RCP's

#11 fire extinguisher

1. Pull the pin 2. Aim at the base of the fire 3. Squeeze the handle 4. Sweep back and forth at the base of the fire

#10 fire

1. Remove Residents from area or immediate danger 2. Activate fire Alarm 3. Close doors and windows to Contain fire 4. Extinguish fire 5. Follow all Facility Policies

#1 initial steps

1. ask nurse about resident's needs, gather supplies 2. knock and identify yourself 3 greet resident by their name 4. identify yourself by name and title 5. explain what you will be doing; encourage resident to help as able 6. gather supplies and check equipment 7. close curtain, drape, and door. keep resident covered, exposing only the area of the resident's body necessary to complete the procedure 8. wash hands 9. wear gloves 10. use proper body mechanics. raise bed to appropriate height and lower side rails if needed .

#9 seizures

1. call for nurse and stay w resident 2. place padding under head and move furniture away from resident 3. do not restrain resident or place anything in their mouth, assist nurse with placing them on their side 4. loosen clothing esp around neck 5. note duration of seizure and areas involved. assist nurse as needed.

#8 choking

1. call for nurse and stay with resident 2. ask if they can speak or cough 3. if not able to speak or cough, move behind resident and slide arms under residents armpits 4. place your fist with thumb side against abdomen midway between waist and rib cage 5. grasp your fist w/ your other hand 6. press your fist into abdomen w/ quick, inward, and upward thrusts 7. repeat until object is expelled 8. assist w/ documentation

#7 falling or fainting

1. call for nurse and stay with resident 2. check if resident is breathing 3. do not move resident. leave in same position until the nurse examines the resident. 4. talk to resident in calm and supportive manner 5. apply direct pressure to any bleeding area with a clean piece of linen 6. take pulse and respiration 7. assist nurse as directed. check resident frequently according to facility policy and procedures.

#23 sit on edge of bed

1. initial steps 2. adjust bed height to lowest position. place residents shoes within reach 3. move resident to side of bed closest to you 4. raise head of bed to sitting position, if necessary 5. place one arm under resident's shoulder blades and the other arm under resident's thighs 6. on count of three, slowly turn resident into sitting position with legs dangling over side of bed 7. allow time for resident to become steady. check for dizziness (10-15 secs) 8. assist resident to put on shoes or slippers 9. move resident to edge of bed so feet are flat on floor 10. final steps

#59 assist to eat

1. initial steps 2. ask resident if they need to use bathroom and wash hands 3. confirm diet card. check name, diet, utensils, and condiments 4. confirm any adaptive equipment is present 5. assist to protect resident's clothing 6. assist to open cartons, arrange food items within reach, season food as they wish, cut up food, etc 7. offer assistance if resident appears to be having difficulty during meal 8. offer to assist in cleansing resident's hands and face following the meal. remove clothing protector. 9. assist resident to room 10. final steps. measure I&O's if required

#58 feeding

1. initial steps 2. ask resident if they need to use bathroom and wash hands 3. confirm diet card. check name, diet, utensils, and condiments 4. explain procedure 5. have resident wash hands, help the resident if needed 6. sit on unaffected side eye level with resident and facing them 7. resident's head of bed should be elevated at least 45 degrees, if in bed 8. protect the resident's clothing with a clothing protector or per facility policy and procedures 9. offer different foods; ask their preference 10. food should be in bite sized pieces or with the spoon half full. food should be fed to the unaffected side of the mouth 11. allow time for resident to chew and empty mouth between bites. notify nurse immediately should choking occur 12. frequently offer beverage 13. make conversation; atmosphere should be pleasant 14. cleanse the resident's hands and face as needed during and after feeding 15. final steps

#45 dressing a dependent resident

1. initial steps 2. assist resident to choose clothing 3. move resident onto back 4. provide privacy 5. guide feet through leg openings of underwear and pants, affected leg first. pull garments up legs to buttock 6. slide arm into shirt sleeve, affected side first 7. turn resident onto unaffected side. pull lower garments over buttocks and hip. tuck shirt under resident (pants then shirt) 8. turn resident onto affected side. pull lower garments over buttocks and hip and straighten shirt 9. turn resident onto back and slide arm into shirt sleeve, align and fasten garments 10. final steps

#46 assist to bathroom

1. initial steps 2. assist resident to put on non skid socks and apply gait belt 3. walk with resident into bathroom 4. assist resident to lower garments and sit 5. provide call light and tp 6. put on gloves 7. assist resident to wip area from front to back 8. remove gloves and wash hands 9. assist resident to raise garments 10. assist resident to wash hands 11. walk with resident back to bed or chair 12.final steps

#47 bedside commode

1. initial steps 2. assist resident to put on non skid socks or footwear 3. place commode next to bed on unaffected side 4. assist resident to transfer to commode by transferring thesafest way theyre able 5. give them call light and tp 6. gloves 7. assist resident to wipe front to back 8. wash hands and change gloves 9. assist resident to bed or chair 10. remove and cover pan and take to bathroom 11. prior to disposal, observe urine and/or feces for Color, Odor, Characteristics, and Amount 12. dispose of urine and/or feces, sanitize pan and return 13. remove gloves and wash hands 14. assist resident to wash hands 15. final steps

#28 assist with walker

1. initial steps 2. assist resident to sit on edge of bed. assist to put on resident shoes. apply gait belt if needed 3. place walker in front of resident as close to the bed as possible 4. have resident grasp both arms of walker 5. brace leg of walker with your foot and place your hand on top of walker 6. assist resident to stand on count of three. check for balance and dizziness 7. stand to side and slightly behind resident 8. have resident move walker ahead 6-10 in, then step up to walker moving the weak or injured leg forward to the middle of the walker while pushing down on the handles of the walker, and then bringing the unaffected leg forward even with the weak leg 9. final steps

#24 using a gait belt to assist with ambulation

1. initial steps 2. assist resident to sit on edge of bed. encourage resident to sit for a few seconds to become steady. check for dizziness (10-15 seconds) assist resident to put on non skid socks or footwear 3. place belt around resident's wait with the buckle in front and adjust to a snug fit. position one hand on the belt at the resident's side and the other hand on the belt at the resident's back 4. assist the resident to stand on the count of three 5. assist the resident to gain balance. ask if they are dizzy 6 stand to side and slightly behind resident while continuing to hold onto belt 7. walk at residents pace 8. return resident to chair or bed and remove belt 9. final steps

#27 walking

1. initial steps 2. assist resident to sit on edge of bed. encourage resident to sit for a few seconds to become steady. check for dizziness. assist to put on shoes. apply gait belt if needed 3. assist resident to stand on count of three 4. allow resident to gain balance, check for dizziness 5. stand to side and slightly behind resident 6. walk at residents pace 7. final steps

#17 weight

1. initial steps 2. balance scale 3. depending on scale used, assist resident to stand on platform or sit in chair w/ feet on the footrest or transport wheelchair onto scale and lock brakes 4. when using a standard scale: lower weight to fifty pound mark that causes arm to drop. move it back to previous mark. move upper weight to pound mark that balances pointer in middle of square. add lower and upper marks. when using a digital scale: press weigh button. wait until numbers remain constant 5. when using a wheelchair scale weigh wheelchair first. then weigh wheelchair w/ resident. subtract weight of wheelchair from total weight 6. accurately record weight 7. final steps 8. unusual findings

#29 assist with cane

1. initial steps 2. check cane for presence of rubber tips 3. assist resident to sit on edge of bed. apply gait belt if needed 4. assist resident to stand on count of three 5. allow resident to gain balance. check for dizziness 6. have resident place can approximately 4 in to the side of their stronger foot. the height of the cane should be level with the residents hip 7.stand to the affected side and slightly behind resident 8. have resident move cane forward about 4-6 in, step forward with weak leg to a position even with the cane. then have the resident move strong leg forward and beyond the weak leg and cane 9. final steps

#42 fingernail care

1. initial steps 2. check fingers and nails for Color, Swelling, Cuts, or Splits. check hands for extreme heat or cold. report unusual findings before continuing. C-S-C-S 3. raise head of bed 4. fill bath basin halfway with warm water and have resident check water temp for comfort 5. soak hands and pat dry 6. put on gloves 7. clean under nails with orange stick 8. clip fingernails straight across, then file in a curve 9. remove gloves 10.final steps

#65 abdominal binder

1. initial steps 2. check the skin for redness, open areas, or needed incontinent care 3. place binder flat on the bed and ask resident to lie down with upper border at the upper waist and lower border at the level of the gluteal fold. if resident is in bed, assist him/her to roll side to side while placing binder underneath him or her in the same position 4. bring the ends of the binder around the resident, and overlap them. beginning at the bottom of the binder, secure the velcro fastener strip so that the binder fits snugly 5. ensure there are no wrinkles or creases in the binder 6. final steps

#68 palm cones

1. initial steps 2. clean and dry resident's hand 3. place cone with clean cover in their palm 4. observe hands every shift; clean and dry hands. observe for areas of Redness, Swelling, or open areas and report to the nurse 5. note covering of palm cone and send to laundry when soiled, re-covering cone with a clean covering, as needed 6. final steps

#15 blood pressure

1. initial steps 2. clean earpieces and diaphragm of stethoscope with antiseptic wipe 3. uncover residents arm to shoulder 4. rest residents arm, level with heart, palm upward on comfortable surface 5. wrap proper sized sphygmomanometer cuff around upper unaffected arm approx. 1-2 inches above elbow 6. put stethoscope in ears 7. place diaphragm of stethoscope over brachial artery at elbow 8. close valve on bulb. if BP is known, inflate cuff to 20mm/hg above the usual reading. if BP is unknown, inflate cuff to 160 mm/hg 9. slowly open valve on bulb 10. watch gauge and listen for sound of pulse 11. note reading at first pulse sound 12. note reading when pulse sound disappears 13. completely deflate and remove cuff 14. accurately record systolic and diastolic readings 15. final steps 16. report unusual findings

#32 shower/shampoo

1. initial steps 2. clean/disinfect shower area and shower chair as per facility policy. prep the bathing area and gather supplies to take to the shower area 3. help resident remove clothing and provide privacy 4. turn on water and have resident check water temp for comfort 5. assist resident into shower via wheelchair. lock wheels of wheelchair and transfer resident to shower chair. use safety belt to secure resident stability SHAMPOO 6. give resident a washcloth to cover their eyes, and cotton balls for their ears 7. wet hair 8. put a small amount of shampoo into the palm of your hand and work it into the resident's hair and scalp using your fingertips 9. rinse hair 10. use conditioner if requested 11. let resident wash as much as possible, starting with the face 12. turn off water cover resident w bath blanket 13. remove cotton balls from ears 14. towel dry hair, neck , and ears 15. give resident a towel and pat dry.ensure to thoroughly pat dry under the breasts, between the skin folds, in the peri area and between toes 16 . ensure floor area is dry and non slip device is in place. assist out of shower 17. use a hair dryer if desired 18. apply lotion to skin, help resident dress, comb hair, and return to room 19. final steps

#39 electric razor

1. initial steps 2. raise head of bed 3. do not use near pacemaker-oxygen-water 4. drape towel under resident's chin 5. put on gloves 6. apply electric pre-shave lotion as resident requests 7. hold skin taut and shave resident's face and neck according to guidelines 8. check for any breaks in the skin. apply after shave lotion as resident requests 9. remove towel from resident 10. remove gloves 11. final steps

#55 occupied bed

1. initial steps 2. collect clean linen in order of use 3. carry linen away from your uniform 4. place linen on clean surface 5. lower head of bed and adjust bed to a safe working level, usually waist high. lock bed wheels 6. drape the resident 7. the cna will make the bed one side at a time. they will raise the side rail on far side of bed . assist resident to turn onto side moving away from you towards the raised side rail 8. loosen bottom soiled linen on the side of bed on which you are working from head to toe and rolling/tucking linen toward resident 9. roll bottom soiled linen toward resident and tuck it snuggly against their back 10. place clean bottom linen on unoccupied side of bed and roll remaining clean linen under resident in the center of the bed 11. smooth bottom sheet out and ensure there are no wrinkles. roll all extra material toward resident and tuck it under the resident's body 12. raise the side rail nearest you and assist the resident to turn onto clean bottom sheet. move to opposite side of bed, as resident will now be facing away from you 13. while resident is lying on side, loosen soiled linen and roll linen from head to foot of bed, avoiding contact with your skin or clothing 14. place soiled linen in hamper or bag at foot of bed or in chair 15. pull clean bottom linen as was done on the opposite side 16. assist resident to roll onto back, keeping resident covered and comfortable 17. unfold the top sheet placing it over the resident. request the resident to hold the clean top sheet, while slipping the bath blanket or previous sheet out from underneath the clean sheet 18. assist resident with blanket over the top sheet and tuck the bottom edges of the top sheet and blanket under the bottom of the mattress. miter the corners and loosen the top linens over the resident's feet 19. remove pillow and remove the soiled pillow case by turning inside out 20. with one hand, grasp the clean pillow case at the closed in, turning it inside out over your arm 21. using the same hand that has the case over it, grasp the pillow and pull 22. place the pillow under residents head with open edge away from door 23. assist resident to comfortable position and return bed to normal height 24. remove soiled linens 25. final steps

#54 unoccupied bed

1. initial steps 2. collect clean linen to use 3. carry linen away from your uniform 4. place linen on clean surface (bedside stand, over bed table, or back of chair) 5. place bed in flat position 6. loosen soiled linen. roll linen from head to foot of bed and place in hamper at door of room or in bag and place at foot of bed or chair 7. fanfold bottom sheet to center of bed and fit corners 8. fanfold top sheet to center of bed 9.fanfold blanket over top sheet 10. tuck top linen under foot of mattress and miter corner 11. move to other side of bed 12. fit corners of bottom sheet, unfold top linen, tuck it under foot of mattress, and miter corners 13. fold top of sheet over blanket to make cuff 14. with one hand, grasp the clean pillow case at the closing end, turning it inside out over your arm 15. using the same hand that has the pillow case over it, grasp one narrow edge of the pillow and pill the case over it with your free hand 16. place the pillow at the head of the bed with open edge away from the door 17. for open bed: make toe pleat and fanfold top linen to foot of bed with top edge closest to center of bd 18. for closed bed: pull bedspread over pillow and tuck bedspread under lower edge of pillow. make toe pleat 19. remove soiled linens 20. final steps

#37 oral care for the unconscious resident

1. initial steps 2. drape towel over pillow and under resident's chin 3. turn resident onto unaffected side 4. put on gloves 5. place an emesis basin under resident's chin 6. dip swab in cleaning solution of 1/2 mouthwash and 1/2 water and wipe teeth, gums, tongue, and inside surfaces of mouth, changing swab frequently 7. rinse with clean swab dipped in water 8. check Mouth, Lips, Tongue, and Teeth for Odor, Cracking, Sores, Bleeding, and Discoloration. check for Loose teeth. 9. put on chapstick 10. remove gloves 11. final steps

#42 foot care (basin)

1. initial steps 2. fill halfway with warm water 3. place basin on towel,bathmat, or incontinent pad 4. remove socks. completely submerge feet in water and soak for 5-10 mins 5. put on gloves 6. remove one foot from water. wash entire foot, including between the toes and around the nail beds using a soapy washcloth 7. rinse entire foot, including between the toes 8. dry entire foot, including between the toes 9. repeat steps with other foot 10. place lotion in hand, warm lotion by rubbing hands together, and then massage lotion into entire foot except between toes, removing excess with a towel 11. assist resident to replace socks 12. final steps 13. report any cuts, sores, or other findings to the nurse

#70 assisting with hearing aids

1. initial steps 2. gently clean resident's ear with a damp washcloth. clean hearing aid of wax and dirt 3. insert hearing aid into ear 4. assist to adjust the volume control to a desired level 5. final steps 6. report findings to nurse 7. keep aid in a safe place when not in use

#35 bed shampoo

1. initial steps 2. gently comb hair 3. provide privacy 4. remove resident's gown or pajama top. place a towel around residents neck and shoulders. lower head of bed 5. have resident check temp of water to be used for comfort 6. place bed shampoo basin under resident's head according to manufacturer's instructions 7. place wash basin on chair to catch water flowing from shampoo basin 8. pour water carefully over resident's hair 9. lather hair with shampoo using fingertips. rinse thoroughly. apply conditioner if requested 10. squeeze excess water from hair. towel dry 11. replace gown 12. comb hair. dry hair with dryer if resident wishes 13. final steps

#61 float heels

1. initial steps 2. lift residents lower extremity 3. inspect skin, esp the heels for skin breakdown(redness, warmth, blisters, etc) 4. place a full pillow under calves leaving heels in the air and free from pressure (do not use rolled pillows or blankets) apply heel protectors if indicated 5. final steps

#30 transfer to stretcher/shower bed

1. initial steps 2. loosen sheet directly under resident and roll edges close to resident 3. place stretcher/shower bed at bedside 4. staff should be present at the bedside as well as on the opposite side of the stretcher/shower bed 5. staff should grasp the sheet on each side of resident. on the count of three, slide resident laterally onto stretcher/ shower bed 6. center and align resident. place pillow under their head and cover with a blanket. raise the rails of the stretcher/shower bed 7. final steps

#48 bedpan/fracture pan

1. initial steps 2. lower head of bed 3. gloves 4. turn resident away from you 5. place bedpan or fracture pan under buttocks according to directions 6. gently roll resident back onto pan and check for correct placement 7. cover resident with sheet or blanket 8. raise head of bed to comfortable position for resident 9. give resident call light and tp 10. leave them and return when called 11. lower head of bed 12. press bed pan flat on bed and turn resident to unaffected side 13. wipe resident from front to back. wash hands and change gloves 14. provide peri care 15. cover bed pan and take to bathroom 16. prior to disposal, observe for Color, Odor, Characteristics, and Amount C-O-C-A 17. dispose of urine and sanitize pan 18. remove gloves. wash hands 19. assist resident to wash hands 20. final steps

#19 supine position

1. initial steps 2. lower head of bed 3. move resident to head of bed (if necessary) 4. position resident flat on back with legs slightly apart 5. align resident's shoulders and hips 6. use supportive padding and/ or float heels, if necessary 7. final steps

#41 comb hair

1. initial steps 2. raise head of bed 3. drape towel over pillow 4. remove glasses and hairclips 5. remove tangles by dividing hair into small sections and gently combing out from the ends of hair to scalp 6. use hair products, as resident requests 7. style as requested 8. offer mirror 9. final steps

#18 Assist resident to move to head of bed

1. initial steps 2. lower head of bed and lean pillow against head board. adjust bed height as needed 3. ask resident to bend knees, put feet flat on mattress 4.place one arm under resident's shoulder blades and the other arm under resident's thighs. if a draw sheet or pad is under the resident, two cnas should grasp the sheet or pad firmly, with trunk centered between hands 5. ask resident to push with feet on count of three 6. place pillow under resident's head 7. final steps

#22 semi-fowlers position

1. initial steps 2. move resident to supine position 3. elevate head of bed 30 to 45 degrees 4. use supportive padding if necessary 5. final steps

#21 fowler's position

1. initial steps 2. move resident to supine position 3. elevate head of bed 45 to 60 degrees 4. use supportive padding 5. finial steps

#64 splint application

1. initial steps 2. observe affected joints. if redness, swelling, or warmth is present or if they complain about pain, notify nurse 3.apply splint according to therapy recommendation and physician's order 4. remove splint after designated period of time. cleanse the skin, dry and observe fr swelling, redness, warmth, complaint of pin or open area. 5. do final steps

#71 ted hose

1. initial steps 2. observe skin prior to applying the stockings for any redness, warmth, swelling, excessive dryness, or open area 3. apply the hose before the resident gets out of bed 4. hold heel of stocking and gather the rest in your hand turning house inside out to mid foot area 5. support foot at the heel and slip the front of the stocking over the toes, foot and heel 6. pull the stocking up until it is fully extended 7. smooth away any wrinkles or twisted areas 8. remove the hose at lest twice daily for skin care 9. final steps

#57 passing fresh ice water

1. initial steps 2. obtain cart, ice container, ice scoop, and go to ice machine. keep ice scoop covered 3. fill container with ice using ice scoop 4. replace ice scoop in proper covered container, or cover it with a clean towel or plastic bag to prevent contamination 5. proceed to resident rooms, noting any fluid restrictions prior to pass and any residents who require thickened liquids 6. empty water from pitcher and bedside glass into sink. 7. take pitcher into hall and fill it with ice. do not touch the pitcher with the ice scoop 8. replace the scoop in covered container, clean towel or plastic bag between rooms to prevent contamination 9. return to residents room and fill pitcher with water at bathroom sink, not allowing pitcher to touch faucet 10. pour fresh water into bedside glass and leave a straw with the glass 11. offer the resident a drink of fresh waiter if they are present 12. repeat procedure until all residents have been provided with fresh ice water 13. final steps

#56 thickened liquids

1. initial steps 2. obtain thickener and measuring spoon 3. thicken liquids to desired consistency following manufacturer's instructions 4. offer thickened fluid to resident. encourage them to consume 5. ensure the water pitcher has been removed from the bedside unless facility policy states otherwise 6. final steps 3 types of consistency: nectar - easily pourable, thicker cream soups honey - slightly thicker, drizzle from cup pudding - hold their own shape; not pourable; eaten with a spoon

#62 bed cradle

1. initial steps 2. place bed cradle on bed according to instructions 3. cover bed cradle with top sheet and blanket 4. final steps

#31 transfer two person lift

1. initial steps 2. place chair at bedside. brace it firmly against side of bed. lock wheels of wheelchair 3. assist resident to sit on edge of bed. ensure there is staff on each side of the resident 4. reach around residents back and grasp the other caregivers forearm above wrist. have resident place arms around shoulders or upper arms. 5. each caregiver should reach under residents knees and grasp the other caregivers forearm above wrist 6. on the count of the lift the resident 7. pivot and lower resident into chair 8. align resident in chair 9. final steps

#25 transfer to chair

1. initial steps 2. place chair on resident's unaffected side. brace chair firmly against side of bed 3. assist resident to sit on edge of bed. encourage resident to sit for a few seconds to become steady. check for dizziness. assist resident to put on non skid socks and footwear 4. stand in front of resident and apply gait belt around abdomen 5. grasp the belt on both sides 6. ask resident to place hands on your upper arms 7. on the count of three, help resident into standing position by straightening your knees 8. allow resident to gain balance, check for dizziness 9. move your feet 18 in apart and slowly turn resident 10. lower resident into chair by bending your knees and leaning forward 11. align resident's body and position foot rest. remove gait belt 12. final steps

#34 back rub

1. initial steps 2. place resident in lateral position with neck and back toward you 3. expose back and shoulders 4. rub lotion between your hands 5. make long, firm strokes along spine from buttocks to shoulders. make circular strokes going down the back starting on the shoulders and upper arms then going down the back 6. repeat for 3-5 mins 7. gently pat off excess lotion with towel. 8. final steps

#20 lateral position

1. initial steps 2. place resident in supine position 3. move resident to side of bed closest to you 4. cross resident's arms over chest 5. slightly bend knee of nearest leg to you or cross nearest leg over farthest leg at ankle 6. place your hands under resident's shoulder blades and buttock. turn resident away from you onto side 7. place supportive padding behind back, between knees and ankles, and under top arm 8. final steps Location of Pillows: under head, behind back, between knees and ankles, and under top arm

#66 abduction pillow

1. initial steps 2. place resident in supine position. place the pillow between the resident's legs. slide it with the narrow end pointing toward the groin until it touches the legs all along its length 3. place the upper part of both legs in the pillow's indentations. raise each leg slightly by lifting under the knee and ankle to bring straps under and around the leg and then secure the straps to the pillow 4. final steps 5. report resident intolerance or complaint of pain upon application to the nurse

#14 pulse and respiration

1. initial steps 2. place residents hand on comfortable surface 3. feel for pulse above wrist on thumb side with tips of first three fingers 4. count beats for 60 seconds, noting Rate-Rhythm-Force 5. continue position as if feeling for pulse. count each rise and fall of chest as one respiration 6. count respirations for 60 seconds noting Rate-Rhythm-Sound 7. record pulse and respiration rates 8. report unusual findings 9. finial steps

#26 transfer to wheelchair

1. initial steps 2. place wheelchair on resident's unaffected side. brace firmly against side of bed with wheels locked and foot rests out of way 3. assist resident to sit on edge of bed. encourage resident to sit for a few seconds to become steady. check for dizziness assist resident to put on non skid socks and footwear 4. stand in front of resident and apply gait belt around abdomen 5. grasp the belt on both sides 6. ask resident to place hands on your upper arms 7. on the count of three, help resident into standing position by straightening your knees 8. allow resident to gain balance, check for dizziness 9.move your feet to shoulder width apart and slowly turn resident 10. lower resident into wheelchair by bending your knees and leaning forward 11. align residents body and position foot rest. remove gait belt 12. unlock wheels. transport resident forward through open doorway 13. transport resident up to closed door, open door and back wheelchair through doorway 14. take resident to destination and lock wheelchair 15. final steps

#63 passive ROM

1. initial steps 2. position resident in good body alignment 3. observe joints.if swelling, redness, or warmth is present, or if resident complains of pain, notify nurse 4. support limb above and below joint 5. begin rom at shoulders and include the elbows, wrists, thumbs, fingers, hips, knees, ankles, and toes 6. slowly move joint in all directions it normally moves 7. repeat movement at least five times 8. encourage resident to participate as much as possible 9. stop procedure at any sign of pain and report to nurse immediately 10. final steps

#51 urine specimen collection

1. initial steps 2. prepare label for specimen with appropriate information and place it on specimen container, not the lid, i.e. resident name, date, and time 3. put on gloves 4. assist resident to bathroom or commode, offer bedpan or urinal 5. provide peri-care to the resident 6. ask resident to void into the urine hat placed on the toilet, or to urinate in the bedpan. ask the resident not to put toilet paper with the sample 7. after urination, assist the resident as necessary with perineal care and to wash their hands. change your gloves and wash your hands 8. take bedpan, urinal, and commode pail to bathroom and pour urine into the specimen container. the container should be at least half full 9. cover the urine container with its lid. do not touch the inside of the container. wipe off the outside with a paper towel 10. place the specimen container in the bio hazardous bag supplied by the lab for transport 11. discard excess urine in bedpan or urinal; clean and disinfect equipment as per facility policy 12. final steps

#52 stool specimen collection

1. initial steps 2. prepare label for specimen with appropriate information and place it on specimen container, not the lid, i.e. residents name, date, and time 3. put on gloves 4. when the resident is ready to move bowels, ask them not to urinate at the same time. ask them not to put toilet paper with the sample 5. provide resident with a bedpan, assisting if needed 6. after the bowel movement, assist as needed with perineal care. if resident urinate into specimen, it cannot be used 7. remove gloves, wash hands, and put on clean gloves 8. using two tongue blades. take about two tablespoons of stool and put in the container. try to collect material from different areas of the stool 9. cover the container with lid. label as directed per facility policy and procedure and place in the bio hazard plastic bag supplied by the lab for transport. dispose of remaining stool; clean and disinfect equipment as per facility policy. notify nurse of collection 10. final steps

#60 inspecting skin

1. initial steps 2. provide privacy 3. check BONY areas including ears, shoulder blades, elbows, coccyx, hips, knees, ankles, and heels for Redness and Warmth 4. check FRICTION areas including under breasts and arms, between skin folds, groin, thighs, butt, contracted areas, and around any tubing for Redness, Irritation, Moisture, and Odor 5. undrape resident 6. report unusual findings 7. final steps

#50 empty urinary drainage bag

1. initial steps 2. put on gloves 3. place paper towel on floor beneath bag and place graduated cylinder on paper towel 4. detach spout and point the drainage tube into center of graduated cylinder without letting tube touch sides 5. unclamp spout and drain urine 6. clamp spout 7. replace spout in holder. cover graduated cylinder with paper towel and carry to bathroom 8. check urine for Color, Odor, Characteristics, and Amount and report unusual findings to the nurse COCA 9. measure and accurately record amount of urine 10. dispose of urine, rinse, sanitize, and return graduated cylinder according to facility policies 11. remove gloves 12. final steps

#53 application of incontinent brief

1. initial steps 2. put on gloves 3. provide the resident privacy 4. unfasten and remove soiled brief resident is currently wearing and place in small plastic trash bag for disposal in soiled utility bag 5. provide perineal care as needed 6. wash hands and change gloves 7. place back of brief under resident's hips, plastic side of disposable brief away from residents skin 8. bring front of brief between resident's legs and up to his/her waist 9. fasten each side of brief and adjust fit 10. apply residents clothing 11. final steps

#69 nasal cannula care

1. initial steps 2. put on gloves 3. remove nasal cannula and clean nostrils with a soft cloth or tissue once each shift or as needed 4. note any redness or irritation of the nares or behind the ears, and notify nurse if present. continue procedure only if instructed 5. replace nasal cannula with prongs curving downward. do not cinch side up too tightly 6. remove gloves 7. final steps

#72 post mortem care

1. initial steps 2. put on gloves 3. respect the family's religious restrictions regarding the care of body, if applicable 4. assist roomate to leave the area until body is prepared and removed 5. place body in supine position 6. place one pillow beneath resident's head 7. close the eyes 8. insert dentures and close mouth 9. clean body as necessary. comb hair 10. place a pad under the buttocks to collect any drainage 11. put a clean hospital gown on resident and place body in a comfortable looking position to allow family and friends to view the body 12. remove gloves 13. final steps 14. after the mortuary has removed the body, strip the bed and clean the room according to policy

#40 safety razor

1. initial steps 2. raise bed 3. fill basin halfway with water 4. drape towel under chin 5. gloves 6. moisten beard with washcloth and spread shaving cream over area 7. hold skin taut and shave bear in downward strokes on face and upward strokes on neck 8. rinse resident's face and neck with washcloth 9. pat dry with towel 10. apply after shave lotion if requested 11. remove towel 12. remove gloves 13. final steps

#38 denture care

1. initial steps 2. raise head of bed so resident is sitting up 3. put on gloves 4. drape towel under resident's chin 5. remind resident that you are going to remove their dentures. remove upper dentures by placing your index finger at the ridge on top of the right upper denture and gently moving them up and down to release suction. turn lower denture slightly to lift out of mouth 6. put dentures in denture cup marked with resident's name and take to sink 7. line sink with towel and fill halfway with water 8. apply denture cleaner to toothbrush 9. hold dentures over sink and brush all surfaces 10. rinse dentures under warm water, place in a clean cup and fill with cool water 11. clean residents mouth with swab if necessary. 12. check Mouth, Lips, Tongue, and Teeth for Odor, Cracking, Sores, Bleeding, and Discoloration. check for Loose teeth. 13. help put dentures in mouth and moisturize the lips 14. remove gloves 15. final steps

#36 oral care for the alert and oriented resident

1. initial steps 2. raise head of bed so resident is sitting up 3. put on gloves 4. drape towel under residents chin 5. wet toothbrush and apply small amount of toothpaste 6. first brush upper teeth and then lower teeth 7. hold emesis basin under resident's chin 8. ask resident to rinse mouth with water and spit into basin 9. if requested, give resident mouthwash diluted with half water 10. check Mouth, Lips, Tongue, and Teeth for Odor, Cracking, Sores, Bleeding, and Discoloration. check for Loose teeth. 11. remove towel and wipe residents mouth 12. remove gloves 13. final steps

#49 urinal

1. initial steps 2. raise head of bed to sitting position 3. put on gloves 4. offer urinal to resident or place urinal between his legs and insert penis into opening 5. cover resident 6. give resident call light and toilet paper 7. leave and return when called 8. remove and cover urinal 9. take urinal to bathroom, observe urine for Color, Odor, Characteristics and Amount and report unusual findings to the nurse COCA 10. Dispose of urine, rinse urinal, sanitize and return urinal according to facility policies 11. remove gloves and wash hands 12. assist resident to wash hands 13. final steps

#44 changing resident's gown

1. initial steps 2. untie soiled gown 3. raise top sheet over resident's chest 4. remove resident's arms from gown, Unaffected arm first 5. roll soiled gown from neck down and remove from beneath top sheet. place soiled gown in dirty linen bag 6. slide resident's arms into clean gown 7. tie gown 8. remove top sheet from beneath gown and cover resident 9. final steps

#16 height

1. initial steps 2. using standing balance scale: assist resident onto the scale, facing away from the scale. ask them to stand straight. raise the rod to a level above the resident's head. lower the height measurement device until it rests flat on the resident's head 3. when a resident is unable to stand: Flatten the bed and place resident in supine position. place a mark on the sheet on the top of the head and the bottom of feet. measure the distance. 4. if the resident is unable to lay flat due to contractures: utilize a tape measure and beginning at the top of the head, follow the curves of the spine and legs, measuring to the base of the heel 5. accurately record height 6. final steps

removing ppe

1. remove gloves 2. remove goggles/ face shield 3. remove gown 4. remove mask

#2. final steps

1. remove gloves and wash hands 2. be certain resident is comfortable and in good body alignment 3. lower bed height and position side rails as appropriate. 4. place call light and water within reach on the unaffected side 5. ask if they need anything else 6. thank patient. 7. remove supplies and clean equipment 8. open curtain, drapes, and door according to their wishes 9. perform a visual safety check of resident and environment 10. report unexpected findings to nurse 11. document procedures according to facility procedure

#12 oral temperature (electronic)

1. remove thermometer from storage 2. do initial steps 3. position resident comfortably in bed or chair 4. put on disposable sheath and place thermometer under the tongue and to one side, press button to activate the thermometer 5. the resident should be directed to breathe through their nose 6. instruct resident to hold the thermometer in mouth with lips closed 7. leave thermometer in place until signal is heard, indicating the temperature has been obtained 8. read the temperature reading on the face of the electronic device, remove the thermometer, discard the sheath, and record the reading 9. do final steps

#13 axillary temperature

1. remove thermometer from storage 2. do initial steps 3. position resident comfortably in bed or chair 4. put on disposable sheath, remove resident's arm from sleeve of gown. use washcloth to wipe armpit and ensure it is dry. hold thermometer in place with end in center of armpit, and fold the resident's arm over their chest 5. press button to activate the thermometer 6. hold thermometer in place until signal is heard, indicating that the temperature has been obtained 7. read the thermometer reading on the face of the electronic device, remove the thermometer, discard the sheath, and record the reading 8. assist the resident to return arm through sleeve of clothing or gown 9. final steps

#3 hand washing

1. turn on faucet with clean paper towel 2. adjust water temp 3. angle arms down. wet hands and wrists 4. apply enough soap to cover all hang and wrist surfaces. work up a lather 5. rub hands PALM TO PALM 6. RIGHT PALM over top of LEFT HAND with INTERLACED fingers 7. palm to palm with fingers interlaced 8. backs of fingers to opposing palms with fingers interlocked 9. rotational rubbing of left thumb clasped in right palm and vice versa 10. rotational rubbing, backwards and forwards with clasped fingers of right hand in left palm and vice versa. clean fingernails 11. rinse hands downward 12. dry with single use towels 13. use towel to turn off faucet and discard.

5. gown

1. wash hands 2. open gown and hold out in front of you. let the clean gown unfold without touching any surface 3. slip you hands and arms through the sleeves and pull the gown on 4. tie neck ties in a bow 5. overlap back of the gown and tie waist ties. 6. put on gloves; extend to cover wrist of gown 7. perform procedure . remove gloves 9. untie the neck, then the waist 10. pull away from neck and shoulders, touching inside of gown only 11. fold gown with clean side out and place in laundry or discard 12. wash hands

#6 mask

1. wash hands 2. place upper edge of mask over the bridge of your nose and tie upper ties. if mask has elastic bands, wrap the bands around the back of your head and ensure their security 3. place the lower edge of the mask under your chin and tie the lower ties at the nape of your neck 4. if the mask has a metal strip in the upper edge, form it to your nose 5. perform procedure 6. if the mask becomes damp or if the procedure takes more than 30 mins, you must change your mask 7. if wearing gloves, remove first 8. wash hands 9. untie each set of ties and discard the mask touching only the ties. masks are appropriate for one use only. 10. wash hands

#4. gloves

1. wash hands 2. slide one glove on left hand, then right 3. interlace fingers to secure gloves 4. check for tears and holes 5. if wearing a gown, pull the gloves over the cuff of the gown 6. perform procedure 7. remove first glove by grasping the outer surface of the other glove 8. pull glove off so it is inside out 9. hold the removed glove in a ball of the the palm of your gloved hand. 10. place two fingers of ungloved hand under the cuff and pull down so the first glove is inside of the second glove 11. dispose of gloves 12. wash hands

#33 bed bath

in book