasogastric or nasointestinal) -If for many days (gastrostomy tube inserted directly to stomach) tube clamped in with sutures (stitches) and covered with dressing, when healed, left open to air (let nurse know of swelling, redness, drainage at site -report when pain or discomfort in abdomen, nausea, excessive gas, redness/irritation/drainage around tube insertion site, repeated attempt by person to pull out tube