CNA Study Guide: Long-Term Care Part 2

Answer: Tissue lining the uterus

Answer: A hollow, muscular organ

Answer: Endometrium breaks up and is discharged from the body

Answer: Male sex cell (sperm) unites with female sex cell into one cell (46 chromosomes -- 23 from each).

Answer: Skin loses its elasticity; Fatty tissue layer is lost and makes person more sensitive to cold (protect from drafts); Oil & sweat glands decrease; Dry skin occurs and causes itching and is easily damaged; Skin is fragile and easily injured; Skin breakdown & pressure sores are risks; Skin has fewer nerve endings affecting senses of heat, cold and pain; Nails become thick & tough; Hair turns white or gray and thins

Answer: Produce less saliva which can cause difficulty swallowing (dysphagia); Taste & smell dull; Appetite decreases; Secretion of digestive juices decreases; Loss of teeth & ill fitting dentures cause chewing problems; Peristalsis decreases, stomach & colon empty slower, flatulence & constipation can occur; Dry, fried, & fatty foods avoided to help with swallowing and digestion problems; Oral hygiene and denture care improve tase; High-fiber foods are hard to chew & can irritate intestines; Persons with chewing problems or constipation often need foods providing soft bulk (whole grain cereal, cooked fruits & veggies)

Answer: Bone is broken but the skin in intact

Answer: Broken bone has come through the skin

Answer: Moving the bone back into place - skin is not open

Answer: Involves surgery. The bone is exposed and brought back into alignment with nails, rods, pins, screws, plates, or wires

Answer: Joint inflammation; Pain and decreased mobility occur in the affect joints

Answer: Degenerative joint disease that occurs with aging, joint injury and obesity. Hips, knees, spine, fingers, and thumbs are affected. Joint stiffness occurs with rest and lack of motion. Pain occurs with weight bearing and joint motion. Pain affects rest, sleep, and mobility. Cold weather & dampness seem to increase symptoms

Answer: A chronic inflammatory diease that causes joint pain, swelling, and stiffness. Most common in women and can occur at any age. Some persons need joint replacement surgery

Answer: Lateral position prevents aspiration; Coughing & Deep breathing are encouraged; Bed is kept in semi-Fowler's position; Turning & repositioning are done at least every 2 hrs; Food & fluid needs are met; Elastic stockings prevent thrombi in the legs (blood clots); ROM exercises prevent contractures; Catheter is inserted or bladder training program is started; Bowel trining program may be needed; Safety precautions are practiced (use bed rails according to care plan); Keep signal light within reach on the person's UNAFFECTED side (if unable to use signal light, check person often); Person does as much self-care as possible (assist as needed); Communication methods are established. Magic slates, pencil, paper, picture board, or other methods are used. Limit questions to yes or no answers. Speak slowly. Allow person time to respond; Good skin care prevents pressure ulcers; Speech, physical, and occupational therapies are ordered; Assistive & self-help devices are used as needed; Support, encouragement, & praise are given; Complete a safety check before leaving the room

Answer: Sudden numbness or weakness of the face, arm, or leg - especially on one side; Sudden confusion, trouble speaking, or understanding; Sudden trouble seeing in one or both eyes; Sudden trouble walking, dizziness, loss of balance or coordination; Sudden, sever headaches with no known cause

Answer: Gain attention and alert person to your presence (DO NOT startle person); Position at person's level; Face person when speaking; have person wearing hearing aid and make sure it's on; have person wearing needed eyeglasses to help for speech-reading; Speak clearly, distinctly and slowly; adjust the pitch of your voice as needed and ask person if he or she can hear better now (lower without hearing aid and raise pitch with a hearing aid); DO NOT cover your mouth, smoke, eat, or chew gum while talking; keep hands away from face; stand or sit on side of better ear; State topic of conversation first; Tell person when you are changing the subject; Use short sentences and simple words; Use gestures & facial expressions to give useful clues; Write out important names and words; Say things in another way if person looks confused; Keep conversations & discussions short; Repeat & rephrase statements as needed; Be alert to messages sent by your facial expressions, gestures, and body language; Reduce or elimante background noise (shut-off radios, stereos, TVs air conditioners, and fans)

Answer: Bacterial infection in the lungs that is spread by airborne droplets with coughing, sneezing, speaking & singing (respiratory system)

Answer: A sodium-controlled diet

Answer: Made up of glands that secrete hormones that affect other organs and glands

Answer: Occurs most often in children & young adults: Pancreas produces little or no insulin; Onset is rapid, increase in thirst & urination, constant hunger, weight loss, blurred vision, and extreme fatigue. Treated with daily insulin therapy, healthy eating, & exercise

Answer: Occurs in adults - persons over 40 at risk; Obesity & hypertension are risk factors; Pancreas secretes insulin, however the body cannot use it well; Onset is slow; Person has fatigue, nausea, frequent urination, increased thirst, weight loss, blurred vision, infections frequently, wounds heal slowly. Treated with healthy eating , exercise, oral drugs, sometimes-insulin, weight loss for overweight persons

Answer: Answer: Develops during pregnancy and usually goes away after the baby is born; At rish for type 2 diabetes later in life

Answer: Low sugar in the blood

Answer: High sugar in blood

Answer: Small pouch in colon that is turned inside out

Answer: Condition of having diverticulum (small pouches turned inside out in the colon)

Answer: Infected or inflamed pouch (diverticulum) in the colon. Common in older persons; Low-fiber diet and constipation are risk factors.

Answer: Life threatening disease called Human Immunodeficiency Virus that causes AIDS - attacks the immune system. No vaccine or cure

Answer: Make up for, replace, or substitute. Person makes up for or substitutes a strength for a weakness (Example: Boy is not good in sports. He learns to play music)

Answer: To change. An emotion is shown or changed into a physical symptom (Example: Girl does not want to read out loud in school. She complains of a headache.

Answer: Refusing to accept or believe something that is true. Person refuses to face or accept unpleasant or threatening things (Example: Man has a heart attack. Continues to smoke after being told to quit.)

Answer: Move or take the place of. Individual moves behaviors or emotions from one person, place or thing to a safe person, place or thing (Example: You are angry with your boss. You yell at a friend.)

Answer: Blame another. Individual blames another person or object for unacceptable behaviors, emotions, ideas, or wishes (Example: Girl fails a test. She blames a friend for not helping her study.)

Answer: Sensible, reasonable, or logical. Acceptable reason or excuse is given for one's behavior or actions (Example: Man is often late for work. He did not get a raise. He says that the boss does not like him.)

Answer: Move back or to retreat. Person retreats or moves back to an earlier time or condition (Example: 3 year old boy want a baby bottle when a new baby comes into the family.)

Answer: Hold down or keep back. Person keeps unpleasant or painful thoughts or experiences from the conscious mind (Example: Child was sexually abused. Now 33 years old, she has no memory of the event.)

Answer: Vague, unesy feeling in response to stress. Person senses danger or harm (real or imagined) Person acts to relieve unpleasant feeling. Often occurs when needs are not met. SOME anxiety is normal

Answer: Panic is an intense and sudden feeling of fear, anxiety, terror, or dread. Onset is sudden with no obvious reason. Person cannot function. Signs & symptoms of anxiety are severe (Pain attacks can last for a few minutes or for hours)

Answer: Fear, panic or dread. Person has an intense fear of an object, situation, or actgivity.

Answer: Obsession - Recurrent, unwanted thought or idea. Compulsion - Repeating an act over and over again (a ritual). The act may not make sense, but the person has much anxiety if the act is not done.

Answer: The heart and breathing stop suddenly and without warning

Answer: Before starting chest compressions, check for pulse in the carotid artery on the side near/closest to you. Place 2 fingers on person's Trachea (windpipe) and then slide fingertips down to the groove of the neck

Answer: Bleeding occurs inside the body into tissues and body cavities. Pain, shock, vomiting blood, coughing up blood, and loss of consciousness signal internal hmorrhage. Keep person warm, flat, and quiet until medical help arrives. DO NOT give fluids.

Answer: Usually can be seen if not hidden by clothing. Bleeding from an artery occurs in spurts.

Answer: Healthy adult produces about 1500 ml of urine a day.

Answer: Thin rim bedpan about 1/2'' deep at one end. Smaller end is placed under buttock. Used for: 1. Persons with casts or in traction 2. Persons with limited back motion 3. After spinal cord injury or surgery. 4. After hip fracture or hip replacement surgery.

Answer: Follow Standard Precautions & Bloodborne Pathogen Standard. Allow urine to flow freely through catheter or tubing and DO NOT allow person to lie on it. Keep catheter connected to drainage tubing. Keep drainage bag below bladder. Attach bag to bed frame, back of chair, or lower part of IV pole (DO NOT ATTACH TO BED RAIL OR PUT ON FLOOR). Coil drainage tubing on the bed and secure to bottom linen (tubing must not loop below the drainage bag). Secure catheter to inner thigh or to a man's abdomen (prevents excess movement and friction at insertion site). Check for leaks; Provide catheter care daily or twice a day (follow care plan). Empty bag at end of shift or as nurse directs, measure and record amount of urine, report increases or decreases in amount or urine. Use separate measuring container for each person (prevents spread of microbes). Do not let drain on bag touch any surface. Encourage fluid intake as instructed by the nurse.

Answer: 9 calories

Answer: 4 calories

Answer: 4 calories

Answer: Person's with feeding tubes are at risk for aspiration. The tubing can move out of place from coughing, sneezing, vomiting, suctioning, or poor positioning and move from the stomach into the esophagus & then into the airway. (RN CHECKS PLACEMENT - NEVER NA's RESPONSIBILITY)

Answer: Amount of fluid taken in (intake) and the amount of fluid lost (output) must be equal. Adult needs 1500 ml of water daily to survive. 2000 - 2500 ml of fluid perday are needed for normal fluid balance

Answer: 98.6 - 100. 6 degrees F - - Taken when the oral route cannot be used. Rectal temps are NOT taken if the person has diarrhea, rectal disorder or injury, heart disease, had rectal surgery, is confused or agitated.

Answer: 97.6 - 99. 6 degrees F - - Oral temperatures are NOT taken if person: Unconscious; Infant or child under 6; Has had surgery or injury to face, neck, nose, or mouth; Is receiving oxygen; Breathes through mouth; Has NG tube; Delirious, restless, confused, or disoriented; Paralyzed on one side of body; Has a sore mouth; Has a seizure/convulsion disorder

Answer: 98. 6 degrees F - - This site (the ear) has fewer microbes than the mouth or rectum, so risk of spreading infection is reduced. This site is NOT used if person has: Ear disorder; Ear drainage

Answer: 96.6 - 98.6 degrees F This site (under arm) is less reliable than other sites. It is used when the other sites cannot be used.

Answer: Between 60 - 100 beats per minute. (Report abnormal rates less 60 and more than 100 to nurse at once.)

Answer: 120/80 is normal. Report any hypertension - (systolic pressure above 120 mm Hg or diastolic pressure above 80 mm Hg) and report any hypotension - (Systolic pressure below 90 mm Hg and diastolic pressure below 60 mm Hg)

Answer: Pulse on each side of temple: temporal artery

Answer: Pulse felt on either side of neck; carotid artery

Answer: Pulse felt on the left side of chest slightly below the nipple. Taken with a stethoscope.

Answer: Pulse felt in bend of either arm (inner side - follow arm up from pinkie finger) Brachial Artery

Answer: Used for routine vital signs. Pulse felt on either wrist (thumb side); Radial Artery

Answer: Pulse felt on either side of the groin; Femoral artery

Answer: Pulse felt at the back of either knee; lower part of femoral artery

Answer: Pulse felt on inside of either ankle

Answer: Pulse felt at top of bridge of either foot

Answer: Foods liquid at body temp and which leave small amounts of residue; non-irrating and non-gas forming; Liquids you can see through

Answer: Foods liquid at room temp or melt at body temperature; Foods on clear liquid diet PLUS custard, eggnog, strained soups & fruit, vegetable juices; milk & milk shakes; strined cooked cereals; plain ice cream and sherbet; pudding; yogurt

Answer: Pressure, friction, and shearing, breaks in the skin, poor circulation to an area, moisture, dry skin, irritation by urine & feces. Older & disabled people at greater risk because skin is easily injured.

Answer: Caused by friction and shearing, pulling, or pressure on the skin

Answer: Keep person's & your fingernails short and smoothly filed. Do NOT wear rings or bracelets. Follow the care plan & safety rules to move, position, transfer, bathe, & dress person. Prevent shearing & friction. Use an assist device to move & turn the person.

Answer: Use correct size. Position the part in good alignment. Face the person during procedure. Start at lower (distal) part of extremity and work upward to the top (proximal) part. Expose fingers or toes if possible allowing for circulation checks. Apply bandage with firm, even pressure. Check color & temp of extremity every hour. Re-apply a loose or wrinkled badage. Replace a moist or soiled bandage.

Answer: Penetrates deeper than dry cold. Example: Cold Compress

Answer: Penetrates deeper than dry heat. Water is in contact with the skin. Water conducts heat and has greater and faster effects than dry heat. Example: Hot compresses, Hot soaks, Sitz baths, Hot packs

Answer: Exercises help persons with repiratory problems. They are done after surgery & during bedrest and are painful at this time - Breaking an incision open while coughing is a fear. Usually done every 2 hours

Answer: NA's can ONLY check the oxygen flow rate and report to nurse at once if it is too high or too low. RN or respiratory therapist adjust the flow rate.

Answer: Dying people have psychological, social, and spiritual needs. They may want family or friends present, talk about their fears & worries especially at night when things are quiet. You need to listen and use touch, Some people want to see a spiritual leader or want to take part in religious practices. Provide privacy during prayer & spiritual moments. Person has right to have religious objects nearby (medals, pictures, statues, or religious writing) Handle these valuable with care and respect.

Answer: Care begins after doctor pronounces the person dead. Postmortem care is given by a nurse and you may be asked to assist. Care is done to maintain good appearance to the body and prevent discoloration and skin damage. Right to privacy and to be treated with dignity & respect apply after death.

Answer: The body is positioned in normal alignment before rigor mortis sets in. Body should appear in a comfortable and natural position for family viewing