Understand nurse aide’s range of function in rehabilitative/restorative and maintenance care Unit B Resident Care Skills Resident Care Skills Essential Standard NA4.00 Understand nurse aide skills related to the residents’ vital function and movement Understand nurse aide skills related to the residents’ vital function and movement Indicator 4.02 Understand nurse aide’s range of function in rehabilitative/restorative and maintenance care Understand nurse aide’s range of function in rehabilitative/restorative and maintenance care 14.02Nursing Fundamentals 7243

Restorative/Rehabilitative Care CAST CARE 4.02Nursing Fundamentals 72432

3 Cast used to immobilize body part, providing time for part to heal 4.02Nursing Fundamentals 7243 CAST CARE

4 Cast materials –Plaster of Paris hours to dry expands and gives off heat while drying –Fiberglass dries rapidly lighter than plaster casts –Plastic 4.02Nursing Fundamentals 7243

5 Care of Casts –Allow to air dry –Keep cast uncovered –Use pillows to support cast –Support cast with palms of hands 4.02Nursing Fundamentals 7243

6 Care of Casts –Never put pressure on cast –Turn and position frequently to allow air to circulate around cast 4.02Nursing Fundamentals 7243

7 Maintain good body alignment Keep cast dry Observe cast for rough edges and report Over-bed trapeze provided if appropriate 4.02Nursing Fundamentals 7243

8 Vomiting Elevated temperature Skin irritation around edge of cast 4.02Nursing Fundamentals 7243

9 Drainage Odors Swelling of fingers or toes, inability to move parts Change in color of skin: paleness, cyanosis 4.02Nursing Fundamentals 7243

10 Resident with cast reports of:Resident with cast reports of: –Pain –Numbness –Tingling sensations –Chills –Hot or cold skin –Itching –Tightness –Inability to move fingers or toes –Nausea 4.02Nursing Fundamentals 7243

4.02Nursing Fundamentals COUGHING AND DEEP BREATHING

Nursing Fundamentals PurposesPurposes –To prevent respiratory complications in certain at-risk residents persons on bed rest or reduced activitypersons on bed rest or reduced activity following surgeryfollowing surgery person with respiratory disordersperson with respiratory disorders COUGHING AND DEEP BREATHING 4.02

Nursing Fundamentals PurposesPurposes –Two major complications prevented by coughing and deep breathing: pneumonia - inflammation of lungpneumonia - inflammation of lung atelectasis - collapse of portion of lungatelectasis - collapse of portion of lung 4.02

Nursing Fundamentals PhysiologyPhysiology –Deep Breathing increases level of oxygen in bloodincreases level of oxygen in blood increases lung expansionincreases lung expansion 4.02

Nursing Fundamentals PhysiologyPhysiology –Coughing removes mucus from airways and lungsremoves mucus from airways and lungs may cause collapse of lung if congestion not presentmay cause collapse of lung if congestion not present 4.02

Nursing Fundamentals Considerations with deep breathing and coughingConsiderations with deep breathing and coughing –Doctors order exercises –Frequency of performing exercise varies per doctor’s order 4.02

Nursing Fundamentals Considerations with deep breathing and coughingConsiderations with deep breathing and coughing –Nurse aides receive instructions from supervisor –Coughing may cause pain and be difficult to perform 4.02

Nursing Fundamentals SKILL 4.02G SKILL 4.02G COUGH AND DEEP BREATH Training Lab Assignment Engage in the Skill Acquisition Process for:

4.02Nursing Fundamentals ANTI-EMBOLIC STOCKINGS/HOSE

Nursing Fundamentals PurposePurpose –Provide support –Provide comfort –Promote circulation by providing pressure –Reduce risk of thrombus formation ANTI-EMBOLITIC STOCKINGS/HOSE 4.02

Nursing Fundamentals Indications for useIndications for use –Residents with heart disease and circulatory disorders –Residents on bed rest –Residents who recently had surgery 4.02

Nursing Fundamentals Prevention of blood clots (thrombi)Prevention of blood clots (thrombi) –blood clots form (blood flow is sluggish) –usually develop in deep leg veins –can break loose and travel though blood stream (then known as embolus) 4.02

Nursing Fundamentals Prevention of blood clots (thrombi) –embolus can travel to the lungs and possibly cause death –elastic stockings exert pressure on veins, promoting venous blood flow to heart –also known as anti-embolitic stockings or TED hose 4.02

Nursing Fundamentals Fitting of stockingsFitting of stockings –Come in thigh high or knee high lengths –Resident must be measured to ensure proper fit 4.02

Nursing Fundamentals SKILL 4.02H SKILL 4.02H ANTI-EMBOLITIC STOCKING Training Lab Assignment Engage in the Skill Acquisition Process for:

Understand nurse aide’s range of function in rehabilitative/restorative and maintenance care. 26  END  4.02 Nursing Fundamentals 7243