CNA PREP COURSE- 2018 BFI NURSING MODULE 3

Psychosocial needs A human being has the following psychosocial needs: Needs having to do with social interaction, emotions, intellect, and spirituality. A human being has the following psychosocial needs: Love and affection Acceptance by others Security Self-reliance and independence in daily living Interaction with other people Success and self-esteem

Physical Needs A human being has six basic physical needs: Food and water Protection and shelter Activity Sleep and rest Safety Comfort, freedom from pain

Maslow’s Hierarchy of Needs Start at the basic needs (bottom of pyramid) and work your way up.

Sexual Needs Remember these important points about sexual needs and situations: People continue to have sexual needs throughout their lives. Humans express their sexuality through different behaviors. Knock and wait for a response before entering residents’ rooms. Provide privacy if you encounter a sexual situation. Do not judge any sexual behavior you see. Honor “Do Not Disturb” signs.

Spiritual Needs As an NA you can help your residents with their spiritual needs: Learn about their religion. Assist with practices (never make judgments). Encourage participation in religious services if they are religious. Respect all religious items. Report requests to see clergy to nurse. Get to know resident’s priest, rabbi, or minister. Allow privacy for clergy visits. If asked, read religious materials aloud. Refer resident to spiritual resources if requested.

You should never: Try to change someone’s religion Tell a resident his/her belief or religion is wrong Express judgments about a religious group Insist that a resident join religious activities Interfere with religious practices

Holistic care a type of care that involves considering a whole system, such as a whole person, rather than dividing the system into parts

Imagine the losses residents may be experiencing: Loss of spouse, family, or friends Loss of workplace Loss of ability to go places Loss of home and personal possessions Loss of ability to attend religious services and meetings Loss of ability to care for themselves Loss of ability to move freely Loss of pets Can you think of any others?

Residents may encounter these problems due to lack of independence: Poor self-image Anger Feelings of helplessness, sadness, and hopelessness Feelings of uselessness Increased dependence Depression

PROMOTION OF INDEPENDANCE As an NA you can promote independence in these ways: Encourage residents to do as much as possible for themselves no matter how long it takes. Be patient. Allow residents to make choices. Allow them to choose clothing for today, activities to attend, time of day for shower ex. Day or night. REMEMBER: Never treat residents like children. Respect the fact that they can make their own choices and always encourage self-care.

Cultural Competence for Healthcare Providers- You Tube Cultural diversity the variety of people with varied backgrounds and experiences who live and work together in the world. Cultural Competence for Healthcare Providers- You Tube https://youtu.be/dNLtAj0wy6I

PHYSICAL ACTIVITY Physical activity has the following benefits: Lessens risk of illness Relieves symptoms of depression Improves mood and concentration Improves body function Lowers risk of falls Improves sleep Improves ability to cope with stress Increases energy Increases appetite

Inactivity and mobility can cause many problems for residents: Loss of self-esteem Depression Boredom Pneumonia Urinary tract infection Constipation Blood clots Dulling of the senses

TYPES OF FAMILY There are many types of families: Single-parent families Nuclear families Blended families Multigenerational families Extended families Unmarried couples Same-sex couples

NAs must treat residents’ families and friends in a professional manner: Be respectful and nice Allow privacy for visits Observe and report effects of visits on residents.

STAGES OF DEVELOPMENT Stages of development include: Infancy (birth to 12 months) Grow and develop quickly Development is from head down Childhood: The Toddler Period (1 to 3 years) Formerly dependent, now gain independence and body control Learn to speak, gain coordination and bladder and bowel control May have tantrums or whine to get their way

STAGES OF DEVELOPMENT Stages of development (cont’d.): Childhood: The Preschool Years (3 to 6 years) More social relationships Play cooperatively and learn language Know right from wrong Childhood: School-Age Children (6 to 12 years) Cognitive development (thinking and learning) Get along with others in peer group Develop a conscience and self-esteem

STAGES OF DEVELOPMENT Stages of development (cont’d.): Puberty and Adolescence (12 to 18 years) Secondary sex characteristics appear Reproductive organs begin to function Concern for body and peer acceptance Changing moods Interact with opposite sex Young Adulthood (18 to 40 years) Select a career Select and live with a mate Raise children Develop satisfying sex life

STAGES OF DEVELOPMENT Stages of development (cont’d.): Middle Adulthood (40 to 65 years) More comfortable and stable May have “mid-life crisis” Late Adulthood (65 years and older) Many physical and psychosocial changes Loss of physical health Loss of friends and jobs

Ageism prejudice toward, stereotyping of, and/or discrimination against older persons or the elderly.

Stages of Human Development Remember these facts about aging: People have many different capabilities. Stereotypes are false. Older persons are usually active. Aging is a normal process, not a disease. Aging persons need to adjust to change. They do not need to be dependent

Aging brings many normal changes: Thinner, drier, more fragile, and less elastic skin Weaker muscles Bones more brittle Sensitivity of nerve endings in skin decreases Responses and reflexes slow Short-term memory loss Changes in senses

Normal changes of aging (cont’d.): Less efficient heart Oxygen in blood decreases Decreased appetite More frequent elimination Changes in hormone production Weakened immunity Change in lifestyle

Aging also may bring changes not considered normal: Depression Loss of ability to think logically Poor nutrition Shortness of breath Incontinence REMEMBER: It is important that you report ALL changes in residents.

Remember these guidelines for caring for mentally ill residents: Observe for changes in condition or ability. Document and report observations. Support resident and family and friends. Encourage resident to do as much for himself as possible. Remember that mental illness can be treated.

Denial: refusal to believe one is dying Anger: “Why me?” Terminal illness a disease or condition that will eventually cause death Dr. Kubler-Ross stages on death and dying Denial: refusal to believe one is dying Anger: “Why me?” Bargaining: “Yes me, but . . .” Depression: need to mourn and review one’s life Acceptance: preparing for death

Durable power of attorney for health care Advance directives legal documents that allow people to choose what kind of medical care they wish to have if they are unable to make those decisions themselves. Durable power of attorney for health care a signed, dated, and witnessed paper that appoints someone else to make the medical decisions for a person in the event he or she becomes unable to do so. Living will a document that states the medical care a person wants, or does not want, in case he or she becomes unable to make those decisions for him- or herself. Do-not-resuscitate (DNR) an order that tells medical professionals not to perform CPR.

Signs of Impending death The following are signs of approaching death: Blurred vision that gradually fails Unfocused eyes Impaired speech Diminished sense of touch Loss of movement, muscle tone, and feeling Rising body temperature or below normal temperature Decreasing blood pressure Weak pulse that is abnormally slow or rapid

Signs of approaching death (cont’d.): Slow irregular respirations or rapid, shallow respirations (Cheyne-Stokes) Rattling or gurgling sound as person breathes Cold, pale skin Mottling, spotting, or blotching of skin Perspiration Incontinence Disorientation or confusion Cheyne Stokes Video- https://youtu.be/zrcXQhFK6ro

Postmortem Care Postmortem care care of the body after death. Remember these guidelines for postmortem care: Rigor mortis may make the body difficult to move. Talk to the nurse if you need assistance. Bathe the body gently. Place drainage pads where needed. Do not remove tubes or other equipment. Put in dentures if instructed by the nurse. Close eyes. Post-mortemcare: https://youtu.be/m6qyYWvTIew

POST-MORTEM CARE Guidelines for postmortem care (cont’d.): Position body. Put a small pillow under head. Follow facility policy on personal items. Strip the bed after body is gone. Open windows to air the room. Straighten room. Respect wishes of family and friends. Document procedure. REMEMBER, EACH FACILITY HAS THEIR OWN POLICIES REGARDING POST-MORTEM CARE! FOLLOW YOUR FACILITIES GUIDELINES.

Hospice Care Palliative care These are the goals of hospice care: care that focuses on the comfort and dignity of the person, rather than on curing him or her. These are the goals of hospice care: Promote the comfort of resident Preserve the dignity of resident Hospice works to meet the resident’s physical, emotional, social, and spiritual needs Hospice Care: https://youtu.be/lFjLGYsOlfU