This document provides guidelines for caregivers on proper conduct and care procedures. It addresses 29 topics, including professional behavior, protecting resident rights and privacy, documentation, incident reporting, caring for those with disabilities, emergency procedures, and admission processes. Adhering to the guidelines helps caregivers perform their jobs well while protecting residents and avoiding liability issues.

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