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 PROSTHETIC DEVICES 4.02Nursing Fundamentals 72432

3 Artificial Eye (glass eye)Artificial Eye (glass eye) –encourage resident to remove, clean and replace eye prosthesis if able 4.02Nursing Fundamentals 7243 PROSTHETIC DEVICES

4 EyeglassesEyeglasses –Lens made of glass or plastic –Lens made of glass or plastic –Stored in protective case to prevent damage when not in use –Stored in protective case to prevent damage when not in use –Held by frames 4.02Nursing Fundamentals 7243

5 Eyeglasses (continued)Eyeglasses (continued) –Washed under running water using mild detergent. –Washed under running water using mild detergent. rinsed with clear waterrinsed with clear water dried with tissue or soft clothdried with tissue or soft cloth 4.02Nursing Fundamentals 7243

6 Eyeglasses…Eyeglasses… –Tops of ears and nose observed for redness or irritation from glasses Wash hands before and after cleansing resident’s glassesWash hands before and after cleansing resident’s glasses 4.02Nursing Fundamentals 7243

7 Contact Lenses (hard or soft)Contact Lenses (hard or soft) –Resident encouraged to care for lenses 4.02Nursing Fundamentals 7243

8 Contact Lenses (hard or soft) Unusual observations to be reported:Contact Lenses (hard or soft) Unusual observations to be reported: rednessredness itchingitching swellingswelling complaints of pain, blurring, or scratching sensationscomplaints of pain, blurring, or scratching sensations 4.02Nursing Fundamentals 7243

9 Hearing AidHearing Aid –Ear piece cleaned daily with soap and water; this is the only washable part –Ear piece and tubing should be soft –Wax cleaned from tubing with special equipment 4.02Nursing Fundamentals 7243

10 Hearing Aid…Hearing Aid… Batteries checked for powerBatteries checked for power –Skin observed for redness or irritation in or around ear –Ear wax build-up reported to supervisor 4.02Nursing Fundamentals 7243

11 Inserting hearing aid:Inserting hearing aid: –turn volume toward maximum until whistle is heard –replace batteries if whistle cannot be heard –turn volume to low setting 4.02Nursing Fundamentals 7243

12 Inserting hearing aid (continued) :Inserting hearing aid (continued) : –gently insert ear piece into ear canal and adjust for comfort –loop over ear for over-the-ear models –adjust volume to resident’s satisfaction 4.02Nursing Fundamentals 7243

13 Removing hearing aid:Removing hearing aid: –turn volume to lowest level or off –gently lift ear piece up and out of ear –use tissues to wipe wax off ear piece –store in safe place –remove battery when not in use or open battery case 4.02Nursing Fundamentals 7243

14 BracesBraces –Uses support a weak part of the bodysupport a weak part of the body prevent movement of jointprevent movement of joint correct deformitiescorrect deformities prevent deformitiesprevent deformities 4.02Nursing Fundamentals 7243

15 Braces (continued)Braces (continued) –Materials metal  leather  plasticmetal  leather  plastic –Bony parts under brace require protection in order to prevent skin irritation –Report any wear noticed and when brace parts are loose or missing 4.02Nursing Fundamentals 7243

16 Braces (continued)Braces (continued) –Shoes custom fitted and checked for: broken shoe lacesbroken shoe laces heels and soles that are wornheels and soles that are worn leather that is worn or tornleather that is worn or torn damage from perspirationdamage from perspiration – odors – stains 4.02Nursing Fundamentals 7243

17 Devices for use with amputationDevices for use with amputation –Definition of amputation - partial or complete removal of a body part usually arm or legusually arm or leg below knee most common amputationbelow knee most common amputation 4.02Nursing Fundamentals 7243

18 Devices for use with amputation (continued)Devices for use with amputation (continued) –Examples of prosthetic devices: artificial legartificial leg artificial footartificial foot artificial armartificial arm artificial handartificial hand 4.02Nursing Fundamentals 7243

19 Devices for use with amputation (continued)Devices for use with amputation (continued) –Prosthesis fitted and made for each individual. –Devices must be handled with care and stored in appropriate place when not in use. 4.02Nursing Fundamentals 7243

20 Assisting with artificial limbs: –have right device –check all parts for damage –evaluate resident’s limb for irritation and swelling –pad area of prosthesis touching resident 4.02Nursing Fundamentals 7243

21 Assisting with artificial limbs (continued) : –clean according to individual instructions –report any needed repairs to supervisor –observe and report any skin changes to supervisor 4.02Nursing Fundamentals 7243

22 Breast Forms – used following removal of breastBreast Forms – used following removal of breast –Assist female residents with adjustments of forms when dressing –Follow care suggested by manufacturer –Keep form separate and in safe place when handling clothing for laundry 4.02Nursing Fundamentals 7243

Restorative/Rehabilitative Care MOBILITY NEEDS 4.02Nursing Fundamentals

24 Broad base of support leads to better balance and stabilityBroad base of support leads to better balance and stability Keep weight the same on both feetKeep weight the same on both feet Stoop using the hips and kneesStoop using the hips and knees 4.02Nursing Fundamentals 7243 BODY MECHANICS FOR RESIDENTS

25 Keep the back straightKeep the back straight Lift and carry objects close to body for better balance.Lift and carry objects close to body for better balance. Use both hands to lift or move objectsUse both hands to lift or move objects Use smooth, even movementsUse smooth, even movements 4.02Nursing Fundamentals 7243

26 Do not bend or reach if injury possible; ask for helpDo not bend or reach if injury possible; ask for help Do not twist body to reach an objectDo not twist body to reach an object Keep body in good alignmentKeep body in good alignment 4.02Nursing Fundamentals 7243

27 Dangling - sitting on edge of bed before getting upDangling - sitting on edge of bed before getting up –Standing up too quickly may cause feeling of dizziness and fainting may occur 4.02Nursing Fundamentals 7243 DANGLING

28 Dangling for several minutes allows resident to progress to standing and walking without feeling faintDangling for several minutes allows resident to progress to standing and walking without feeling faint Taking deep breaths helps to prevent light-headednessTaking deep breaths helps to prevent light-headedness 4.02Nursing Fundamentals 7243

29 Most common signs/symptoms if feeling faint:Most common signs/symptoms if feeling faint: –pale face –complaints of dizziness or weakness 4.02Nursing Fundamentals 7243

30 Return resident to supine position if they have difficulty danglingReturn resident to supine position if they have difficulty dangling If dangling is well tolerated, progress to standing positionIf dangling is well tolerated, progress to standing position 4.02Nursing Fundamentals 7243

31 Get assistance if resident is weak or unsteadyGet assistance if resident is weak or unsteady Assist resident to stand by placing your hands under the resident’s arms with hands around the shoulder blades, and use good body mechanics to assist to standing positionAssist resident to stand by placing your hands under the resident’s arms with hands around the shoulder blades, and use good body mechanics to assist to standing position 4.02Nursing Fundamentals 7243 STANDING

32 Have resident stand by side of bed for several minutes prior to ambulatingHave resident stand by side of bed for several minutes prior to ambulating Return to bed or assist to chair if having difficulty standingReturn to bed or assist to chair if having difficulty standing If standing tolerated, progress to ambulatingIf standing tolerated, progress to ambulating 4.02Nursing Fundamentals 7243

33 Effects on bodyEffects on body –stimulates circulation –strengthens muscles –relieves pressure on body parts –increases joint mobility –improves function of digestive and urinary systems 4.02Nursing Fundamentals 7243 AMBULATING – WALKING

34 Effects on body (continued)Effects on body (continued) –increased independence leads to more positive self-image –provides sense of accomplishment –prevents lung congestion 4.02Nursing Fundamentals 7243

35 Encourage to ambulate as much as possibleEncourage to ambulate as much as possible Suggest use of handrails for supportSuggest use of handrails for support 4.02Nursing Fundamentals 7243

36 If resident starts to fall, ease to the floor by:If resident starts to fall, ease to the floor by: –grasping gait belt –resting buttocks against nurse aide’s leg –sliding down aide’s leg to floor 4.02Nursing Fundamentals 7243

37 Be prepared to assist, but allow the resident to do as much as possibleBe prepared to assist, but allow the resident to do as much as possible Safety considerations:Safety considerations: –use gait belt –get assistance if needed –allow adequate time for walking so resident does not feel rushed 4.02Nursing Fundamentals 7243