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CNA Study Guide
South Dakota Certified Nursing Assistant
| Term | Definition |
|---|---|
| Parkinson's Disease | Nerve cell damage in the brain causes dopamine levels to drop, leading the symptoms of Parkinson's Often starts with a tremor in one hand |
| Early Signs of Parkinson's | Sleep problems, tremor, smell loss, constipation, small handwriting, depression, bradykinesia, fatigue, masked face, moving slowly, restlessly sleeping, rigidity |
| Pill-rolling | A type of tremor (resting) characterized by simultaneous rubbing movements of thumb and index fingers against each other |
| Sputum Collection | (phlegm) Early morning sample is best |
| Sputum Culture | A test to detect and identify bacteria or fungi that infect the lungs or breathing passages |
| HIV/AIDS | Human Immunodeficiency Virus and Acquired Immunodeficiency Syndrome HIV- attacks body's immune system; if not treated, can lead to AIDS; can be controlled with proper medical care Transferred via blood, semen, vaginal secretions and breast milk |
| Foot Cradle | A bed cradle is a frame that is installed at the foot of the bed to keep sheets and blankets off legs and feet Helps with air circulation, sensitive skin and keeping skin dry (in bed for long periods of time) |
| Physical Signs of Aging | Grey hair, wrinkles, age spots, less able to store fluids, spinal discs shrink and lose elasticity, shrinking body height Bones tend to shrink in size and density, weakening them and making them more susceptible to fracture |
| Bath Water Temp | 100-105 Degrees Turn on cold then hot Turn off hot then cold |
| Cold and Warm Packs | Wrap pack in thin towel, apply to painful area for 15-20 minutes, Check on resident every 5 minutes |
| Jaundice | Associated with Liver Infection(s) Yellow skin, yellow coloring in mouth, dark urine, pale stools, itching (pruritis) Too much bilirubin in blood (hyperbilirubinemia) |
| Transmission of Infection | Occurs when a person with an infectious disease touches or exchanged body fluids with someone else |
| Falls | Most common accident in elderly Fractures of hip, forearm, humerus, pelvis |
| HIPPA | Health Insurance Portability and Accountability Act of 1996 Signed into law by Bill Clinton |
| TED Hose | Put on in morning and take off at night TED Hose are specially designed to help prevent blood clots and swelling in legs (Thrombo-Embolic Deterrent) |
| Antiembolic Stockings | Antiembolic Stockings are tight stockings designed to reduce the risk of deep vain thrombosis and pulmonary embolism |
| Signs of Dying | Sudden burst of energy, blotchy skin, decreased BP, less urine, cannot swallow, congested lungs |
| Fowler's Position | Head of bed is elevated between 45-60 degrees Commonly used for head, shoulder, and chest surgeries and respiratory distress syndrome Facilitates breathing |
| Semi-Fowler's Position | Supine position where head of bed is elevated 30-45 degrees and legs of patient can be flat or bent at the knee |
| Prone | Person lies flat with chest down, dorsal side up, ventral side down 180 degree contrast |
| Semi-Prone | Patient laying face down, one or both knees flexed to one side |
| Sims' Position | Patient assumes posture halfway between the lateral and prone position Lower arm is behind client, upper arm is flexed at shoulder and elbow |
| Hemiplegia | Hemi- one side Pleg- paralysis Muscle weakness or partial paralysis on one side of the body (arms, legs, facial muscles) |
| Quadriplegic | Quad- neck down Pleg- paralysis Person who is permanently unable to move or feel both arms and legs (injury or illness) |
| Hydration | The replacement of body fluids lost through sweating, urination, exhaling and eliminating waste Body loses about 2-3 quarts a day on average |
| Shearing | When the skin sticks to surfaces and can damage the skin Occurs when tissue layers move over the top of each other, causing blood vessels to stretch and break as they pass through the subcutaneous tissue |
| Sun-Downing | Dementia residents have increased behavior after sunset Refers to the state of confusion occurring in late afternoon and lasting into the night |
| Maslov's Hierarchy of Needs | Physiological Needs (air, water, food, sleep) Safety Needs (personal security, employment) Belongingness and Love (friends, relationships) Esteem (self-esteem, status) Self-Actualization (achieving one's full potential) |
| Vital Signs | Measurements of the body's most basic functions 4-6 most crucial medical signs that indicate the status of the body's vital functions Taken to help assess the general physical health of a person, give clues to possible diseases |
| Blood Pressure | The force of blood exerted on the walls of the arteries to move blood through the circulatory system Sphygmomanometer and Stethoscope |
| Normal BP | Systolic : 90-120 mmHg Ventricles contract Diastolic : 60-80 mmHg Ventricles relax |
| Pulse | 60-100 Less than 60 - Bradycardia More than 100 - Tachycardia |
| Anatomical locations of pulses | Apical (left center below the nipple) Carotid (either side of neck, below windpipe) Radial (either wrist, between wrist bone and tendon on thumb side of wrist) |
| Respiratory Rate | 12-20 Breaths per minute (normal) Rate at which breathing occurs, it is set and controlled by the respiratory center of the brain |
| Diaphragm | Major muscle of respiration (breathing in and out) Separates the thoracic and abdominal cavity Dome shaped It's contraction increases volume of thorax and inflates the lungs |
| Cerebrovascular Accident (CVA) | A stroke or brain attack, interruption in the flow of blood to cells in the brain When cells are deprived of oxygen, they die |
| Dressing Stroke Patients | Dress the weak side first Undress the strong side first |
| Dysphasia | Difficulty communicating through written or spoken word (language disorder) Occurs when the areas of brain that turn thoughts into spoken words is damaged and cannot function properly |
| PO | per os (oral, by mouth) |
| NPO | Nothing by mouth nil per os Typically used before surgeries |
| Aspiration | accidentally breathing fluid or food into the lungs |
| Gastrostomy Tube/G-Tube | When receiving feeding tubes, head of bed is elevated |
| What population of patients gain daily weights? | Dialysis and heart failure patients |
| Dementia | Multiple types A group of thinking and social symptoms that interfere with daily functioning Forgetfulness and limited social skills, thinking abilities |
| Ambulate | The ability to walk from place to place independently, with or without assistive devices |
| Contracture | Condition of shortening of the muscles, tendons and other tissues that leads to shortening, stiffness and deformity of joints ROM (range of motion) exercises help prevent |
| Osteoperosis | Disease that weakens the bones, caused from deficiency of calcium and vitamin D and protein Thinning of bones with reduction in bone mass Osteo - bone Por- small opening Osis - abnormal condition |
| Integumentary System | Skin, hair, nails, oil/sweat glands With age, skin loses elasticity and becomes dry and thinner |
| Ombudsman | Investigates resident complaints and speaks on behalf of the resident (advocate) |
| Sharps Container | Leak proof, puncture resistant container Opening to accommodate depositing a sharp but not large enough for a hand to enter |
| Seizure | Burst of uncontrolled electrical activity between brain cells that cause abnormalities in muscle tone or movement Epilepsy : seizure from flashing lights |
| Kardex | Nursing Care Plan, individualized plan of care that directs the care the patient receives Developed by RN |
| Standard Precautions | Minimum infection prevention practices that apply to ALL patient/resident care Purpose : to protect healthcare providers from infection and prevent the spread of infection from patient to patient |
| Heart Rate (HR) | Feeling for the heartbeat and counting beats for 30 seconds and multiply times 2 Normal : 60-100 BPM |
| Pressure Ulcer | Injury that breaks down the skin and underlying tissue (bedsores or pressure sores) |
| Pressure Injury | Localized damage to the skin as well as underlying soft tissue, usually over a bony prominence or related to medical devices Developed when a large amount of pressure is applied to an area of skin over a short period of time |
| Hepatitis A | Highly contagious, infection in the liver, preventable by vaccine Spreads from contaminated food or water or contact with infected person(s) Fatigue, nausea, abdominal pain, fever, loss of appetite |
| Hepatitis B | Can be acute or chronic, can cause chronic infection and puts people at high risk for cirrhosis and liver cancer |
| Hepatitis C | Spread through contact with blood from infected person (sharing needles) |
| Hepatitis D | Only occur in people with Hepatitis B also Spread when blood or other bodily fluids from infected person enters body |
| Hepatitis E | Widespread, results in self-limited, acute illness |
| Hepatitis F | Hypothetical Virus |
| Hepatitis G | Can cause mild clinical disease with symptoms associated with acute viral Hepatitis (asymptomatic most of the time) |
| Stage 1 Dementia | No signs, functions normally |
| Stage 2 Dementia | Very mild cognitive decline Occasional forgetting events, words |
| Stage 3 Dementia | Mild cognitive decline More noticeable forgetting, trouble with complex tasks, memory loss |
| Alzheimer's Disease | Progressive disease that destroys memory and other mental functions Brain cell connections and cells degenerate and die, destroying memory |
| Tuberculosis (TB) | Infectious bacteria that effects lungs Spread through coughing/sneezing Cough, nigh sweats, fever, weight loss Mycobacterium tuberculosis (bacteria) |
| Gonorrhea | Sexually transmitted bacterial infection (can cause infertility) Painful urination, abdominal discharge from penis or vagina, can be treated with antibiotics Neisseria Gonorrhoeae Bacterium |
| Carbohydrates | Sugar Molecules, one of three main nutrients found in foods and beverages Body breaks down carbs into glucose (blood sugar) which is the main source of energy for cells, tissues, and organs |
| Canes | Position cane tip 6-10 inches to side and in front of strong foot |
| Walkers | Position 6-8 inches away from feet |
| Cold Emergencies | Frostbite Hypothermia |
| Heat Emergencies | Sunburn Heat cramps Heat exhaustion Heat stroke |
| Burns | 1st degree : not severe 2nd degree : exposed nerve endings 3rd degree : destroyed nerve endings |
| Syncope | Fainting, insufficient supply of Oxygen to brain |
| Epistaxis | Nosebleed |
| Bleeding | Internal : Swelling, vomiting blood, hard to breathe, bruising External : visible, wound and blood exposed |
| Chain of Infection | Infectious Agent Reservoir Portal of Exit Method of Transmission Portal of Entry Susceptible Host |
| Spread of Infection | Contact, Droplet, Airborne, Vehicle (through food/water), Vector (living organisms- mosquitoes) |
| MRSA | Most common multidrug resistant organism Staph bacteria become resistant to antibiotics |
| VRE | Vancomycin-resistant Enterococci Bacteria in genitals |
| CRE | Carbapenem-resistant Enterobacterales Group of bacteria resistant to carbapenems (antibiotic) |
| C. Diff | Clostridioides Difficile Spreads from previous "shed" in stool (contaminated stool) Normal Flora : microorganisms that live in body without causing disease Residents with C. Diff must be placed on contact precautions |
| Legionella | Freshwater habitats (lakes/streams) Spread through human water systems (hot tubs, water fountains, showerheads, faucets) |
| Influenza | Fever, muscle aches, sore throat, chills (last 2-7 days) After exposure, 1-4 days to set, most likely to spread Hard surface - 48 hours Paper, cloth - 12 hours Mandatory yearly vaccine |
| 5 stages of dying | 1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance |
| DNR | Do Not Resuscitate |
| Risk factors of foodborne illness | Inappropriate food storage, undercooking food, ineffective equipment sanitation, using unsafe food/water sources, and substandard personal hygiene |
| Causes of foodborne illness | Bacteria : Salmonella (eggs), E. Coli (undercooked meats), Cholera (rice), Listeria (lunch meats) Viruses, parasites, chemicals, physical contaminants |
| The Big Six 1. Norovirus | 1. Most common, contagious, up to 2 weeks, touching contamination then eating/ingesting, symptoms 10-50 hours after exposure and last 24-72 hours |
| The Big Six 2. Non-typhoidal Salmonella | 2. Primary cause of foodborne illness (hospital/deaths), symptoms 12-72 hours after exposure, lasting 4-7 days |
| The Big Six 3. Salmonella Typhi | 3. Rare, high fevers, aches, weakness, diarrhea, headache, rose-colored rash |
| The Big Six 4. Shiga Toxin-producing Escherichia Coli | 4. E. Coli, bloody diarrhea, symptoms 3-4 days after exposure and last 1-9 days, common in children under 5 and older adults |
| The Big Six 5. Shigella | 5. Shigellosis, highly contagious, symptoms 8-50 hours after exposure, last 5-7 days, common in daycares, prisons and mental health facilities, kids experience rectal bleeding |
| The Big Six 6. Hepatitis A | 6. Fecal waste contamination, symptoms 28-30 days after exposure, last 1-2 weeks or months |
| Food temperatures | Poultry : 165 degrees Eggs, ground pork : 160 degrees Roast, Pork chops : 145 degrees Fruits/Veggies : 135 degrees Danger Zone : 41-135 degrees |
| Tooth | Crown, root, neck, enamel (protects and covers tooth) |
| Diaphoresis | Profuse sweating |
| Bathing | Partial bath : face, underarms, perineal, hands (wash clean to dirty) |
| Levels of Functioning | Independent : no assistance Supervision : encouragement or cueing Limited Assistance : involved, physical help guiding needed Extensive Assistance : requires weight-bearing assistance Total Dependence : no participation, staff completes ADL |
| Grooming Assistance | Velcro, mirrors on stands, good lighting, grooming tools (kit), hold dentures with towel (less slippery) |
| Dressing Assistance | Sock aids, shoe horn, dressing sticks, button hooks/zipper pulls, elastic shoe laces, leg straps, reachers |
| Facial Hair | Safety Razors : considered sharps Electric Razors : used on patient prone to bleeding, improves safety, reduces waste, little to no training required |
| Incontinence | Functional (physical barrier), Stress (weakness of pelvic floor, leakage), Urge (over activity of detrusor muscle), Overflow (weak urine system, impaired muscle contractibility), Mixed (multiple types) |
| Incontinence Management | Urination Diary, prompted voiding, bladder rehabilitation, pelvic muscle exercises (Kegel), incontinence products (briefs), Catheterization |
| Urinary Tract - produces, stores and excretes urine | Kidneys, Ureterus, Urinary Bladder, Urethra Renal System : gets rid of toxins, regulates BP, acid-base balance, controls volume of blood/fluid, aid RBC production, regulate electrolyte levels (sodium, potassium, calcium) |
| Fecal Medication | Oral Osmotic (pulls water into colon, facilitates stool passage), Oral Bulk formers (absorb water and form soft, bulky stool), Oral Stool softeners (adds moisture to stool), Oral stimulants ( triggering intestinal muscle contractions) |
| Fecal Medication other | Laxatives that trigger movement (6-12 hours) Laxatives that soften stool (1-3 days) Immediate support : rectal suppositories (30 mins), enemas (minutes) |
| Prompted Voiding | - monitor (check resident) - prompt (take to bathroom) - praise (even for trying) - inform (when you'll be back) |
| Assistive Eating devices (Cups and Plates) | CUPS : dysphasia (small sips), independence/spill proof (2 handles, lid with straw), nosey (cut out for nose) PLATES : plate-guards (keep food on plate), compartment (divides food), suction (stays on table) |
| Assistive Eating devices (Utensils) | UTENSILS : built-up handle (big grip, arthritis), bent angle (limited mobility), rounded blade knives (prevents food from sliding) |
| Dysphgia | -abnormal, ineffective, difficulty swallowing - drooling, falling out of mouth, gurgling voice, food left in mouth (pocketing) |
| Aspiration Pneumonia | Poor oral hygiene, respiratory conditions, weak cough, poor gag reflex, weak immune system, dementia, dysphagia, dehydration |
| Food Levels | L7 : Black- regular food L6 : Blue - bite-sized L5 : Orange - minced/moist L4 : Green - pureed L3 : Yellow - liquified |
| Drink Levels | L4 : Green - extremely thick L3 : Yellow - moderately thick L2 : Pink - through straw (mild) L1 : Grey - thicker than water L0 : White - water |
| IDDSI Fluid Syringe Test | 10 mL syringe for 10 seconds L4 : 8+ mL remain L3 : 4-8 mL remain L2 : 1-4 mL remain L1 : less than 1 mL remain |
| Swallowing Techniques | Chin Tuck : narrows airway, gives more control over swallowing Head Rotation : tilt/turn head to weak side Effortful Swallow : tongue on roof of mouth, hard swallow Supraglottic Swallow : hold breath, airway closed before swallow |
| Saliva | begins breakdown of food, moistens oral mucosa, sticks food for easier swallowing, enhances flavor, neutralizes acids, decreases bacterial growth, strengthens teeth (calcium), keeps dentures in place |
| Dry Mouth | Xerostomia - not enough saliva Common in diabetics, Sjogren's Syndrome, stroke, AIDS/HIV, oral thrush, Alzheimer's, dehydration, radiation/oxygen exposure, NPO patients |
| Rhythm | Irregular : number of beats in 60 seconds Regular : number of beats in 30 seconds times 2 |
| Temperature Oral | Blue probe Normal : 98.6 Low Normal : 97.6 High Normal : 99.6 |
| Temperature Rectal | Red probe Most accurate form Normal : 99.6 Low Normal : 98.6 High Normal : 100.6 |
| Temperature Axillary | Blue probe Least accurate Normal : 97.6 Low Normal : 96.6 High Normal : 98.6 |
| Temperature Tympanic (ear) | Normal : 98.6 Low Normal : 96.6 High Normal : 99.7 |
| Temperature Temporal Artery (forehead) | Normal : 99.6 Low Normal : 97.2 High Normal : 100.1 |
| Oxygen Saturation | SpO2 or O2Sat percentage of oxygen carried by RBC Normal range : 95-100% |
| Respiratory System | Lungs, nose, trachea, diaphragm |
| Cyanosis | Blue-ish coloring of skin, lips, mucous, membranes Sign the body isn't getting enough oxygen |
| Stridor | Loud, high-pitched sound from airway |
| Sputum | Saliva and mucous mix, coughed up from respiratory tract |
| Breathing | Hyperventilation : rapid/deeper Hypoventilation : slow/shallow/irregular Tachypnea : rapid breathing 20+ respirations/min Bradypnea : slow breathing 12- respirations/min |
| Apnea | Not breathing |
| Trochanter Roll | Roll made from blanket or sheets, to prevent outward hip rotation (supine) |
| ROM (Upper) | Shoulder : flexion, extension, abduction, adduction, rotation Elbow : flexion, extension Wrist : adduction, abduction, flexion, extension Thumb : saddle joint, reposition/opposition Fingers : flexion, extension, adduction, abduction REPEAT OTHER SIDE |
| ROM (Lower) | Hip : ball-and-socket, external/internal rotation Knee : flexion, extension, hinge joint Ankle : dorsiflexion, plantar flexion Feet/toes : supination, pronation REPEAT OTHER SIDE x5 |
| Types of Scales | Standing scales, chair scales, bed scales, wheelchair scales, lift scales, in-home scales, calibrate scale (properly adjust to ensure accuracy) |
| Layers of Skin | Epidermis (outermost, makes new skin cells, gives color, protects from infection and UV rays) Dermis (thickest, strongest, makes sweat/oil glands, grows hair, blood vessels and nerve endings) Hypodermis (subcutaneous fat layer, stores fat, insulates) |
| Staging System | Describes the amount of tissue destroyed rather than healed |
| Stage 1 Pressure Injury Stage 2 Pressure Injury | 1 : intact skin with a localized area of non-blanchable erythema (visual, sensational, temperature changes) 2 : partial-thickness skin loss (exposed dermis, viable wound bed, adipose isn't visible) |
| Stage 3 Pressure Injury Stage 4 Pressure Injury | 3 : full-thickness skin loss (adipose visible, fascia, muscle, etc., not visible) 4 : full-thickness skin and tissue loss (exposed fascia, tendon, bone, muscle) |
| Unstageable Pressure Injury Deep Tissue Pressure Injury | Unstageable : extent of tissue damage cannot be confirmed because obscuration by slough/eschar Deep-Tissue : Intact or not intact (red, deep, purple or marroon) |
| Medical Device Related Pressure Injury Mucosal Membrane Pressure Injury | Medical : conforms to shape of device (use staging system) Mucosal Membrane : found on mucous membranes with a history of medical device(s) (cannot be staged) |
| Risk Factors of Pressure Injuries | External : Medical devices, resting surfaces, socioeconomic status, medications Internal : pain impairment, muscle spasms, impaired nutrition, moisture exposure, history |
| Braden Scale | SIX FACTORS: sensory function, moisture, activity, mobility, nutrition, shear/friction Upon admission, weekly for a month, quarterly 12 or less is high risk |
| Norton Scale | FIVE FACTORS: sensory function, moisture, activity, mobility, nutrition 5-20 scale (less than 14 is high risk) |
| Restorative Nursing | Rehabilitation : shorter stay, speech, physical, occupational therapy Restorative Care : required by state/federal regulations (improve quality of life) |
| Low Vision | 1. Central Vision Loss (reading/recognizing) 2. Peripheral Vision Loss (finding things) 3. Night Blindness 4. Hazy/Blurred Vision |
| Vision Conditions | Cataracts : clouding of lens (distort bright/dim lights) Glaucoma : damage to optic nerve ("tunnel vision", cannot be reversed) |
| Diabetic Retinopathy | Swelling of Macula-- black spots |
| Hearing Loss | Conductive Hearing Loss : sound can't get to inner ear (build up of earwax, fluid) Sensorineural Hearing Loss : problem in cochlea, auditory nerve or brain (Noise, Aging, Medications, Trauma, Stroke, Infection, Tumors) |
| Speech Disorders | Broca's Aphasia : expressive (cannot send out thoughts through speech) Wernicke's Aphasia : receptive (cannot understand language) Aphasia : cannot use speech muscles to make understandable speech Global Aphasia : mixed |
| Intellectual Disability 1 | Spina Bifida : defect in spinal column, early as first month of pregnancy Spastic Cerebral Palsy : increased muscle tone, posture, movement problems Cerebral Palsy : brain damage or abnormal development |
| Intellectual Disability 2 | Fragile X : change in a gene that makes a protein needed for brain development Down Syndrome : 47 instead of 46 chromosomes, happens at fertilization |
| Immune Conditions | |
| Musculoskeletal Conditions | |
| Central Nervous System Conditions | |
| Endocrine Conditions | |
| Cardiovascular Conditions | |
| Respiratory Conditions | |
| Urinary Conditions | |
| Shock | |
| Geriatric Syndromes | Symptoms likely to occur with age (falls, delirium, depression, incontinence, polypharmacy) |
| Chronic Conditions (THE BIG THREE) | |
| Chronic Conditions | |
| Dementia Early Stage Patterns | Short term memory loss |
| Dementia Middle Stage Patterns | Communication difficulties |
| Dementia Late Stage Patterns | |
| Dementia Basic Guidelines | Never argue with patient, slow down, be patient, don't overexplain, positive statements, concrete terms, reassurance, watch your frustration level, limit choices and open-ended questions, multisensory cues, build confidence, substitute statements for q's |
Created by:
emmahuber
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