Download presentation
Presentation is loading. Please wait.
1
1. Define important words in this chapter
additive a substance added to another substance, changing its effect. axilla underarm or armpit area. bridge a type of dental appliance that replaces missing or pulled teeth. dandruff excessive shedding of dead skin cells from the scalp.
2
1. Define important words in this chapter
dentures artificial teeth. edema swelling in body tissues caused by excess fluid. edentulous lacking teeth; toothless. gingivitis an inflammation of the gums.
3
1. Define important words in this chapter
grooming practices to care for oneself, such as caring for fingernails and hair. halitosis bad breath. hygiene practices to keep the body clean. partial bath bath that includes washing the face, underarms, hands, and perineal area.
4
1. Define important words in this chapter
pediculosis an infestation of lice. plaque a substance that accumulates on the teeth from food and bacteria. tartar hard deposits on the teeth that are filled with bacteria; may cause gum disease and loose teeth if they are not removed.
5
2. Explain personal care of residents
Define the following terms: hygiene practices to keep the body clean. grooming practices to care for oneself, such as caring for fingernails and hair.
6
2. Explain personal care of residents
Assisting with a.m. care includes the following: Taking resident to the bathroom, offering a bedpan, urinal, or an incontinent brief change, helping with perineal care if needed, and assisting with handwashing Helping with mouth care or denture care before and/or after breakfast, as the resident prefers Assisting with washing face and hands in bed, shower room, or in the bathroom
7
2. Explain personal care of residents
Assisting with a.m. care (cont'd): Changing resident’s gown, pajamas, or clothing Providing breakfast and fluids Assisting with bathing Helping resident with shaving, hair care, hand and fingernail care, foot care, and cosmetics Making the bed and tidying resident’s room
8
2. Explain personal care of residents
Assisting with p.m. care includes the following: Taking resident to the bathroom, offering bedpan or urinal, or an incontinent brief change and assisting with handwashing Helping with mouth care or denture care after lunch and dinner, as the resident prefers Providing lunch, dinner, snacks, and fluids; giving fresh drinking water Assisting the resident with bathing, if evening is preferable
9
2. Explain personal care of residents
Assisting with p.m. care (cont'd): Giving a back massage Changing into resident’s gown or pajamas Helping resident with hair care Assisting with washing face and removing makeup as needed Changing linens as needed and preparing the bed for the resident’s return Tidying resident’s room
10
2. Explain personal care of residents
Think about this question: Can you think of any additional personal care tasks (other than those listed) that you might assist residents with in the morning or in the evening?
11
Transparency 12-1: Assisting with Personal Care
Encourage residents to perform self-care whenever they can. This promotes dignity, independence, and proper body functioning. Be empathetic to emotions residents are experiencing. Always explain what you will be doing and answer any questions. Let the resident make as many choices as possible about the care that will be performed. Allow enough time for residents to use the bathroom, without rushing or interrupting them. Provide for personal choice.
12
Transparency 12-1: Assisting with Personal Care (cont’d)
Be patient. Be respectful and provide privacy during phone calls and visits. Keep residents covered during bathing and dressing. Promote residents’ safety. Talk to residents during personal care and report changes, concerns, or problems.
13
3. Describe different types of baths and list observations to make about the skin during bathing
Define the following terms: partial bath bath that includes washing the face, underarms, hands, and perineal area. additive a substance added to another substance, changing its effect. edema swelling in body tissues caused by excess fluid.
14
3. Describe different types of baths and list observations to make about the skin during bathing
Know the four basic types of baths and how each is best suited to particular residents: Partial bath is best suited to a resident who has drier, fragile, and more sensitive skin, should not have daily full baths, is unable to get up to take a shower or tub bath, and/or wants a quick bath before a meal and plans on taking a shower or bath later in the day. Shower is best suited to a resident who is able to stand during a shower, and/or is able to safely sit in a shower chair.
15
3. Describe different types of baths and list observations to make about the skin during bathing
Four basic types of baths (cont'd): Tub bath is best suited to a resident who is able to transfer into and out of a tub and/or has a doctor’s order for a special bath using an additive. Complete bed bath is best suited to a resident who is unable to get out of bed to shower or bathe, and requires a full bath.
16
3. Describe different types of baths and list observations to make about the skin during bathing
REMEMBER: During personal care, you can you obtain information about residents by making observations and asking questions.
17
3. Describe different types of baths and list observations to make about the skin during bathing
Be sure to observe and report any of the following during bathing: Change in size of one or both pupils Difference in appearance from one eye to another Yellow or red color in whites of the eyes Changes in vision, ability to hear, and sense of smell Drooping on one side of the face Weight loss Drainage coming from any area, including eyes, ears, nipples, or genitals
18
3. Describe different types of baths and list observations to make about the skin during bathing
Observe and report during bathing (cont'd): Foul odors from any body area Pale, blue-tinged (cyanotic), white, reddened, or purple areas on the skin Dry, flaky, broken, or cracked skin Lumps or bumps on the skin Moles or spots on the skin, especially those that are red, white, yellow, dark brown, gray, or black Rashes or any skin discoloration Bruises Blisters Cuts, scrapes, or scratches
19
3. Describe different types of baths and list observations to make about the skin during bathing
Observe and report during bathing (cont'd): Open sores or ulcers on any area of the body Changes in open sore, wound, or ulcer (color, size, drainage, odor, overall depth of sore) Swelling/edema of any area, especially the knuckles, fingers, groin, abdomen, legs, ankles, or feet (edema is swelling in body tissues caused by excess fluid) Poor condition of fingernails or toenails; nails in need of trimming Dry, cracked, or broken skin in between toes or toenails
20
3. Describe different types of baths and list observations to make about the skin during bathing
Observe and report during bathing (cont'd): Itching or scratching Change in emotional state Change in level of mobility Complaints of pain, discomfort, or stiff neck Numbness, burning, warmth, or tingling in the extremities or other areas of the body
21
4. Explain safety guidelines for bathing
REMEMBER: Safety must be the highest priority when bathing residents. Many accidents happen in the bathroom or shower room. Nursing assistants should assess the area for any risks before bathing a resident.
22
Transparency 12-2: Safety Guidelines and Bathing
Ask for help if you need it. Follow the care plan. If this is the NA’s responsibility, clean areas and equipment before and after use. Make sure floor in shower or tub room is dry. Place nonslip mats in regular tubs. Make sure safety bars are in working order. Encourage residents to use them. Gather all needed supplies and equipment and place these items within reach. Do not use bath oils, gels, or powders. Make sure water is at a comfortable temperature for each resident. Temperature should not be higher than 105° F. Store electrical appliances away from water source. Do not leave residents alone while bathing.
23
5. List the order in which body parts are washed during bathing
Define the following term: axilla underarm or armpit area.
24
5. List the order in which body parts are washed during bathing
REMEMBER: When assisting with bathing, washing from the cleanest area to the dirtiest reduces the risk of transferring microorganisms.
25
Transparency 12-3: Bathing Wheel
1. Eyes 2. Face 3. Ears 4. Neck 5. Arms, Axilla (axillae), and Hands 6. Chest and Abdomen 7. Legs and Feet 8. Back 9. Perineal Area 10. Buttocks
26
5. List the order in which body parts are washed during bathing
Know the correct order to wash body parts, as listed on the Bathing Wheel: Eyes Face Ears Neck Arms, axilla (axillae), and hands Chest and abdomen Legs and feet Back Perineal area Buttocks
27
6. Explain how to assist with bathing
Remember these points about bathing: Bathing increases circulation and provides an opportunity for NAs to observe the skin. Prepare the shower or tub room and gather supplies before moving the resident there. Keep the room warm enough. Wear gloves while bathing a resident and change gloves before giving perineal care. Resident should help choose a comfortable water temperature. Make sure all soap residue is removed. Observe the skin closely during bathing.
28
Giving a complete bed bath
Equipment: bath blanket, bath basin, soap, bath thermometer, 2-4 washcloths, 2-4 bath towels, bed pads, clean clothes, 2 pairs of gloves, lotion, deodorant, orangewood stick nail brush When bathing, move resident’s body gently and naturally. Avoid force and over-extension of limbs and joints. 1. Identify yourself by name. Identify the resident. Greet the resident by name. Wash your hands. 3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. Be sure the room is at a comfortable temperature and there are no drafts. 5. Adjust bed to safe working level, usually waist high. Lock bed wheels.
29
Giving a complete bed bath
6. Place a bath blanket or towel over resident. Ask him to hold onto it as you remove or fold back top bedding to the foot of the bed. Remove gown, while keeping resident covered with bath blanket (or top sheet). Place gown in proper container.
30
Giving a complete bed bath
7. Fill the basin with warm water. Test water temperature with thermometer or against the inside of your wrist. Water temperature should be no higher than 105°F. Have resident check water temperature to see if it is comfortable. Adjust if necessary. Change the water when it becomes too cool, soapy, or dirty. 8. Put on gloves. Ask the resident to participate in washing. Help him do this when needed. 10. Uncover only one part of the body at a time. Place a towel or bed pad under the body part being washed. 11. Wash, rinse, and dry one part of the body at a time. Start at the head. Work down, and complete the front first. When washing, use a clean area of the washcloth for each stroke.
31
Giving a complete bed bath
Eyes, Face, Ears, Neck: Wash face with wet washcloth (no soap). Begin with the eye farther away from you. Wash inner area to outer area. Use a different area of the washcloth for each stroke. Wash the face from the middle outward. Use firm but gentle strokes. Wash the ears and behind the ears. Wash the neck. Rinse and pat dry with blotting motion.
32
Giving a complete bed bath
Arms and Axillae: Remove one arm from under the towel. With a soapy washcloth, wash the upper arm and underarm. Use long strokes from the shoulder to the wrist. Rinse and pat dry. Repeat for the other arm.
33
Giving a complete bed bath
Hands: Wash one hand in a basin. Clean under the nails with an orangewood stick or nail brush. Rinse and pat dry. Make sure to dry between the fingers. Give nail care (see procedure later in this chapter). Repeat for the other hand. Put lotion on the resident’s elbows and hands.
34
Giving a complete bed bath
Chest: Place the towel across the resident’s chest. Pull the bath blanket down to the waist. Lift the towel only enough to wash the chest. Rinse it and pat dry. For a female resident, wash, rinse, and dry breasts and under breasts. Check the skin in this area for signs of irritation. Abdomen: Keep towel across chest. Fold the bath blanket down so that it still covers the genital area. Wash the abdomen, rinse, and pat dry. Cover with the towel. Pull the bath blanket up to the resident’s chin. Remove the towel.
35
Giving a complete bed bath
Legs and Feet: Expose one leg. Place a towel or bed pad under it. Wash the thigh. Use long, downward strokes. Rinse and pat dry. Do the same from the knee to the ankle.
36
Giving a complete bed bath
Legs and feet (cont’d): Place another towel or bed pad under the foot. Move the basin to the towel. Place the foot into the basin. Wash the foot and between the toes. Rinse foot and pat dry. Make sure areas between toes are dry.
37
Giving a complete bed bath
Legs and feet (cont’d): Give nail care if it has been assigned. Do not give nail care to a resident with diabetes. Never clip a resident’s toenails. Apply lotion to the foot if ordered, especially to the heels. Do not apply lotion between the toes. Repeat steps for the other leg and foot.
38
Giving a complete bed bath
Back: Help resident move to the center of the bed. Ask resident to turn onto his side so his back is facing you. If the bed has rails, raise the rail on the far side for safety. Fold the blanket away from the back. Place a towel lengthwise next to the back. Wash the back and neck with long, downward strokes. Rinse and pat dry. Apply lotion if ordered.
39
Giving a complete bed bath
Place the towel under the buttocks and upper thighs. Help the resident turn onto his back. If the resident is able to wash his perineal area, place a basin of clean, warm water, a washcloth, and towel within reach. Hand items to the resident as needed. If the resident wants you to leave the room, return bed to the lowest position, and remove and discard your gloves. Wash your hands. Leave supplies and the call light within reach. If the resident has a urinary catheter in place, remind him not to pull on it. 13. If the resident cannot provide perineal care, you will do it. Remove and discard your gloves. Wash your hands. Put on clean gloves. Provide privacy at all times. 14. Perineal area and buttocks: Change the bath water. Place a towel or bed pad under the perineal area. Wash, rinse, and dry perineal area. Work from front to back (clean to dirty).
40
Giving a complete bed bath
For a female resident: Use water and a small amount of soap, and clean from front to back. Use single strokes. Do not wash from the back to the front, as this may cause infection. Use a clean area of washcloth or clean washcloth for each stroke. With your thumb and forefinger, separate the labia majora, the outside folds of perineal skin that protect the urinary meatus and the vaginal opening. The meatus is the opening of the female urethra that is above the vaginal opening.
41
Giving a complete bed bath
Perineal care for a female resident (cont’d): Wipe from front to back on one side with a clean washcloth, using a single stroke. Using a clean area of the washcloth, wipe the other side from front to back. Using another clean area of the washcloth, wipe down the center from front to back. Clean the perineum (area between vagina and anus) last with a front to back motion. Rinse the area thoroughly in the same way. Make sure all soap is removed. Dry entire perineal area. Move from front to back, using a blotting motion with a towel. Ask resident to turn on her side. Using a clean washcloth, wash, rinse, and dry buttocks and anal area. Clean the anal area without contaminating the perineal area.
42
Giving a complete bed bath
For a male resident: If the resident is uncircumcised, pull back the foreskin first. Gently push skin towards the base of penis. Hold the penis by the shaft. Wash in a circular motion from the tip down to the base. Use a clean area of washcloth or clean washcloth for each stroke.
43
Giving a complete bed bath
Perineal care for a male resident (cont’d): Thoroughly rinse the penis and pat dry. If resident is uncircumcised, gently return foreskin to normal position. Then wash the scrotum and groin. The groin is the area from the pubis (area around the penis and scrotum) to the upper thighs. Rinse thoroughly and pat dry. Ask the resident to turn on his side. Wash, rinse, and dry buttocks and anal area. Clean the anal area without contaminating the perineal area. 15. Cover the resident with the bath blanket. 16. Empty, rinse, and dry bath basin. Place basin in designated dirty supply area or return to storage, depending on facility policy. 17. Place soiled clothing and linens in proper containers.
44
Giving a complete bed bath
18. Remove and discard gloves. Wash your hands. 20. Provide deodorant. Assist with brushing or combing resident’s hair (see procedure later in the chapter). Put clean clothing on resident. Replace bedding, and place bath blanket in proper container. Make resident comfortable. Return bed to lowest position. Remove privacy measures. 23. Leave call light within resident’s reach. 24. Wash your hands. 25. Be courteous and respectful at all times. 26. Report any changes in the resident to the nurse. Document procedure using facility guidelines.
45
6. Explain how to assist with bathing
Think about this question: Why is it important to change the bath water whenever it becomes too cool, soapy, or dirty?
46
6. Explain how to assist with bathing
REMEMBER: Perineal care is considered a procedure and should be done as a step-by-step technique, different for males and females. The NA must turn the resident on his or her side and clean the anal area to complete the procedure.
47
6. Explain how to assist with bathing
Think about this question: Why is it so important to clean the anal area without contaminating the perineal area?
48
Shampooing a resident’s hair in bed
Equipment: shampoo, hair conditioner (if requested), 2 bath towels, washcloth, bath thermometer, pitcher or handheld shower or sink attachment, waterproof pad, bath blanket, gloves, trough and catch basin, comb and brush, hair dryer 1. Identify yourself by name. Identify the resident. Greet the resident by name. Wash your hands. 3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. Be sure the room is at a comfortable temperature and there are no drafts. 5. Arrange the supplies within reach.
49
Shampooing a resident’s hair in bed
Test water temperature with thermometer or against the inside of your wrist. Ensure it is safe. Water temperature should be no higher than 105°F. Have resident check water temperature. Adjust if necessary. Remove all pillows and place the resident in a flat position. Adjust the bed to a safe level, usually waist high. Lock bed wheels. Put on gloves. 9. Place the waterproof pad under the resident’s head and shoulders. Cover the resident with the bath blanket. Fold back the top sheet and regular blankets. 10. Place the trough under resident’s head. Connect trough to catch basin. Place one towel across the resident’s shoulders. 11. Protect resident’s eyes with dry washcloth.
50
Shampooing a resident’s hair in bed
12. Use pitcher or attachment to wet hair thoroughly. Apply a small amount of shampoo, usually the size of a quarter, to your hands and rub them together. 13. Lather and massage scalp with fingertips. Use a circular motion from front to back. Do not scratch the scalp.
51
Shampooing a resident’s hair in bed
14. Rinse hair until water runs clear. Use conditioner if the resident wants it. Rinse as directed on container. Be sure to rinse the hair thoroughly to prevent the scalp from getting dry and itchy. Wrap resident’s hair in a clean towel. Dry his face and neck with the washcloth used to protect eyes. Remove trough and waterproof pad. Raise the head of the bed. Gently rub the scalp and hair with the towel. Comb or brush resident’s hair. Dry hair with a hair dryer on low setting if allowed. Style hair as the resident prefers. Empty, rinse, and wipe bath basin/pitcher. Return to proper storage.
52
Shampooing a resident’s hair in bed
Clean comb or brush. Return hair dryer and comb or brush to proper storage. Place soiled linen in proper container. Remove and discard gloves. Wash your hands. Make resident comfortable. Return bed to lowest position. Remove privacy measures. Leave call light within resident’s reach. Wash your hands. Be courteous and respectful at all times. Report any changes in the resident to the nurse. Document procedure using facility guidelines.
53
6. Explain how to assist with bathing
Nursing assistants should remember this information about shampooing hair at a sink or on a stretcher: Some residents will have their hair shampooed at a sink. Padding the edge of the sink will help ensure that the resident’s neck is comfortable. The resident’s head should be tilted back slightly, in a comfortable position that is not overextended. When assisting a resident on a stretcher with shampooing hair, the NA will bring the stretcher to the sink and adjust the height of the stretcher to be even with the sink. Stretcher wheels should be locked and safety straps fastened. The side rail farthest from the NA should be raised.
54
Giving a shower or tub bath
Equipment: bath blanket, soap, shampoo, bath thermometer, 2-4 washcloths, 2-4 bath towels, clean gown and robe or clothes, nonskid footwear, 2 pairs of gloves, lotion, deodorant, hair dryer 1. Wash your hands. Place equipment in shower or tub room. Put on gloves. Shower or tub area and shower chair must be cleaned before use. Clean them if part of your duties. Place bucket under shower chair (in case resident urinates or has a bowel movement). Turn on heat lamp to warm the room if lamp is available. Remove and discard gloves. Wash your hands. 4. Go to resident’s room. Identify yourself by name. Identify the resident. Greet the resident by name.
55
Giving a shower or tub bath
5. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 6. Provide for the resident’s privacy with a curtain, screen, or door. Help resident to put on nonskid footwear. Transport resident to shower or tub room. Put on clean gloves. Help resident remove clothing and shoes. Cover with a bath blanket.
56
Giving a shower or tub bath
For a shower: 10. If using a shower chair, place it into position and lock its wheels. Safely transfer resident into shower chair. 11. Turn on water. Test water temperature with thermometer or against the inside of your wrist. Water temperature should be no higher than 105°F. Have resident check water temperature. Adjust if necessary. Check water temperature frequently throughout the shower.
57
Giving a shower or tub bath
Unlock the shower chair and move it into the shower stall. Lock wheels. Stay with the resident during the procedure. Let resident wash as much as possible on his own. Help to wash as needed. Help resident shampoo hair. The resident’s head should be tilted back slightly; it should not be tilted back beyond its normal range. Make sure that water and shampoo/conditioner do not get into the resident’s eyes. Rinse the hair thoroughly. Using the soap, help to wash and rinse the entire body. Move from head to toe (clean to dirty). Turn off water. Unlock shower chair wheels. Roll resident out of shower.
58
Giving a shower or tub bath
For a tub bath: Residents may need help getting into the bath, depending on their level of mobility. Safely transfer resident onto chair or tub lift, or help resident into bath. Fill the tub halfway with warm water. Test water temperature with thermometer or against the inside of your wrist. Water temperature should be no higher than 105° F. Have resident check water temperature. Adjust if necessary. Stay with resident during procedure. Let resident wash as much as possible on his own. Help to wash as needed. Help resident shampoo and rinse hair. Using the soap, help to wash and rinse the entire body. Move from head to toe (clean to dirty). Drain the tub. Cover the resident with bath blanket while the tub drains.
59
Giving a shower or tub bath
Help resident out of tub and onto a chair. Remaining steps for either procedure: Give resident towel(s) and help to pat dry. Remember to pat dry under the breasts, between skin folds, in the perineal area, and between toes. Apply lotion and deodorant as needed. Place soiled clothing and linens in proper containers. Remove and discard gloves. Wash your hands. Help resident dress and comb hair before leaving shower or tub room (see procedures later in this chapter). Offer a hair dryer if needed. Put on nonskid footwear. Turn off heat lamp. Return resident to room. Make resident comfortable. Leave call light within resident’s reach.
60
Giving a shower or tub bath
Be courteous and respectful at all times. Report any changes in the resident to the nurse. Document procedure using facility guidelines.
61
7. Describe how to perform a back rub
Remember the following about back rubs: Back rubs help relax tired, tense muscles and improve circulation. Back rubs are often given after bathing or prior to going to bed at night. They may also be given regularly to relieve pain or discomfort. Sometimes back rubs should not be given due to conditions or illnesses. The nursing assistant should follow the care plan. If the resident has broken or open skin on his back, the NA must apply gloves before giving a back rub.
62
Equipment: bath blanket or towel, lotion
Giving a back rub Equipment: bath blanket or towel, lotion 1. Identify yourself by name. Identify the resident. Greet the resident by name. 2. Wash your hands. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. Adjust bed to safe working level, usually waist high. Lower the head of the bed. Lock bed wheels.
63
Giving a back rub Position resident lying on his side (lateral position) or his stomach (prone position). Many elderly residents find lying on their stomachs uncomfortable. If so, have him lie on his side. Cover resident with a bath blanket. Fold back bed covers. Expose the back to the top of the buttocks. Back rubs can also be given with the resident sitting up. 7. Warm lotion by putting bottle in warm water for five minutes. Run your hands under warm water. Pour lotion on your hands. Rub them together. Always put lotion on your hands rather than directly on resident’s skin.
64
Giving a back rub 8. Place hands on each side of upper part of the buttocks. Use the full palm of hand. Make long, smooth upward strokes with both hands. Move along each side of the spine, up to the shoulders. Circle your hands outward. Move along outer edges of the back. At buttocks, make another circle. Move hands back up to the shoulders. Without taking hands off the resident’s skin, repeat this motion for three to five minutes.
65
12. Dry the back if extra lotion remains on it.
Giving a back rub 9. Knead with the first two fingers and thumb of each hand. Place them at base of the spine. Move upward together along each side of the spine. Apply gentle downward pressure with fingers and thumbs. Follow same direction as with the long smooth strokes, circling at the shoulders and buttocks. Gently massage bony areas (spine, shoulder blades, hip bones). Use circular motions with your fingertips. If any of these areas are pale, white, or red, massage around them rather than on them. 11. Let the resident know when you are almost through. Finish with long, smooth strokes. 12. Dry the back if extra lotion remains on it. 13. Remove bath blanket or towel. Help the resident to get dressed. Make resident comfortable. 14. Return bed to lowest position. Remove privacy measures.
66
16. Leave call light within resident’s reach. 17. Wash your hands.
Giving a back rub 15. Store supplies. Place soiled clothing and linens in proper containers. 16. Leave call light within resident’s reach. 17. Wash your hands. Be courteous and respectful at all times. Report any changes in the resident to the nurse, including pale, white or red areas. Document procedure using facility guidelines.
67
7. Describe how to perform a back rub
REMEMBER: An NA must wear gloves when giving a back rub to a resident who has broken or open skin.
68
8. Explain guidelines for performing oral care
Define the following terms: halitosis bad breath. plaque a substance that accumulates on the teeth from food and bacteria. tartar hard deposits on the teeth that are filled with bacteria; may cause gum disease and loose teeth if they are not removed. gingivitis an inflammation of the gums. edentulous lacking teeth; toothless.
69
8. Explain guidelines for performing oral care
Oral care consists of the following: Brushing the teeth, tongue, and gums Flossing with dental floss Caring for the lips Caring for dentures
70
8. Explain guidelines for performing oral care
REMEMBER: Gloves must always be worn when performing oral care.
71
8. Explain guidelines for performing oral care
Remember to observe and report any of the following when performing oral care: Dry, cracked, bleeding, or chapped lips Cold sores on the lips Raised areas Swollen, irritated, red, bleeding, or whitish gums Loose, cracked, chipped, broken, or decayed teeth Yellow-filled or red sores, such as canker sores inside the mouth White spots inside the mouth
72
8. Explain guidelines for performing oral care
Observe and report, oral care (cont'd): Pus or drainage Coated or swollen tongue Bad breath or fruity-smelling breath Change in the resident’s ability to drink, suck on a straw, or swallow Gagging or choking Resident reports of mouth pain
73
8. Explain guidelines for performing oral care
REMEMBER: Gum care is very important. Studies have shown a link between gum disease and the risk of heart disease, stroke, and diabetes.
74
4. Provide for the resident’s privacy with a curtain, screen, or door.
Providing oral care Equipment: toothbrush, toothpaste, emesis basin, gloves, clothing protector or towel, glass of water, lip moisturizer 1. Identify yourself by name. Identify the resident. Greet the resident by name. Wash your hands. 3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. 5. If resident is in bed, adjust the bed to a safe working level, usually waist high. Raise the head of the bed to have the resident in an upright sitting position. Lock bed wheels.
75
7. Place a clothing protector or towel across resident’s chest.
Providing oral care 6. Put on gloves. 7. Place a clothing protector or towel across resident’s chest. Wet brush. Apply a small amount of toothpaste. Clean entire mouth, including tongue and all surfaces of teeth and the gumline, using gentle strokes. First brush inner, outer and chewing surfaces of the upper teeth, then do the same with the lower teeth. Use short strokes. Brush back and forth. Brush tongue.
76
Providing oral care 10. Give the resident water to rinse the mouth. Place emesis basin under the resident’s chin, with the inward curve under the chin. Have resident spit water into emesis basin. Wipe resident’s mouth and remove the protector or towel. Apply lip moisturizer.
77
12. Place soiled linen in proper container.
Providing oral care 11. Rinse toothbrush and place in proper container. Empty, rinse and dry emesis basin. Place basin in designated dirty supply area or return to storage, depending on facility policy. 12. Place soiled linen in proper container. Remove and discard gloves. Wash your hands. 14. Make resident comfortable. 15. Return bed to lowest position. Remove privacy measures. 16. Leave call light within resident’s reach. Wash your hands. Be courteous and respectful at all times. Report any changes in the resident to the nurse. Report any problems with teeth, mouth, tongue, or lips to nurse. These include odor, cracking, sores, bleeding, and any discoloration. Document procedure using facility guidelines.
78
8. Explain guidelines for performing oral care
REMEMBER: Giving oral care to a resident who has no teeth is similar to caring for a resident who has teeth. Using a moistened swab, the NA will clean the outside and inside of the mouth, including the lips and top and bottom gums and gumlines, as well as the tongue. The swab should be changed as needed.
79
8. Explain guidelines for performing oral care
A resident who can brush his own teeth may still need the following assistance from an NA: Collect and set up supplies Cover the overbed table Raise the head of the bed Provide a clothing protector or towel for the chest Pour fresh water and mouthwash Help with cleaning the face and neck Remove the supplies Empty, clean, and store supplies
80
Equipment: floss, cup of water, emesis basin, gloves, towel
Flossing teeth Equipment: floss, cup of water, emesis basin, gloves, towel 1. Identify yourself by name. Identify the resident. Greet the resident by name. 2. Wash your hands. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. If the resident is in bed, adjust the bed to a safe working level, usually waist high. Raise the head of the bed to have the resident in an upright sitting position. Lock bed wheels. Put on gloves.
81
Wrap the ends of floss securely around each index finger.
Flossing teeth Wrap the ends of floss securely around each index finger.
82
Flossing teeth 8. Starting with the back teeth, place floss between teeth. Move it down the surface of the tooth. Use a gentle sawing motion.
83
Flossing teeth Continue to the gum line. At the gum line, curve the floss. Slip it gently into the space between the gum and tooth. Then go back up, scraping that side of the tooth. Repeat on the side of the other tooth.
84
Offer resident a face towel when done flossing all teeth.
Flossing teeth 9. After every two teeth, unwind floss from your fingers. Move it so you are using a clean area. Floss all teeth. 10. Offer water to rinse the mouth. Ask the resident to spit it into the basin. Offer resident a face towel when done flossing all teeth. 12. Discard floss. Discard water and empty basin into the toilet. Rinse basin and place basin in designated dirty supply area or return to storage, depending on facility policy. Store supplies. 13. Place soiled linen in proper container. 14. Remove and discard gloves. Wash your hands. Make resident comfortable. 16. Return bed to lowest position. Remove privacy measures. 17. Leave call light within resident’s reach.
85
Flossing teeth 18. Wash your hands. 19. Be courteous and respectful at all times. 20. Report any changes in the resident to the nurse. Report any problems with teeth, mouth, tongue, or lips to nurse. These include odor, cracking, sores, bleeding, and any discoloration. Document procedure using facility guidelines.
86
9. Define dentures and explain care guidelines
Define the following terms: dentures artificial teeth. bridge a type of dental appliance that replaces missing or pulled teeth.
87
9. Define dentures and explain care guidelines
Know these points about denture care: Dentures are expensive and must be handled carefully. NAs must wear gloves when cleaning dentures. Dentures should be stored in clean, moderate/cool water in a covered, labeled denture cup, or returned to the resident.
88
Cleaning and storing dentures
Equipment: denture brush or toothbrush, denture cleanser or tablet, labeled denture cup with cover, 2 towels, gauze squares, gloves, cup of water, emesis basin, denture cream or adhesive (if replacing dentures in mouth) Identify yourself by name. Identify the resident. Greet the resident by name. Wash your hands. 3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. Encourage resident to assist if possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. 5. If resident is in bed, adjust the bed to safe working level, usually waist high. Raise the head of the bed to have the resident in an upright sitting position. Lock bed wheels. 6. Put on gloves.
89
Cleaning and storing dentures
Line sink/basin with a towel(s) and partially fill sink with water. This prevents dentures from breaking if dropped. Handle dentures carefully. 8. If a resident cannot remove her dentures, remove them for her (if facility policy). 9. Remove the lower denture first. The lower denture is easier to remove because it floats on the gum line of the lower jaw. Grasp the lower denture with a gauze square (for a good grip) and remove it. The upper denture is sealed by suction. Firmly grasp the upper denture with a gauze square. Give a slight downward pull to break the suction. Turn it at an angle to take it out of the mouth. 10. Rinse dentures in clean, moderate/cool running water before brushing them. Do not use hot water. Hot water may warp or damage dentures. Apply denture cleanser to toothbrush.
90
Cleaning and storing dentures
Brush the dentures on all surfaces. These include the inner, outer, and chewing surfaces of the dentures, as well as the grove that will touch gum surfaces. Rinse all surfaces of dentures under moderate/cool running water. Do not use hot water. Offer water to rinse the resident’s mouth. Ask the resident to spit it into the emesis basin.
91
Cleaning and storing dentures
15. Rinse denture cup if placing clean dentures in the cup. 16. Place dentures in clean, labeled denture cup with special solution or moderate/cool water. Dentures should be completely covered with solution. Place lid on denture cup and return denture cup to storage.
92
Cleaning and storing dentures
17. Some residents will want to wear their dentures all of the time. They will only want them removed for cleaning. If replacing dentures in resident’s mouth, make sure resident is still sitting upright. If needed, apply denture cream or adhesive to the dentures. When the resident’s mouth is open, place upper denture into the mouth by turning it at an angle. Straighten it. Press it onto the upper gum line firmly and evenly.
93
Cleaning and storing dentures
(cont'd) Insert the lower denture onto the gum line of the lower jaw. Press firmly. 18. Rinse brush. Clean and dry equipment and return it to storage. Place basin in designated dirty supply area or return to storage, depending on facility policy. Drain sink. 19. Place soiled linen in proper container. 20. Remove and discard gloves. Wash your hands. Make resident comfortable. 22. Return bed to lowest position. Remove privacy measures. 23. Leave call light within resident’s reach. 24. Wash your hands. 25. Be courteous and respectful at all times. 26. Report any changes in the resident or the appearance of dentures to the nurse. Document procedure using facility guidelines.
94
10. Discuss guidelines for performing oral care for an unconscious resident
Remember these points about oral care for an unconscious resident: Oral care must be done frequently. Oral care keeps the mouth clean and moist. Oral care removes sordes and helps prevent them from developing. The NA should use as little liquid as possible and turn the resident’s head to the side to prevent aspiration. Unconscious residents may still be able to hear. The NA should explain the procedure to the resident and treat the resident with the same respect he would a conscious resident.
95
10. Discuss guidelines for performing oral care for an unconscious resident
REMEMBER: Even when people are unconscious they still may be able to hear what is going on around them. NAs should limit their discussions to the care being provided and should speak to unconscious residents as they would to any resident.
96
Providing oral care for the unconscious resident
Equipment: sponge swabs, tongue depressor, towel, emesis basin, gloves, cup of water, lip moisturizer, cleaning solution (check the care plan) 1. Identify yourself by name. Identify the resident. Greet the resident by name. Residents who are unconscious may be able to hear you. Speak to them as you would to any resident. Wash your hands. 3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. 5. Adjust the bed to a safe level, usually waist high. Lock bed wheels. 6. Put on gloves.
97
Providing oral care for the unconscious resident
7. Turn resident on his side or turn head to the side. Place a towel under his cheek and chin. Place an emesis basin next to the cheek and chin for excess fluid. 8. Hold mouth open with tongue depressor. Do not use your fingers to open the mouth or keep it open.
98
Providing oral care for the unconscious resident
9. Dip sponge swab in cleaning solution. Squeeze excess solution to prevent aspiration. Wipe inner, outer, and chewing surfaces of the upper and lower teeth, gums, tongue, and inside surfaces of mouth. Remove debris with the swab. Change swab often. Repeat until the mouth is clean.
99
Providing oral care for the unconscious resident
10. Rinse with clean swab dipped in water. Squeeze swab first to remove excess water. 11. Remove the towel and basin. Pat lips or face dry. Apply lip moisturizer. Discard disposable supplies. Empty, rinse, and dry basin. Place basin in designated dirty supply area or return to storage, depending on facility policy. Place soiled linen in the proper container. 14. Remove and discard gloves. Wash your hands. 15. Make resident comfortable. 16. Return bed to lowest position. Remove privacy measures. 17. Leave call light within resident’s reach. 18. Wash your hands.
100
Providing oral care for the unconscious resident
19. Be courteous and respectful at all times. 20. Report any changes in the resident to the nurse. Report any problems with teeth, mouth, tongue, or lips to nurse. These include odor, cracking, sores, bleeding, and any discoloration. Document procedure using facility guidelines.
101
10. Discuss guidelines for performing oral care for an unconscious resident
Remember these guidelines for giving eye care to an unconscious resident: Don gloves. When cleaning the eye, use a different area of the washcloth for each stroke. Rinse it thoroughly, then use a clean washcloth for the opposite eye. Wipe from the inner area of the eye to the outer area of the eye when cleaning. Use moist compresses as directed.
102
11. Explain how to assist with grooming
REMEMBER: Grooming is a very important part of the activities of daily living (ADLs). Each day, some residents will require help with brushing and styling their hair, shaving, dressing, caring for fingernails, and applying makeup and jewelry.
103
11. Explain how to assist with grooming
Nursing assistants should remember these points about grooming: Appearance has a great deal to do with the way people feel about themselves. Regular grooming can have a positive effect on self-esteem, attitude, and independence; it also helps a person feel better physically. Nursing assistants should promote self-care and independence whenever possible.
104
11. Explain how to assist with grooming
Remember these points for assisting with shaving: Respect personal preferences regarding shaving. Wash and comb beards and mustaches every day. Do not trim facial hair. Soften hair first if using disposable or safety razor. Shave in direction of hair growth. Use shaving products only with a resident’s permission. Discard disposable shaving products properly. Do not share razors between residents. Do not use electric razors near water or oxygen. Handle safety razor blades carefully, and discard old blades in sharps container.
105
4. Provide for the resident’s privacy with a curtain, screen, or door.
Shaving a resident Equipment: razor, basin filled halfway with warm water (if using a safety or disposable razor), washcloth, 2 towels, mirror, shaving cream or soap (if using a safety or disposable razor), gloves, after-shave lotion (if resident desires it) 1. Identify yourself by name. Identify the resident. Greet the resident by name. Wash your hands. 3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. If resident is in bed, adjust bed to a safe working level, usually waist high. Lock bed wheels. 6. Raise head of bed so resident is sitting up. Place towel across the resident’s chest, under his chin. Put on gloves.
106
Shaving using a safety or disposable razor:
Shaving a resident Shaving using a safety or disposable razor: Soften the beard with a warm, wet washcloth on the face for a few minutes before shaving. Lather the face with shaving cream or soap and warm water. Hold skin taut. Shave in direction of the hair growth. Shave beard in short, downward, and even strokes on face and upward strokes on neck. Rinse the blade often in warm water to keep it clean and wet.
107
Shaving using an electric razor:
Shaving a resident When you have finished, wash, rinse, and dry the resident’s face with a warm, wet washcloth. If he is able, let him use the washcloth himself. Use the towel to dry his face. Offer mirror to resident. Shaving using an electric razor: Use a small brush to clean razor, if necessary. Do not use an electric razor near any water source or when oxygen is in use. Turn on the razor and hold skin taut. Shave with smooth, even movements. If using a foil shaver, shave beard with back and forth motion in direction of beard growth. If using a three-head shaver, shave beard in circular motion. Shave the chin and under the chin. Offer a mirror to resident.
108
11. Apply after-shave lotion as resident wishes.
Shaving a resident Final steps: 11. Apply after-shave lotion as resident wishes. 12. Remove the towel and place towel and washcloth in proper container. Clean equipment and store it. For safety razor: rinse the razor and store it. For disposable razor: dispose of it in a sharps container. Do not recap razor. For electric razor: clean head of razor. Remove whiskers from razor. Recap shaving head and return razor to case. 14. Remove and discard gloves. Wash your hands. 15. Make sure that the resident and environment are free from loose hairs. Make resident comfortable. 16. Return bed to lowest position. Remove privacy measures. 17. Leave call light within resident’s reach.
109
Shaving a resident 18. Wash your hands. 19. Be courteous and respectful at all times. 20. Report any changes in the resident to the nurse. Document procedure using facility guidelines.
110
11. Explain how to assist with grooming
Remember these points when assisting with nail care: Cleaning and caring for nails is part of the bathing process. Be gentle when using orangewood sticks. Follow facility policy regarding trimming fingernails or toenails. Do not use nail equipment on more than one resident.
111
Providing fingernail care
Equipment: orangewood stick, emery board, basin, soap, gloves, washcloth, 2 towels, bath thermometer 1. Identify yourself by name. Identify the resident. Greet the resident by name. 2. Wash your hands. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. 5. If the resident is in bed, adjust bed to safe working level, usually waist high. Lock bed wheels. 6. Fill the basin halfway with warm water. Test water temperature with thermometer or against the inside of your wrist. Ensure it is safe. Water temperature should be no higher than 105°F. Have resident check water temperature. Adjust if necessary. Place basin at a comfortable level for resident.
112
Providing fingernail care
7. Put on gloves. 8. Soak the resident’s hands and nails in the basin of water. Soak all 10 fingertips for at least five minutes. 9. Remove hands from water. Wash hands with soapy washcloth. Rinse. Pat hands dry with towel, including between fingers. Remove the hand basin.
113
Providing fingernail care
Place resident’s hands on the towel. Gently clean under each fingernail with orangewood stick. 11. Wipe orangewood stick on towel after each nail. Wash resident’s hands again. Dry them thoroughly, especially between fingers. 12. Shape nails with an emery board or file, moving in one direction only (not back and forth). File in a curve. Finish with nails smooth and free of rough edges.
114
Providing fingernail care
Empty, rinse, and wipe basin. Place basin in designated dirty supply area or return to storage, depending on facility policy. 14. Place soiled linen in proper container. 15. Remove and discard gloves. Wash your hands. 16. Make resident comfortable. 17. Return bed to lowest position. Remove privacy measures. 18. Leave call light within resident’s reach. Wash your hands. 20. Be courteous and respectful at all times. 21. Report any changes in the resident to the nurse. Document procedure using facility guidelines.
115
11. Explain how to assist with grooming
Remember these points when assisting with hair care: Allow residents to choose their own hairstyles. Do not comb residents’ hair in a childish style. Be gentle when handling hair. Do not cut residents’ hair.
116
11. Explain how to assist with grooming
Define the following terms: dandruff excessive shedding of dead skin cells from the scalp. pediculosis an infestation of lice.
117
11. Explain how to assist with grooming
Causes of dandruff may include the following: Climate, especially in dry, cold areas Stress Excessive sweating A type of fungus Hormonal changes Some types of dermatitis
118
Combing or brushing hair
Equipment: comb, brush, towel, mirror, hair care items requested by resident Use hair care products that the resident prefers for his or her type of hair. 1. Identify yourself by name. Identify the resident. Greet the resident by name. Wash your hands. 3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door. 5. If the resident is in bed, adjust bed to safe working level, usually waist high. Raise the head of the bed to have the resident in an upright sitting position. Lock bed wheels.
119
Combing or brushing hair
6. Place a towel under the head or around the shoulders. 7. Remove any hair pins, hair ties, and clips. 8. Remove tangles first by dividing hair into small sections. Hold lock of hair just above the tangle so you do not pull at the scalp. Gently comb or brush through the tangle. Be careful not to break hair or cause any discomfort.
120
Combing or brushing hair
After tangles are removed, brush two-inch sections of hair at a time. 10. Neatly style hair as resident prefers. Avoid childish hairstyles. Each resident may prefer different styles and different hair products. Offer mirror to resident. 11. Make resident comfortable. 12. Return bed to lowest position. Remove privacy measures.
121
Combing or brushing hair
13. Return supplies to proper storage. Clean hair from brush/comb. Clean comb and brush. 14. Place soiled linen in proper container. 15. Leave call light within resident’s reach. 16. Wash your hands. 17. Be courteous and respectful at all times. 18. Report any changes in the resident to the nurse. Document procedure using facility guidelines.
122
11. Explain how to assist with grooming
Remember these points about lice, or pediculosis: Parts of the body that may have lice infestation include the head, the pubic area, and other areas of the body, such as the underarms. Symptoms of lice include intense itching, scratching, and scratch marks or rashes on the scalp, neck, or body. Lice eggs can be seen on the hair, behind the ears, and on the neck. Lice droppings look like a fine black powder. Report symptoms immediately. Lice can spread very quickly.
123
11. Explain how to assist with grooming
Remember these points when assisting with dressing and undressing: Weaker side is called weaker, affected, or involved side. Do not refer to it as a “bad side” or talk about the “bad” leg or arm. Encourage independence with dressing and undressing. Do not rush residents when dressing. Make sure all clothing is marked with resident’s name. Treat clothing carefully. Allow residents to choose their own clothing. Make sure clothing fits properly.
124
11. Explain how to assist with grooming
Assisting with dressing and undressing (cont'd): Provide privacy when dressing and undressing. Keep residents covered. Gently smooth socks and stockings to remove wrinkles and twists. Front-fastening bras are easier for residents to work by themselves. Put back-fastening bras on waist and fasten them in front first before rotating around. Clothing with elastic waistbands is easier to get on and off. Use assistive devices when needed. When undressing, start with the stronger, or unaffected, side.
125
Equipment: clean clothes of resident’s choice, nonskid footwear
Dressing a resident Equipment: clean clothes of resident’s choice, nonskid footwear When putting on all items, move resident’s body gently and naturally. Avoid force and over-extension of limbs and joints. 1. Identify yourself by name. Identify the resident. Greet the resident by name. Wash your hands. 3. Explain procedure to resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. 4. Provide for the resident’s privacy with a curtain, screen, or door.
126
Dressing a resident Ask resident what she would like to wear. Dress her in outfit of choice. 6. Remove resident’s gown or top. Do not completely expose resident. Take clothes off stronger side first when undressing. Then remove from weaker side. Place gown or top in proper container for cleaning. 7. Gather up sleeve to ease pulling it over the weaker arm. Insert your hand through sleeve and grasp resident’s hand to support arm while dressing.
127
Place bed at the lowest position. Lock bed wheels.
Dressing a resident 7. (cont’d) Assist resident to put the affected/weaker arm through the sleeve of the shirt, sweater, or slip before placing garment on the unaffected/stronger arm. 8. Help resident to put on skirt, pants, or dress. Put the weaker leg through skirt or pants first. Raise the buttocks or turn resident from side to side to draw pants over the buttocks up to waist. Place bed at the lowest position. Lock bed wheels. 10. Have resident sit down. Pull up socks until they are both smooth and without wrinkles. Put on nonskid footwear. Fasten securely. 11. Finish with resident dressed appropriately. Make sure clothing is right-side out and zippers/buttons are fastened. Make sure skirt, pants, or dress is not caught under resident’s shoes.
128
Dressing a resident 12. Make resident comfortable. Remove privacy measures. 13. Place gown in soiled linen container. 14. Leave call light within resident’s reach. 15. Wash your hands. 16. Be courteous and respectful at all times. 17. Report any changes in the resident to the nurse. Document procedure using facility guidelines.
129
11. Explain how to assist with grooming
It is important to remember these points when dressing a resident with an IV: Do not pull on or catch the tubing on the clothing. Keep the IV bag above the IV site at all times. First remove the clothing, starting with the side without the IV. Slowly pull off clothing, sliding it over the tubing. Lift the IV bag off the hook and pull the garment over the bag. Hang the bag back on the hook. Put on clothing first on the side with the IV. Lift the bag off the hook, and slide the clean clothing over the bag. Hang the bag back on the hook.
130
11. Explain how to assist with grooming
Dressing a resident with an IV (cont’d): Gently pull the clothing over the tubing and the arm. Pull the clothing over the other arm and secure clothing. Check to make sure that the tubing is not kinked after you are finished. If you note the IV is not dripping, report to the nurse immediately. Ask the nurse to check the IV if you have any concerns.
131
Exam 1 Multiple Choice. Choose the correct answer. 1. Hygiene is (A) Another word for bad breath (B) Methods of keeping the body clean (C) Activities of daily living, such as eating, drinking, and elimination (D) A.M. care and P.M. care 2. One way to promote dignity and independence with personal care is to (A) Encourage residents to perform tasks independently even if it takes longer (B) Choose which clothes and cosmetics the resident will wear (C) Encourage residents to do their activities of daily living quickly (D) Leave residents alone while bathing
132
Exam 1 (cont'd) 3. Ms. Martin is an elderly resident with very dry skin. What kind of bath would be appropriate for her? (A) Partial bath (B) Shower (C) Tub bath (D) Complete bed bath 4. Mr. Reynosa has a doctor’s order for Epsom salts additives during bathing. What kind of bath would be most appropriate for him?
133
Exam 1 (cont'd) 5. Ms. Reid is unable to get out of bed due to recent surgery. She is very concerned with cleanliness and wants to bathe every day. Which kind of bath is most appropriate for her? (A) Partial bath (B) Shower (C) Tub bath (D) Complete bed bath 6. The decision on which bath to give a resident is made by (A) The physical therapist (B) The nursing assistant (C) The doctor and the resident (D) The resident’s family
134
Exam 1 (cont'd) 7. Observing residents’ skin during personal care and bathing is especially important in the prevention of (A) Depression (B) Abuse (C) Pressure ulcers (D) Diabetes 8. Which of the following is the highest priority for nursing assistants when bathing residents? (A) Speed (B) Safety (C) Making sure every resident has a bath every day (D) Observing for mobility
135
Exam 1 (cont'd) 9. A nursing assistant can make bathing safer for residents by (A) Asking for help if she cannot safely handle the task alone (B) Gathering all needed equipment after entering the bath/shower area (C) Making sure the water temperature is not over 120°F (D) Leaving residents alone while bathing or showering 10. A general rule for bathing a person is (A) Wash from dirtiest to cleanest (B) Wash from cleanest to dirtiest (C) Wash body parts in whatever order the resident prefers (D) Wash body parts in whatever order the nursing assistant prefers
136
Exam 1 (cont'd) 11. The part of the body that should be washed last is the (A) Face (B) Legs (C) Buttocks (D) Hands 12. Which of the following should be washed every day? (A) Hair (B) Knees (C) Chest (D) Perineum
137
Exam 1 (cont'd) 13. Which of the following is true of giving a complete bed bath? (A) The nursing assistant should wash the anal area before the perineal area. (B) The nursing assistant should make sure that the water temperature is no higher than 110°F. (C) The nursing assistant should place a towel or bed pad under the part of the body that is being washed. (D) The nursing assistant should uncover the resident’s entire body before beginning the bath. 14. If the nursing assistant notices redness around bony areas during a massage, she should (A) Massage around these areas (B) Massage these areas (C) Discontinue the massage (D) Apply extra lotion to these areas
138
Exam 1 (cont'd) 15. How often must oral care be provided for residents? (A) Once a day (B) At least twice a day (C) Only when the resident requests it (D) Every other day 16. A resident who is edentulous (A) Lacks teeth (B) Has bad breath (C) Is wearing dentures (D) Has tartar deposits on the teeth
139
Exam 1 (cont'd) 17. Which of the following is true about oral care? (A) Residents without teeth will not require any oral care. (B) Residents who are unconscious and do not eat do not require any oral care. (C) Oral care is not just care of the teeth, but also the mouth, tongue and gums. (D) Residents who wear dentures do not require oral care. 18. Which of the following is the proper temperature for rinsing and storing dentures? (A) Warm (B) Cool (C) Hot (D) Boiling
140
Exam 1 (cont'd) 19. The primary risk for unconscious residents is (A) Mouth dryness (B) Aspiration (C) Gingivitis (D) Mouth sores 20. In which of the following procedures must a nursing assistant always wear gloves? (A) Shaving a resident (B) Combing or brushing hair (C) Dressing a resident (D) Turning a resident
141
Exam 1 (cont'd) 21. Ways to prevent aspiration during oral care of unconscious residents include (A) Pouring mouthwash slowly into the resident’s mouth (B) Turning residents on their backs when giving oral care (C) Avoiding performing oral care on unconscious residents (D) Using as little liquid as possible when giving oral care 22. A nursing assistant should give nail care (A) Whenever she has time (B) When she is bathing a resident (C) When she notices a resident’s nails are getting long (D) When the resident’s nail polish wears off
142
Exam 1 (cont'd) 23. Which of the following statements is true? (A) Residents’ hair should be handled gently because hair can be pulled out when combing or brushing it. (B) Residents’ hair should be combed or brushed into childish hairstyles because they look cute on elderly people. (C) Nursing assistants should cut residents’ hair when it gets long and when residents request it. (D) Pediculosis (lice) cannot spread quickly. 24. When assisting a resident who has one weak side with dressing, (A) Clothing should be put on the weak side first (B) Clothing should be put on the strong side first (C) The weak side should be referred to as the “bad side” (D) It does not matter which side clothing is put on first
143
Exam 2 Multiple Choice. Choose the correct answer. 1. Before helping a resident into a shower, the nursing assistant should (A) Test the water temperature (B) Massage the resident’s head (C) Soak the resident’s fingertips (D) Exfoliate the resident’s skin with a brush 2. A female resident’s perineal area should be cleaned (A) Without using soap (B) With a special oil (C) From front to back (D) From the anal area to the meatus
144
Exam 2 (cont’d) 3. In which position should a nursing assistant place an unconscious resident before giving oral care? (A) Supine (B) Lateral (C) Fowler’s (D) Prone 4. What is an example of an additive that may be used for special baths? (A) Sugar (B) Corn meal (C) Oatmeal (D) Alcohol
145
Exam 2 (cont’d) 5. The medical term for swelling in body tissues caused by excess fluid is (A) Emesis (B) Edema (C) Enema (D) Eczema 6. Pediculosis causes symptoms such as (A) Itching and rashes (B) Acne and lesions (C) Cuts and abrasions (D) Boils and abscesses
146
Exam 2 (cont’d) 7. Sticks commonly used for nail care are called (A) Rosewood sticks (B) Greasewood sticks (C) Sandalwood sticks (D) Orangewood sticks 8. The advantage of a dental bridge is (A) The nursing assistant does not have to wear gloves while handling it (B) It replaces missing teeth (C) It will never crack (D) It cannot be cleaned
147
Exam 2 (cont’d) 9. In what direction should a nursing assistant shave a resident’s face when using a disposable razor? (A) Away from the resident’s chin (B) Toward the resident’s chin (C) In the direction of hair growth (D) In the opposite direction of hair growth 10. Tartar is (A) Clenching the teeth (B) Gum inflammation (C) Bad-smelling breath (D) Bacterial deposits
148
Exam 2 (cont’d) 11. When providing oral care to an edentulous resident, the NA should (A) Use swabs to clean the mouth (B) Use only mouthwash to clean the mouth (C) Use a firm toothbrush to clean teeth (D) Use dental floss as the final step 12. What temperature should the lotion be for a back massage? (A) Warm (B) Hot (C) Cold (D) Icy
149
Exam 2 (cont’d) 13. The safest type of razor for a nursing assistant to use on residents is (A) A safety razor (B) An electric razor (C) A disposable razor (D) A straight edge razor
Similar presentations
© 2025 SlidePlayer.com. Inc.
All rights reserved.