for cna

1. FOLLOWINGGUIDELINES ALLOW YOU TO DO YOUR JOBTO THE BEST OF YOUR ABILITY,THEY
PROTECT THE RESIDENTAND YOU FROM LIABILITY…..
GUIDELINES FOR
1. PROFESSIONALBEHAVIOR
 BE POSITIVE
 DO ONLY WHAT YOU ARE ASSIGNEDTO DO
 KEEP RESIDENT INFOCONFIDENTIAL
 BE POLITE AND CHEERFUL
 DON’TDISCUSS YOUR PERSONALPROBLEMS
 DO NOT USE YOUR PHONEON THE JOB
 DO NOT USE PROFANITY
 LISTEN
 CALL RESIDENT “MR” OR “MRS”
 NEVERACCEPT TIPS
 ALWAYSEXPLAIN WHAT IS GOING TO BE DONE BEFORE CARE STARTES
 FOLLOW PRACTICESSUCH AS HANDWASHING
2. PROTECTINGRESIDENT RIGHTS
 NEVERABUSE
 IMMEDIATELY REPORT ABUSE TO NURSE
 INVOLVERESIDENTIN PLANNING
 OFFER CHOICES
 DON’TUNNECESSARILYEXPOSETHE BODY
 RESPECT RESIDENT’SREFUSAL OF CARE
 BE TRUTHFUL IN DOCUMENTING
 KNOCKANDASKPERMISSION TO ENTER RESIDENT ROOM
 DON’TOPEN MAIL OR LOOKTHROUGH BELONGINGS
 RESPECT RESDIENTS’PERSONALPOSSESSIONS
 REPORT OBSERVATIONSTONURSE
3. PROTECTINGPRIVACY
 DON’TTALK ABOUT RESIDENTS IN PUBLIC AREAS(DININGROOM, ELEVATOR,ETC)
 IF YOU SEE A RESIDENT’SFAMILY IN A PUBLIC, BE CAREFUL WITH YOUR GREETING, DON’T
MENTION NURSING
 DON’TBRING YOUR FAMILY/FRIENDSTONURSING HOME WITHOUT APPROVALOFDON
 DON’TSHARE PHOTOS,VIDEOSOF RESIDENT ON SOCIALMEDIA
 DON’TLEAVE CHART, DOCUMENTS OUT FOROTHERS TO SEE

2. 4. DOCUMENTATION
 DOCUMENT IMMEDIATELY AFTER CAREIS GIVEN,BUT NOT BEFORE THE CARE IS DONE
 BE BRIEF AND CONCISE
 USE FACTS,NOTOPINIONS
 USE BLACKINK
 CORRECT MISTAKESBY DRAWINGONE LINE THROUGH, NO WHITE OUT, NOPENCIL
 SIGN FULL NAME, TITLE, DATE AND TIME
 USE 24 HOUR CLOCK IF REQUIRED BY FACILITY
5 INCIDENTREPORTING
 DESCRIBE WHAT HAPPEN,FACTSONLY
 DO NOT WRITE ANYTHINGABOUT THE INCIDENTREPORT IN THE MEDICAL RECORD!!
 DESCRIBE THE ACTION TAKEN TO GIVECARE IF INJURY OCCURRED
5. CARINGFOR HEARINGIMPAIRED PERSON
 MAKE SURE HEATINBGAIDE IS ON AND BATTERY IS WORKING
 REDUCE BACKGROUNDNOISE
 NEVERLET HEARING AIDGET WET, REMOVE WITH SHOWER, SHAMPOOANDBEDTIME
 GET ATTENTION BY WALKINGIN FRONTOR TOUCH LIGHTLY ON ARM
 SPEAKCLEARLY, SLOWLY ANDIN GOOD LIGHTING, FACETO FACE
 DO NOT SHOUT OR MOUTH WORDS IN AN EXAGGERATED WAY
 KEEP THE PITCHLOW!!
 IF HEARINGBETTER IN ONEEAR, SPEAKIN THAT ONE
 USE PICTURE CARDSOR A NOTEPADASNEEDED
6. CARINGFOR PERSON WITH VISION IMPAIRMENT
 CLEAN GLASS LENSES WITH WATER AND SOFTTISSUE
 KNOCK,IDSELF, DON’TTOUCH UNTIL YOU HAVESAIDE YOUR NAME, ANNOUNCEWHEN YOU
ARE LEAVINGTHE ROOM
 SPEAKFACETO FACEIN PROPERLIGHTING
 AVOID“SEE”, “LOOK” AND“WATCH”
 GIVE SPECIFICDIRECTIONS“ON YOUR RIGHT”
 USE THE FACE OF AN IMAGINARYCLOCK ASA GUIDE TO EXPLAIN WHERE OBJECTS ARE
 DON’TREARRANGE
 TELL WHERE CALL LIGHT IS
 LEAVE DOORSEITHER COMPLETELY CLOSED OR OPEN,NOTPARTLY OPEN
 WHEN AMBULATING- WALKSLIGHTLY AHEAD,LETTING RESIDENTHOLD YOUR ARM
 USE LARGE CLOCKS,LARGE PRINTBOOKS.BRAILLE BOOKS

3. 7. CARINGFOR A PERSON AFTERA CVA
 KEEP DIRECTIONS,WORDSSIMPLE
 ASKCLOSED ENDED QUESTIONS
 USE SIGNALSLIKE“SHAKE YOUR HEAD OR BLINKYOUR EYES TO COMMUNICATE
 USE PEN ANDPATER IF NEEDED
 NEVERCALL INVOLVEDARMOR LEG THE “BAD SIDE”,CALL THE “WEAK ARM” OR “AFFECTED
SIDE”
 USE COMMUNICATION BOARDS
 UNDERSTANDTHAT CVA MAY HAVECAUSED BOTH EXPRESSIVE(CAN’TCOMMUNICATEWITH
SPEECH) AND RECEPTIVE (CAN’TUNDERSTANDWHAT IS BEING SAID) DYSPHASIA
 MAY BE EMOTIONALLY LABILE (CRYOR LAUGH FOR NOAPPARENTREASON)
8. CARINGFOR THE ANGRYPERSON
 STAY CALM, DON’T RESPONDTO VERBALATTACKS
 EMPATHIZE
 TRY TO DETERMINE CAUSE OF ANGER
 LISENT
 TREAT WITH DIGNITYAND RESPECT
 STAY AT A SAFEDISTANCE
 REPORT COMBATIVEBEHAVIOR
9. CARINGFOR A PERSON WITH INAPPROPRIATEBEHAVIOR
 “IM SORRY,IM NOTALLOWED TO DO THAT”
 “THAT MAKES ME UNCOMFORTABLE”
 “I REALLY CAN’TTALKABOUT MY PERSONALLIFE ON THE JOB”
 IF YOU ENCOUNTER SOMEONE MASTURBATING OR HAVINGSEX,DON’TOVERREACT,TRY TO
DISTRACT,TAKE TO ROOMFOR PRIVACY
 REPORT TO NURSE
10. PRACTICINGSTANDARDPRECAUTIONS
 USED ON ALL RESIDENTS
 WASH HANDS
 WEAR GLOVES ANDWASH HANDSIMMEDIATELY AFTER REMOVING
 IMMEDIATELY WASH SKIN IFCONTAMINATEDWITH BLOOD
 WEAR GOGGLES IF CHANCEOF SPLASHING
 PLACE SHARPTSIN SHARPSCONTAINER
 NEVERATTEMPT TO RECAPA NEEDLE
 BAG ONTAMINATEDITEMS IN RED BIOHAZARDBAG

4.  PUT ON GOWN,MASK, GOGGLES ANDGLOVES IN THIS ORDER
 REMOVE PPE: GLOVES,GOWN, GOGGLES, MASK
11. CLEANINGUP BLOOD SPILLS
 NOTIFYHOUSEKEEPING
 DON GLOVESAND USE ABSORBINGPOWDER,SCOOPUP AND PLACEIN RED BA G
 APPLYTHE PROPERDISINFECTANTFOR10 MINUTES TO AREA
 DON’TPICKUP GLASSWITH YOUR HANDS- USE BROOMANDDUSTPAN
12. ISOLATION
 ALSOCALLED TRANSMISSION BASEDPRECAUTIONS
 ONLY WEAR THE PPENEEDED FORTHAT ROOM
 DON’TSHARE EQUIPMENT- DEDICATE A BP CUFF,DISPOSABLETHERMOMETER, ETC TO THE
RESIDENT
 HANDSANITIZEGOING IN AND COMINGOUT
 BE ORGANIZEDSO YOU DON’THAVE TO KEEP GOINGIN ANDOUT OF ROOM
13. CARINGFOR THE PERSON WITH TB
 PRIVATEROOM, NEGATIVEAIR,DOOR CLOSEDAT ALL TIMES
 N95 MASK
14. PREVENTING FALLS
 CLUTTER FREE
 NO RUGS
 NONSKID,STUDY SHOES,SHOELACESTIED
 CLOTHES THAT DON’T DRAG
 PERSONALITEMS NEARBY
 ANSWERCALL LIGHTS ASAP
 CLEAN UP SPILLSSTAT
 REPORT BROKEN,LOOSE EQUIPMENT
 ADEQUATE LIGHTING
 LOCKSON W/C, BRAKES ON BED
 LOWER BED AFTER CAREGIVEN
 GET HELP WITH TRANDFERS
 TOILET PRN
 DON’TREARRANGE
 KNOWWHO IS HIGH RISKFOR FALLS
 IF RESIDENTBEGINS TO FALL, DO NOT TRY TO CATCH, SLIDE TO FLOOR SUPPORINTHEAD
 REPORT ALL FALLS

5. 15. PREVENTINGBURNS
 ALWAYSCHECK TEMP OF WATER WITH THERMOMETER OR INSIDEOF YOUR WRIST
 ASK RESIDENT IF WATER IS COMFORTABLE
 REPORT FRAYED ELECTRICAL CORDS,UNSAFEAPPLIANCESSTATEANDREMOVE FROM ROOM
 POUR HOT DRINKSAWAY FROMRESIDENT
 DON’TPLACE HOT LIQUIDS ON EDGE OFTABLE
 MAKE SURE SITTINGUP BEFORE SERVINGHOT LIQUIDS
16. USING OXYGEN
 POST NOSMOKINGSIGN
 REMOVE FIRE HAZARDS(WOOL ITEMS, HAIRDRYER, FLAMMABLES, SMOKINGMATERIALS)
FROMROOM
 NO EXTENSION CORDSON CONCENTRATOR
 ADJUST STRAPOF MASK OR NASALCANNULA ON FACEANDCHECK FOR IRRITATION
 DON PETROLEUM BASEDPRODUCTS SUCH ASVASELINEOR CHAPSTICK
 NEVERADJUST SETTING OF O2
 LEARN HOW TO TURN OFF IN AN EMERGENCY
17. HANDLINGEQUIPMENT, LINEN AND CLOTHING
 HOLD ALL EQUIPMENT TO PREVENTCONTAMINATION OFCLOTHNGAND THE TRANSFEROF
GERMS
 CLEAN/DISINFECTALLSURGACES,BEDS, BEDRAILS AND DOORKNOBS,CALLLIGHTS, DRESSER
HANDLES
 HOLD LINEN AWAYFROMYOUR BODY
 BAG SOILED AT THE POINTOFORIGIN
18. RESTRAINTS
 MAKE SURE THERE ISA DOCTOR’SORDER
 FOLLOW MANUFACTURER’S DESCRIPTION FORAPPLYINGANDUSE
 CHECK TIGHTNESS,SLIP 2-3 FINGERSINSIDE
 KEEP CALL BELL NEARANDANSWER STAT
 DOCUMENT TIME ON ANDOFF
 ASSISTWITH ELIMINATION,HYDRATION,MEALS,EXERCISE
 CHECK FOR IRRITATION UNDERRESTRAINT
 REPOSITION ANDKEEPIN GOOD ALIGNMENT
 AMBULATE ISABLE
 REMOVE EVERY 2 HOURS

6. 19. PROPERBODY MECHANICS
 BEND AT THE KNEES
 PIVOTINSTEADOF TWISTING
 HOLD THE LOAD CLOSE
 STANDWITH FEET APART(WIDE BASE OFSUPPORT)
 DON’TOVERREACH
 GET HELP
 NEVERTRY TO BREAK A FALL
 SYNCHRONIZEMOVEMENTS BY COUNTINGOUTLOUD
 PUSH, PULL INSTEADOFLIFTING
 RAISEBED UP TO COMFORTABLE WORKINGHEIGHT
 USE THIGH, SHOULDER ANDUPPER ARMMUSCLES
20. REDUCING FIRE HAZARDS
 SUPERVISESMOKERS, USE BURN RESISTANTAPRON
 REPORT FRAYED WIRES,DAMAGED ELECTRICAL CORDSSTAT
 DON’TBLOCK FIRE EXITS,DOORS
 KNOWP-A-S-SFOREXTINGUISHER
 KNOWR-A-C-EFORREACTING TO FIRE OR SMOKE
 MOVE IMMOBLILE RESIDENTS IN A BLANKET
 STAY LOW IN A ROOM TO ESCAPEFIRE
 CHECK DOOR FORHEAT BEFORE ENTERING
 PLUG DOORWAYWITH WET TOWELS OR CLOINGTO PREVENT SMOKE FROMENTERING A
ROOM
 STOP,DROP ANDROLL IF ON FIRE
 USE DAMP COVERINGOVERMOUTH ANDNOSE TO REDUCE SMOKE INHALALTION
21. EMERGENCIES
 FOR CHOKING- ABDOMINALTHRUSTS (UNLESSABLE TO SPEAKOR COUGH, THEN DO NOTHING)
 FOR HEMORRAHAGE- APPLYANDDON’T RELEASE PRESSURE
 FOR NOSEBLOOD- PINCHBRIDGE OFNOSE ANDHAVE PERSON HOLD HEAD DOWN
 FOR FAINTNESS- SITWITHHEAD TOWARDSKNEES
 FOR SHOCK- RAISEFEET HIGHER THAN HEAD
 FOR SEIZURE- PLACEON FLOOR,CLEAR THE AREA,TURN ON SIDE,PROTECT HEAD, TIME IT,
DON’TRESTRAIN,NOTHINGIN THE MOUTH
 FOR EVERY ER- FIRSTSTEP IS TO CALL THE NURSE

7. 22. RESPECTINGSEXUAL NEEDS
 KNOCK,LISTEN TO BE INVITEDIN (IFRESIDENT ABLE TO RESPOND)
 IF YOU ENCOUNTER CONSENSUALSEX,GIVE PRIVACYANDLEAVEROOMINFORMNURSE AND
PLACE DO NOTDISTURB SIGN ON DOOR
 BE OPEN ANDNONJUDGMENTALABOUT SEXUAL PREFERENCES ANDORIENTATION
 ALWAYSUSE A TRANSGENDERPERSON’SCHOSEN NAME
23. RESPECTINGSPIRITUAL NEEDS
 LISTEN
 RESPECT FASTING,PRACTICES
 ENCOURAGE PARTICIPATION
 RESPECT RELIGIOUS ITEMS
 PRIVACYDURING CLERGY VISITS
 IF ASKED,YOU CAN READ RELIGIOUS MATERIALS,IF YOU ARE UNCOMFORTABLE, ASKANOTHER
STAFFMEMBER
 NEVERDISCUSS YOUR PERSONALBELIEFS OR TELL A RESIDENT WHAT HE BELIEVES IS WRONG
24. CARINGFOR ADULT WITH INTELLECTUAL DISABILITIES
 TREAT AS AN ADULT
 PRAISEANDENCOURAGE OFTEN
 ASSISTWITH ADLS
 PROMOTE INDEPENDENCE
 ENCOURAGE SOCIALINTERACTION
 REPEAT WHAT YOU SAYAS NEEDED
 IF DOWN SYNDROME, DIVIDETASK INTOSIMPLE STEPS
 IF CEREBRAL PALSY,MAY NEED HELP WITH ADLS, AMBULATION,TOILETING,GENTL EXERCISES,
KEEP BODY ALIGNED
 IF SPINA BIFADA- ASSISTWITHADLSAND ROM
25. USING A WHEELCHAIR
 LOCK BRAKESBEFORE TRANSFERIN/OUT
 FOLD UP FOOTREST BEFORE IN/OUT
 KEEP SEAT PADCLEAN ANDDRY, USE GEL CUSHION TO REDUCE PRESSURE
 HIPSBACK IN SEAT, ARMS ON ARMRESTS, FEET ON FOOTTREST
 PUSH FORWARDUNLESS ENTERINGAN ELEVATOR OR GOING DOWN A RAMP
 REPOSITION EVERYHOUR

8. 26. USE OFSTRETCHERS
 LOCK WHEELS
 SECURE ON STRETCHER WITH SAFETY BELT
 COVERWITH SHEET
 PUSH FROMTHE HEAD ENDENTER DOORWAYSBY OPENINGDOOR,ENTERING FIRSTAND
PULLING STRETCHER THROUGHAT LEAST 3 PEOPLE ARE NEEDED TO TRANSFERONTO/OFFA
STRETCHER
27. MECHANICALLIFTS
 TWO PEOPLE TO USE
 KEEP CHAIRBEING TRANSFERREDINTO CLOSE BY
 HECK FOR DAMAGE BEFORE
 USE CORRECT SLING
 CHECK SLING ANDSTRAPSFOR DAMAGE
 OPEN LEGS OF STANDTO WIDEST POSITION BEFORELIFTING OFFTHE BED
28. WALKERS,CANES ANDCRUTCHES
 CANEHELD ON STRONGSIDE, CANEMOVED, WEAK LEG MOVED, THEN STRONG LEG
 AIDE WALKSLIGHTLY BEHIND, ON WEAK SIDE IFASSISTINGWITH AMBULATION WITH A CANE
 GAIT BELT OVERCLOTHES, BELOW BREAST, SNUG AROUND WAIST,HELD WITH HANDSFACING
UP
 PLACE WHEELCHAIR ON STRONG SIDE
 QUAD CANEHAS FOUR TIPS
 WEIGHT IS SUPPORTEDBY UPPER ARMS WHEN USING CRUTCHES, NEVERTHE UNDERARMS
 WHEN USING A WALKER,BOTH HANDSON WALKER, PLACED6 INCHESIN FRONT,STAY NEAR
RESIDENT ON WEAKER SIDE
29. ADMISSION
 PREP ROOM: OPEN BED, GET SUPPLIES,ADMISSION KIT
 ID SELF, SMILE, BE FIRENDLY
 NOTE WHO IS WITH RESIDENT, RESIDENT’SMOOD
 EXPLAIN DAY-TO-DAYLIFE,ORIENTTO SURROUNDING, SHOW HOW TO USE CALL BELL
 UNPACKANDCOMPLETE BELONGINGSCHECKLIST
 GET HEIGHT ANDWEIGHT
 12 INCHES= 1 FOOT
 USE TAPEMEASURE FROMTOP OF HEAD TO HEEL IF UNABLE TO STAND
 USE SAME SCALE,SAME AMOUNT OFCLOTHING, SAME TIME OF DAY TO GET ACCURATE
WEIGHT

9. 30. RESIDENT’SUNIT
 KEEP NEATAND CLEAN
 WIPE OVERBEDTABLE
 REMOVE MEAL TRAYS RIGHT AFTER MEALS
 STRAIGHTEN BED, REMOVE CRUMBS
 RESTOCK SUPPLIES
 REFILL WATER PITCHER
 EMPTY TRASH OR NOTIFYHOUSEKEEPING
 REPROT INSECTS
 DON’TMOVE OR THROW AWAYBELONGINGS WITHOUT PERMISSION
 OFFER TO HELP ORGANIZEANDARRANGE ITEMS
31. BEDMAKING
 MAKE WRINKLE-FREE,DRY BED
 HOLD LINEN AWAYFROMYOUR BODY
 COLLECT IN ORDER OF USE
 PLACE ON CLEAN DRY CHAIROR OVERBED TABLE IN ROOM
 WEAR GLOVES TO REMOVE SOILED SHETS
 LOOF FORJEWELRY, MONEY, DENTURES, GLASSESBEFORE STRIPPINGSHEETS
 FOLD DIRTIEST PARTSOF SHEETS INSIDEWHEN REMOOVING
 DON’TFAN SHEETS
 MAKE ONE SIDE AT A TIME
 BAG SOILED LINEN AT POINTOF ORIGIN
 DON’TPLACE LINEN ON FLOOR
32. SKIN CARE
 REPORT DISCOLORATION,ETC
 REPOSITION Q2H
 CLEAN INCONTINENTRESIDENTQ2H
 MASSAGE WITH LOTION WITH LITTLE OR NOPRESSURE OVER BONYAREAS
 DO NOT MASSAGEOVER WHITE, RED OR PRUPLE AREAS
 ENCOURAGE GOOD NUTRITION ANDHYDRATION
 KEEP PLASTICOR RUBBER AWAYFROMSKIN
 MAKE A WRINKLEFREE BED
 NEVERPULL RESIDENT ACROSSSHEETS OR PULL SOMETHING FROMUNDER RESIDENT- CAUSES
SHEARING
 LEAVE IN A LOW FOWLER’S AFTER MEALS, REPOSITION EVERY15 MINUTES IFIN A CHAIRAND
CANNOTMOVE SELF
 RELIEVER PRESSURE WITH PILLOWS,SPECIALMATTRESSES, BED CRADLES,TOE PLEATIN
OCCUPIED BED,

10. 33. POSITIONINGDEVICES
 USE A DRAWSHEET TO MOVE IN BED
 USE A FOOTBOARDTO PREVENT FOOTDROP
 USE A BED CRADLE TO KEEP BED COVERSFROM RESTING ON LEGS
 HANDROLLSTO PREVENT HANDCONTRACTURES
 ORTHOTIC DEVICESTO SUPPORAND ALIGN AN ARM OR LEG (SPLINTS)
 TROCHANTERROLLS ARE PLACED ALONGHIPS ANDLEGS TO PREVENTTURNING OUT
 ABDUCTION WEDGE/PILLOW TO KEEP HIPS ABDUCTED
34. BATHING
 FACE,HANDS,UNDERARMS, PERINEUMWASHED EVERYDAY
 RINSESOAPWELL
 REDUCE DRAFTS,COVERWITH BATH BLANKET
 GATHER SUPPLIES before soresidentisn’tleftalone
 Checkwatertemp(inside of wrist,thermometer) andconfirmwithresident(105 forfootcare
and perineal care;105-115 for restof body
 Wear gloves
 Remove all soap
 Pat skindry
 Separate part of washcloth to washeacheye- innertooutercanthus
 Onlyexpose partbeingwashed
35. Showers
 Do not leave residentalone
 Make sure safety/grabbarsare inworkingorder
 Dry floor
 Have residentsitinshowerchair
36. Footand nail care
 File andclipfingernailsstraightacross
 No lotiononpalmsof handsor betweentoes
 File fingernailsinone direction,notbackand forth
37. Shaving
 File indirectionhairgrows
 Holdskin taut
 Disposable razorin sharpscontainer

11.  Safetyrazor has a sharp blade andcomeswitha safetycase (notcommonlyused)
 Electricrazor bestfor diabeticsandthose onan anticoagulantmedication(bloodthinners)
38. Hair care
 Combin sections
 If tangled, workfromendstowardscalp
 Long hairpinnedup,braided
 Cleancombor brush
 Protecteyesfromsoapwhenshampooing
 Nevercuthair
39. Dressing
 Offerchoices
 Undressunaffectedside /dressaffectedside
 Blouse/shirt,thenpantsandsocks/shoes
40. Routine mouthcare
 Place infowler’sposition
 Done afterbreakfastandbedtime (HS)
 Must be able toexpectorate (spit)
 Brush inner,outerandchewingsurfacesinthisorder,use shortstrokes,brushbackandforth
 Include the tongue
41. Mouthcare forunconscious
 Done Q2h
 Place inlateral positiontopreventaspiration
 Done withswabsor toothettes
42. Denture care
 Use tepidwater,store indenture cupfilledwithtepidwater(hotwaterwill warpthe plate)
 Line sinkwithtowel toprotectfromdamage
 Remove atbedtime
 Alwaysrinse dentureswellbeforebrushing
43. Basic nursingskill
 For pulse- use radial artery,thumbside of wrist,don’tuse yourthumbtomeasure
 Newbornpulse 120 to 180 beats/min;small kidsrange from100 to 120 beats/min

12.  Brachial artery usedforBP; apical pulse requireslisteningoverapex of heartwithastethoscope
 For respirations,don’ttell the personyouare measuring,pretendto take pulse
 Top numberof BP issystolic;bottomnumberisdiastolic(report140 or > or 90 or >
 Use the rightysize BPcuff to avoidwrongreadings
 Nevertake a BP onthe side where amastectomy wasdone or the personhasa dialysisaccess
inthat arm
 Hot and coldapplicationsmustbe checkedevery15minutesandneverleftonfor>20 minutes
 Don’tapplyhot/coldapplication directlytoskin
 Coldconstrictsor closesbloodvessels
 Heat dilatesoropensbloodvessels
 Reportpainimmediately
 Reposition,assistwithambulation,give abackrub, warmshower,encourage slow,deep
breathing,be empatheticif personinpain
 Do performa nonsterile dressingchange youwill needtochange yourglovestwice;toperform
a dressingchange whichrequiresyoutocleanthe wound,youwill needtochange yourgloves3
times
 If residentonO2- donot adjustlevel,make sure humidifyingbottle isnotempty(tell nurse),
nasal cannulathat is soiled,crackedorhardshouldbe replaced;aftercoldor flushouldbe
changed
 Make sure O2 concentratorisat least6 inchesfroma wall
 Wait 15-20 minutesafterhot/coldliquid,exercise,cigarette before takinganoral temp
 Simspositionforrectal temp,holdthermometerinplace,lubricate- mostaccurate wayto
measure
44. Preventingunintendedwtloss
 Foodshouldlook,taste,smell good- have apositive tone of voice whendescribingfood
 Assistwithfeedingprn
 Seasonto residentpreferences
 Allowenoughtime tofinishmeal
 Recordmeal/snackintake
 Positionupright
 If residenthaslossof appetite- askabout
 Reportpoor intake
45. Assistwith elasticbandages(ace wraps)
 Keepthe areato be wrappedcleanand dry
 Applysnuglytocontrol bleedingandpreventmovement,butnotcut off circulation
 Wrap in a figure-eightpattern
 Check10-15 minutesafterapplicationtoensure fingers/toesare warmandpink
 Checkfor loosenessorwrinkles

13. 46. Assistingwithtube feedings
 Keeptubingunkinked
 Be aware of NPO orders
 Mouthcare Q2h
 HOB elevated30degreesatall times,butduringfeeding45degreesorhigherandleave upfor
at least30 minutespc
 Reportswelling,drainage,accidental removal of tube
47. ServingMeal trays/promotingappetite
 Wash yourhands,wash residenthands
 ID residentandmake sure menucard hasright dietforrightperson
 Serve all residentsatone table before movingtonext
 Serve feederslast
 Do not touch,taste or blowon foodor
 Shouldhave beentoiletedandallowedtosaygrace
 Foodshouldbe servedatpropertemp
 Place handoverfoodto determine temp
 Place residentin90 degree position
 Offerchoices
 Use builtuputensilsasneeded
48. DiningTechniques
 Use assistive devices
 Use hand-over-handtechniquetoguide handtomouth
 Give verbacues“ope” “swallow”
 Setfoodup for visuallyimpairedlikeanimaginaryclock
 If CVA,place foodinunaffectedside of mouth
 Keepbodyingoodalignment(straight)
 Is visuallyimpaired,place foodinfieldof vision
 Checkfor pocketing
49. Preventingaspiration
 Offersmall spoonfuls
 Feedslowly
 Make sure mouthis emptybefore placingmore foodin
 Leave upfor 30 minutespc

14. 50. Preventingdehydration
 Force fluids(encourage)offeravarietyof fluids(approx.6ounces) every2hr while awake
o