What are the precautions to prevent a resident from falling?
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What are the precautions to prevent a resident from falling?
1. Assess the needs of the resident. 2. If the resident is identified as "risk for falls," a sign should be placed so all staff knows to be alert for extra precautions. 3. While the resident is in bed, the bed should be kept in the lowest position, with side rails up. 4. Before standing, allow the resident to sit or dangle at the edge of the bed to prevent dizziness. 5. The resident should wear rubber-soled shoes or socks with grippers. 6. The floor should be free from small rugs, puddles, or items that could cause the resident to trip. 7. During standing or transferring, brakes on the bed and wheelchair must be locked.
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The process of exchanging information with others by sending and receiving messages
Communicating involving the use of spoken or written words or sounds
Communicating without using words
The different groups of people with varied backgrounds and experiences who live together in the world
A system of learned behaviors, practiced by a group of people, that are considered to be the tradition of that people and are passed on from one generation to the next
Phrases that are used over and over again and do not really mean anything
Information based on what a person sees, hears, touches, or smells
Objective information/Signs
Information that a person cannot or did not observe, but is based on something reported to the person that may or may not be true
Subjective information/Symptoms
The inability to control the bladder or bowel's
Skin that is blue or gray
An accident, problem, or unexpected event during the course of care that is not part of the normal routine in a healthcare facility
An accident or incident that results in great physical or psychological injury or death
A loss of function or ability
The ability to see objects in the distance better then objects near by
The ability to see things near but not far
A condition that occurs when blood supply to part of the brain is blocked or a blood vessel leaks or ruptures within the brain
Cerebrovascular accident/stroke/CVA
Paralysis on one side of the body
Weakness on one side of the body
Slurred speech or and an ability to speak
Inability to understand spoken or written words
Laughing or crying without any reason or when it's inappropriate
Violet or hostile behavior
Guidelines: careful documentation
Document care –
immediately after it is given
Use black ink
Mistake – draw one line and right correct information then initial and date
As specified in the care plan
Use 24 hour clock or military time
Think before documenting – be brief and clear
Use facts, not opinions
Sign full name and title date
Guidelines: incident reporting
Tell what happened – time and the mental and physical condition of the person
Tell how the person tolerated the incident – his reaction
State the facts; do not give opinions
Do not write anything in the incident report on the medical record
Describe the action taken to give care
Include suggestions for change
Guidelines: telephone communication
When making a call, follow the steps:
Always identify yourself before asking to speak to someone never ask who is this when someone is calling
After identifying – ask for a person with whom you need to speak
Person available – identify self again; state why you are calling
Person not available – ask to leave a message
Leave a brief clear message – name facilities name phone number and brief description of why you call
Be polite – thank person who takes message
When answering calls, follow the steps:
Always identify facilities name, your name and your position
Place call her on hold – if you need to find the person the collar wishes to speak with
Call are leaving message – write down and repeat
Thank the person for calling and say goodbye
Guidelines: hearing impairment
Make sure resident is wearing it and turned on
Reduce or remove noise – close doors if needed
Get residents attention before speaking
Speak clearly slowly and in good lighting directly face the person
Do not shout or mouth the words in exaggerated way
Pitch of voice– Low
Resident may read lips – no chewing gum or eating while speaking
Resident here's better out of one ear – speak and stand on that side
Use short sentences and simple words
Repeat what you have said using different words
Use picture cards or notepad
Some have speech problems and difficult to understand Dash asked to repeat or write down
Be understanding and supportive – hearing to Decline normal for age
Guidelines: vision impairment
Eyeglasses -clean and being worn and fit well
Contact lenses – leave care to resident
Knock on door and identify self– Let resident know when leaving
Proper lighting in room – face resident when speaking
Entering new room with resident – orient him or her to where things are
Always explain what you were doing while caring for resident – give specific directions
Imaginary clock – guide to explain position of objects
Personal items or furniture – do not change the position
Call light– Tell resident where it is
Doors – completely open or completely closed
Walking – walk slightly ahead of resident and let resident touch arm
Encourage the use of other senses
Use large clocks, clocks that chime and radios to help keep track of time
Resident guide dog-do not play with, distract, or feed it
Guidelines: communication and stroke
Questions and directions – simple
Ask yes or no question
Agree on signals
Listen attentively – give time to respond
Resident can write – pencil and paper
Use weaker or involved to referred to side with paralysis or weakness
Call light – within reach
Verbal and nonverbal communication – express your positive attitude
Aid communication –Use communication boards or special cards
Guidelines: combative behavior
Never hit back – block physical blows or step out of the way
Allow resident time to calm down
Insured the resident is safe and give him or her space – at least arm's-length away
Remain calm – lower tone voice
Be flexible and patient
Stay neutral – no responding to verbal attacks or argue or accuse
Gestures– No frightening or startling
Consider what provoked the resident
Report inappropriate behavior to nurse
Guidelines angry behavior
Stay calm
Do not argue or respond to verbal attacks
Empathize with resident
Try to find out what caused the anger
Treat resident with dignity and respect
Answer call lights promptly
Stay at a safe distance if resident becomes combative
Briefly describe three steps in the communication process.
First step – sender sends a message
Second step – receiver receives message
Third step-provides feedback by restating message or responding
Give one example of nonverbal communication.
Tone- How a person says something
Body language
Facial expressions
Posture
What is some positive responses to cultural diversity?
acceptance and knowledge
Not bias
Why should "why" questions be avoided when talking with residence?
It makes people feel defensive and you may receive an angry response
If a resident speaks a different language than the nursing assistant does, what can the nursing assistant do?
Speak slowly and clearly
keep message short and simple
be alert for words resident understands or signs that resident is pretending
may need pictures or
gestures
ask someone to interpret
What is one way to provide feedback while listening?
Focusing on the person sending message and giving feedback by showing acknowledgment,
a question, or
repeating sanders message
What can silence or pauses help a resident do?
Encourages the other person to gather their thoughts and compose messages
What is one reason that a nursing assistant should not ignore a resident's request?
It is considered a negligent behavior
With whom should NAs use medical terminology – care team members or residents and their families?
List 10 signs and symptoms that should be reported immediately to the nurse.
SHAW ALL FCCT McB
Falls
Chest pains
Sever headaches
trouble breathing
abnormal pulse, respiration, or blood pressure
change in mental status
sudden weakness or loss of mobility
high fever
loss of consciousness
change in level of consciousness
bleeding
change in residence condition
bruises, abrasions, or other signs of possible abuse
Describe for reasons why careful documentation is important.
Guarantee clear and complete communication among all care team members
Legal record of every residents treatment
Helps protect nursing assistants and there employers from liability by proving what they did
Gives an up-to-date record of the status and care of each resident
When should care be documented – before or after it is done?
Immediately after it is done
Convert 10:00 p.m. to military time.
Convert 1400 hrs. to regular time.
What is considered an incident at a facility?
Something that is not part of the normal routine
A mistake an care such as
feeding a resident from
the wrong meal tray resident falling or being injured
accusations made by resident
Give two reasons why computers maybe used in a facility.
What is the purpose of the resident call light or call system?
Provides a way for resident to call staff for help
When a resident has a hearing impairment on who's face should the light be shining ball communicating – the residents or the nursing assistants?
How can a nursing assistant explain the position of objects in front of a visually impaired resident?
Use an imaginary clock as a guide
How should questions be phrased to a resident who has had a stroke?
Phrase questions so they can be answered with a yes or no
How should a nursing assistant referred to the weaker side of a resident who has had a stroke?
Weaker, involved, affected
What should a nursing assistant always do after a resident behaves inappropriately?
Report the behavior even if they think it was harmless
What should an NA do if resident doesn't hear her, doesn't hear correctly, or doesn't understand?
Face resident and speak directly to resident using a low, pleasant, professional tone of voice.
What should an NA do if a resident is difficult to understand?
Ask resident to repeat or explain and then restate in own words to make sure you understand
Should NAs offer opinions or advice?
No, out of their scope of practice
When communicating with residents, what steps should the NA remember?
Always greet using his/her preferred name
Identify self
Topic being discussed- focus on it
Face resident when speaking
Giving care- talk with resident
Resident speaks- listen and respond
Praise and smile often
Encourage resident to interact with you and others
Be courteous
Leaving room- tell resident
What are some ways to ensure NAs send and receive clear messages?
Be a good listener- allow other person to express ideas completely
Provide feedback- acknowledge, ask question, or repeat senders message
Bring up topic of concern- non threatening way to let resident decide if they want to discuss it
Let some pauses happen- encourages person to gather thoughts and compose messages
Tune into other cultures- learn words and expressions
Accept resident's religion or lack of- respect resident, do not question their beliefs, and don't discuss your beliefs
Understand the importance of touch- ask permission, learn about resident's and adjust needs
Ask more- resident reports symptoms, events, or feelings- have them repeat- ask for more info
Make sure communication aids clean and good working order
What are some ways that could help with communication and developing good relationships?
Avoid changing subject resident wants to talk about-
Do not ignore residents request- considered negligent behavior; either honor or explain why can't be fulfilled and report
Do not talk down to an elderly or disabled
Sit or stand near resident who started conversation
Lean forward in chair when resident is speaking
Talk directly to resident
Approach the person who is talking
Put self in resident shoes- empathize
Sho resident families and friends that you have time for them too-
listen, give privacy for visits, ask family questions: great source of infoAfter an oral report, what must an NA do?
Document when, why, about what, and to whom the oral report was given
What is the key to care planning?
What does a medical chart include?
Admission, graphic, and flow sheet
Medical history
Doctor orders
Progress and nurses notes
Test results
What should be filed if a resident falls, nursing assistant makes a mistake in care, NA or resident breaks or damages something, resident or family makes request outside NAs scope of practice, a resident or family makes sexual advances or remarks, or NA injured on job, exposed to blood or bodily fluids?
An incident report must be filed
What is the most common type of stroke?
Ischemic stroke- blood supply is blocked, brain cells begin to die- no oxygen
After a resident has a stroke, what might they experience?
Hemiplegia
Hemiparesis
Expressive and/or receptive aphasia
Loss of sensation and cognitive abilities and memory
Incontinence
Confusion
Poor judgment
One-sided neglect
Emotional lability
Dysphagia
What maybe the cause of combative behavior?
Disease affecting brain
Frustration
Personality
A person expresses thoughts, feeling, and beliefs in a direct honest way and involves respect for a persons own needs and feelings and for those of other people
A person expresses his thoughts, feelings, and beliefs in a way that humiliates, disgraces, or overpowers the other person and little or no respect is shown for the needs for feelings of others
This sheet contains protected health information about the person, such as name address, Social Security number, date of birth, and email address among other items
Shows illnesses, immunizations, medications, previous surgeries, family and social history
This provides instructions given to other members of the care team
This shows updates from all care team members detailing changes or new information in the persons condition
This shows blood test, lab results, other tests
This shows the person is reported symptoms and actions taken to address them
Check off sheets for documenting care; may also be called ADL sheet