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NAC - Unit 2
Information that may or may not be on the exam
| Question | Answer |
|---|---|
| f/u | follow up |
| CVA | cerebral vascular accident |
| CHF | congestive heart failure |
| DM | diabetes mellitus |
| I & O | Intake and output |
| NOC | night |
| NPO | nothing by mouth |
| w/c | wheelchair |
| NAS | no added salt |
| Fx | fracture |
| PT | Physical therapy |
| OT | Occupational therapy |
| ST | Speech therapy |
| STAT | immediate |
| FWW | front wheeled walker |
| < | less than |
| > | greater than |
| gtt | drop |
| rxn | reaction |
| abd | abdomen |
| UA | urinalysis |
| Hx | history |
| N/V | nausea and vomiting |
| aspiration | the inhalation of food, fluid, or foreign material into the lungs #1 cause of pneumonia in LTC |
| atrophy | weakening or wasting away muscles |
| body mechanics | the way the parts of the body work together when a person moves |
| contracture | the permanent and painful shortening of a muscle, tendon, or ligament that can restrict movement |
| cyanosis | blue or pale skin and/or mucous membranes due to decreased oxygen in the blood |
| What does the acronym PASS stand for? | Acronym for use of a fire extingusher, Pull - Aim - Squeeze - Sweep |
| What does the acronym RACE stand for? | Steps taken during a fire; Rescue or Remove, Activate alarm, Contain or confine, Extinguish or evacuate |
| What are the 4 ways to prevent a fall? | Bed locked and low, gait belt firm around patient's waist, Non-skid shoes or socks, and Signal light |
| When do you lock the breaks on a wheelchair? | When moving pt in and out of bed to wheelchair or visa versa, making sure foot rest is out of the way w/c to bed |
| How do you tell which bed is #1 and which bed is #2` | Pt. in bed one will be near the door and is listed as the first name on the door, bed #2 is nearest to the widow and the name is on the bottom |
| dysphagia | means difficulty swallowing |
| hoarding | Collecting and putting things away in a guarded way. ( example - twinkie in bra or under fold of breast) |
| What is the best position to put the pt. in when giving food or drink while in bed? | Sitting upright at a 90 degrees |
| When carrying object how should you be holding it? | Close to your body |
| When lifting or putting something on the ground, what should your body mechanics be? | using your legs and thighs by squatting while lifting |
| What is a restraint? | Physical or chemical way to restrict voluntary movement or behavior. |
| Who authorizes a restraint and what type do you use? | Only when needed and only with doctor's orders and the least restrictive restraint possible must be chosen |
| Is oxygen considered a drug? | Yes |
| What is a emese basin? | Kidney shaped, it is used to collect bodily fluids such as vomit |
| What is the heimlich maneuver now called? | abdominal thrust |
| What is the most common item that causing choking? | Meat is the #1 followed by lettuce. In nursing homes broccoli can also cause problems to make sure to cut everything up in bite size pieces |
| emesis | the act of vomiting, or ejecting stomach contents through the mouth and/or nose. |
| epistaxis | nosebleed |
| hyperglycemia | high blood glucose (blood sugar) |
| hypoglycemia | low blood glucose (blood sugar) |
| myocardial infarction (MI) | condition which blood flow to the heart is blocked and muscle cells die. AKA Heart attack |
| syncope | temporary loss of consciousness; aka fainting |
| obstructed airway | when someone is choking, they usually put their hands to their throats |
| When someone is choking what should you do? | If they are making sounds, be calm, supportive and let them work it out. |
| shock | occurs when organs and tissues in the body do not receive an adequate blood supply |
| What is another way to say severe bleeding? | hemorrhage |
| What is a code team? | Team chosen for a shift to respond in case of resident emergency |
| What do you do when someone is having a seizure? | For safety protect their head if you can put a pillow under them, make sure they are breathing and if necessary turn them on their side to prevent choking on vomit |
| What does L/min mean? | Liters per minute |
| When would you use L/min? | This is used for the dosage from oxygen which can be 1/2 to 2 L/min |
| What is the other name for a transfer belt? | gait belt |
| When is it appropriate to do an abdominal thrust? | When there is no signs of air, color change on face |
| ambulation | act of moving/walking with/without an assistive device |
| dangle | sit up with legs hanging over the side of the bed in order to regain balance |
| logrolling | moving a person as a unit, without disturbing the alignment of the body |
| mechanical lift | special equipment used to lift and move or lift and weigh a person (hydraulic lift) |
| prone | body position in which a person is lying on his stomach, or front side of the body |
| shearing | skin moving one way and the bone underneath it remaining fixed or moving in the opposite direction |
| supine | body position in which a person is lying flat on his back. |
| transfer belt | belt made of canvas or other heavy material used to help people who are weak, unsteady, or uncoordinated to stand, sit or walk |
| What is another name for the mechanical lift | Hoyer |
| friction | the rubbing of a surface against each other |
| How often should bedbound patients be repositioned? | It is critical and it should be done at least every 2 hours |
| What is the degrees that you lift a bed for high-Fowler's position? | Upper body is sitting nearly straight up 60 to 90 degree |
| What position would you be in for semi-Fowler's? | upper body is not raised as high 30 to 45 degrees |
| How many NAC should be used when doing logrolling? | At least 2 people |
| Why would you put someone in a dangle position on the bed? | To help prevent orthostatic hypotension |
| Where and how should you put a gait belt on? | on pt. waist over cloths and snug. |
| When transferring patient which side should you be transferrig them one? | Transfer on their strong side |
| What side of the patients body do you ambulation | on their weak side |
| bridge | a type of dental appliance that replaces missing or pulled teeth |
| Can a bridge be a partial? | yes |
| dentures | artificial teeth |
| gingivitis | inflammation of the gums |
| halitosis | bad breath |
| plaque | substance that accumulates on the teeth from food and bacteria |
| How many different ways are there to give a patient a bath? | 4 |
| What are the different types of baths | partial bath, shower, a tub bath, and complete bed bath |
| Who determines the type of bath a patient gets | Type of bath given is determined first by the resident's needs and abilites and then by the resident's preference |
| How hot should the water be when giving a patient a bath | 105 degree because by the time you get the container next to the bed it will cool a little bit |
| What is a partial bath | washing face, underarms, hands and perineal area |
| Do you give your patients a massage | No because you could cause shearing. You can lightly apply lotion |
| What type of water is used to clean dentures | tepid water (luke warm) |
| Do you floss patient's mouths | no |
| When cleaning finger nails and toe nails how long do you soak? | hand for finger nails soak for 5 to 10 minutes, feet for toe nails 10 to 20 minutes |
| When putting on patients cloths remember POW, what does this mean? | when putting on cloths put on the weak side first |
| What does TOSS stand for | Take of strong side first |
| renal calculi | kidney stones |
| Appropriately how much urine can one person produce in a day? | 1200 to 1500 mL |
| What is the most common bacteria that causes UTI's in LTC | E. coli bacteria |
| Urinary tract infection (UTI) | infect of the urethra, bladder, ureter or kidney. Most common bacteria is E coli, it moves from the anus into the urethra and then to the bladder causing the UTI |
| Where is E. Coli most commonly found | gastrointestinal tract |
| When cleaning women's prenatal area how do you wash? | cleanest to dirtiest so from front to back |
| What is a clean-catch specimen | midstream specimen into a clean sterile container |
| What is BPH | benign prostatic hyperplasia |
| How often do you empty a folly bag | every 8 hours |
| What is the folly bag | it is a container that captures urine that is clear so that you can make observations on the pt urine |
| Can a chlorhexidine gluconate cloth decrease UTI's | yes by about 85% |
| How often should a patient be bathed? | Once or twice a week depending on the patients needs |
| When documenting urine what are you looking for? | quantity, color and clarity |
| How many different colors are used to describe the color of urine | 8 |
| What does pink tinged urine mean | there is blood in the urine |
| Is amber and straw color exchangeable | yes they both mean mild to moderate dehydration issue with the patient |
| What does tea colored urine indicate | severe dehydration, possible organ failure or end of life |
| What does bright yellow urine indicate | the person is taking some type of B vitamin or prenatal vitamins |
| What does yellow or pale yellow urine indicate | The person is getting adequate hydration |
| What does colorless urine indicate | no problems |
| How many different ways are there to describe the clarity of urine | 4 |
| What do you do if your pt urine is clear | nothing because that is normal |
| What does cloudy urine indicate | It is not normal first of all and it should be investigated because it could indicate a possible UTI |
| What should you do if the urine has sediment in it? | It is not normal and requires further investigation |
| What do you do when there are mucus threads in the urine | this can be normal and looks like there are little white threads in your urine |
| Do you use a normal tooth brush to brush a patients teeth | you use a oral swab |
| What pt should get mouth care every 2 hrs | NPO, someone is on O2, febrile, N/G tube, Vomiting or unconscious all of these cause dry or sticky mouth |
| When washing hands how long do you scrub or rub your fingers, hands and wrist for? | Start at fingertips and slow move to approx. 2" above the wrist for at least 20 second |
| What about your fingernails and nail beds? | You scrub your nails and beds after washing for at least 20 seconds. |
| How do you dry your hands? | Pat dry starting or rub working fingers toward the wrist, DO NOT MOVE back down, dump paper towel and get a new one |
| What supplies do you need out before putting the pt/res on the bed pan? | toilet paper, hand wipe, bed pan (in room in night stand), gloves and paper towel |
| Do you lower the bed before placing bedpan? | Yes, lower to level, put your gloves on then place bedpan under pt/res |
| What do you need to ask the pt/res before putting the on the bedpan | As them raise their knees, then to raise their hips while you are placing bedpan - making sure it is place correctly under the buttocks |
| Do you dry bedpan before placing in with dirty equipment? | No you never dry the bed pan |
| What equipment do you need for measuring and recording urinary output? | Nothing but clean gloves at the sink, make a point to put urine in graduated container over the toilet, then place on top of paper towel |
| Where do you dump the bed pan | Only in the toilet |
| How do you measure the urinary output | reading the graduate by looking at eye level, rounding to the nearest 25ccs |
| Can you perform more than on skill at a time | Yes, as long as you maintain privacy |
| What supplies are needed for perineal care | wash basin, incontinent pad, 4 wash rags (4 fold method), bath towel, soap and gloves, 105 degree water |
| How do you preform perineal care | Using 4 fold method, start in perineal area, opening labia, wiping from front to back (cleanest to dirtiest), fold way dirt part of w/cloth, then repeat on each side, then turn pt and do anus to tail bone, then each buttock the same way |
| What equipment do you gather before putting pt on bed pan | bed pan, paper towel, toilet paper, hand wipes and gloves |
| How do you get bed pan under pt | With bed flat, ask pt to raise their knees, give the a count to raise their hips so that you can put the bed pan under them |
| What supplies are needed for catheter care | wash basin, incontient pad, 3 wash clothes (4 fold), soap, water at 105 degrees |
| How do you do catheter care to the pt | Once equipment is setup, 1 dry wash cloth, 1 wet wash cloth and soapy cloth, all folded using the 4 fold method, gab catheter and stabiliza at the meatus wipe down to 4 inches from bottom, then repeat with wet and dry cloth |
| How do you take urinary measurements | Place graduate on paper towel, take bed pan and empty to graduate over toilet, then place on paper towel, look at eye level and round to nearest 25ccs |
| What do you do when assisting w/walking, sitting, or standing with pt that is unstable | Use a gait belt, around pt waist, over clothing and snuggly - remembering to tell pt why you are putting it on that way |
| Where all the different place you can take a pulse and for how long do you take them for clinical testing | each of these are for one minute, carotid, apical (just below left nipple), brachial, radio, femoral, pedal |
| How long is the urethra for men and then women | Men's are 6 to 8" long, women are 1 1/2" to 2" long |
| List the urinary system organs and what is the extra one that men have | 2 - Kidneys which have millions of nephrons, 2 - ureters, bladder, at the bottom of the bladder you have receptors, then men have a prostrate and then both have urethras |
| What is cellulitis | a skin infection caused by bacteria moving into the tissues due to a break in the skin |
| What is dermatitis | inflammation of the skin also known as ecema |
| What are pressure injuries | localized damage to the skin that occurs due to shearing or to continued pressure over time; also known as pressure sores, decubitus ulcers or bed sores |
| What is psoriasis | autoimmune disease -a chronic skin condition caused by skin cells growing too quickly that results in red, white, or silver patches, itching and discomfort |
| What are scabies | a contagious skin infection caused by mites burrowing into the skin that results in pimple-like irritations, rashes, intense itching and sores |
| What is shearing | the skin moving one way and the bone underneath it remaining fixed or moving in the opposite direction |
| What is shingles | a viral infection caused by the same virus that causes chickenpox; results in pain, itching, and rash |
| What are changes in the integumentary system due to aging | Fat and collagen decreases, skin sags, lose of elasticity, causing wrinkles, hair and nail growth slows, skin becomes drier, thinner and more fragile skin, fatty layer thins so they feel colder, hair turns gray, brown spots or age spots |
| What is the normal treatment for dermatitis | topical steroid creams, soothing or drying lotions prescribed by doctor |
| Where might you find a cellulitis spot on a pt | In LTC at the IV site |
| When in a lateral position where might you have pressure injuries | side of head, ear, shoulder, hip, greater trochanter, knees and ankles |
| When in the prone position where might you have pressure injuries | cheek, collarbone, breasts (women), abdomen, genitals (men), knees and toes |
| When in the supine position where might your pressure injuries be | back of head, shoulder blades, elbows, buttocks, sacrum (base of spine), between the legs, and heels |
| When working with pt what should you make sure you do to help prevent pressure injuries | dry, wrinkle-free linens, no wrinkles in their clothing and making sure you are repositioning the pt at least every 2 hours |
| What are the stages of pressure injuries | stage 1 - skin is intact, stage 2 - partial-thickness skin loss epidermis and dermis discolored and moist, stage 3 - full-thickness skin loss fat is visible in the injury, eschar may be present, slough is yellow, tan, gray, green or brown, stage 4 - full |
| What is abduction | moving a body part away from the midline of the body |
| What is active assisted range of motion (AAROM) | exercise to put a joint through its full arc of motion that are done by the res w/ some assistance form a staff member |
| What is active range of motion (AROM) | exercise to put a joint through its full arc of motion that are done by the res himself, without help |
| What is adduction | moving a body part toward the mid-line of the body |
| What is dorsiflexion | bending backward |
| What is extension | straightening a body part |
| What is flexion | bending a body part |
| What is foot drop | weakness of muscles in the feet/ankles that interferes w/the ability to flex the ankles and walk normally - plantar flexion ballerina toes |
| What is passive range of motion (PROM) | exercises to put a joint through its full range of motion that are done by a staff member, w/out the res help |
| What is range of motion (ROM) | exercises that put a joint through its full arc of motion |
| What is rehabilitation | care that is managed by professionals to restore a person to the highest possible level of functioning after an illness or injury |
| What is restorative care | care given after rehabilitation to maintain a person's function and increases independence - works to maintain functioning, to improve his quality of life, and increase independence |
| What are possible complications of immobility | Gastrointestinal - constipation, Urinary - Urinary tract infection (UTI), Integumentary - Pressure injuries/slow healing wounds, Circulatory -blood clots, especially in the legs, Respiratory - pneumonia, musculoskeletal - muscle atrophy/contractures, Nerv |
| What do you document when skin | Color, temperature and moisture (turgor) |
| How should you document temperature | Very warm (febrile), warm (normal), cool (possible hypothermia) |
| How many different colors are there to describe skin color? | 7 |
| What is pallor skin color | white |
| What is pale skin | no tan |
| What is pink skin | normal, healthily glow, arterial pink blood in facial area because of the capillaries |
| What is erythema | localized redness, flushed |
| What is dusty skin | light gray, localized @ nail beads/mouth - low blood oxygen |
| What is cyanotic skin | blue/gray , lips, or nail beds that indicates a lack of oxygen in the blood - death |
| mottled | skin pattern, black or dark purple - indicates EOL starts the farthest away from the heart at the toes and slowly travels through the body |
| How do you describe moisture in the skin | moist (very warm), dry (normal), clammy (cool) |
| If you see P/W/D in a chart what does this mean | Pink, warm and dry (normal limits) |
| Is dermatitis contagious | No, however, it is really itchy |
| What might cause dermatitis | stress, allergens, weather change, can be found in the creases of your elbows and behind knees |
| What might be prescribed to help with dermatitis | steroid cream |
| Is psoriasis contagious | No, this maybe caused by autoimmune dx |
| What is and can be done for psoriasis | hyper production of skin cells, flakey sometimes silver in color, plaques of skin, medications and or tanning bed time |
| Is shingles caused by the herpes zoster | Yes, once you have had chickenpox it lives in your body for the rest of your life and can flare up at anytime |
| Is shingles contagious | Yes, when you have blisters is when you are contagious |
| What is eschar | dead black skin cells around pressure injuries |
| Are NAC responsible for making sure all assisted devices are well maintained | Yes |
| What are examples of assisted devices | glasses, walker, wheel chair, dentures, hearing aids |
| What is a bed cradle | A half hoop shape or device used to lay the sheets and blankets on so they do not touch the feet of the pt |
| What are the 4 skills that you perform while pt is in supine position | bed pan, compression socks, re-positioning pt and ROM of ankle and knee |
| What supplies are needed when you reposition a pt | 2 pillows and a bath blanket |
| Where do you put the supplies you need for repositioning the pt | One pillow goes behind from shoulder to hip or buttocks, 1 pillow goes between legs to off set leg, knee and ankle and bath blanket goes under the arm for resting position |
| What supplies do you need to perform a bed bath | New clean gown, gloves, 3 wash cloths, basin, hand towel, bath towel, soap |
| Where are do you clean for bed bath | 1 wash cloth wet, to wipe eye to side, eye to side around the face - 1 soapy for shoulder down to fingers and then up to arm pit, then use wet one to clean soap - towel is used to pat dry face and then arm when completed |
| What supplies do you need when dressing a pt | you choice 2 shirts and ask pt which one they want, then you put on weak side first (POW) then have them assist you with the other arm. Make sure it is straighten, button looks like you would wear it |
| What supplies are needed when brushing dentures | gloves, paper towel, dentures, tooth brush, tooth paste, emesis basin, denture cup |
| Where do you clean dentures | At the sink, paper towel down for barrier then rinse lip, dump water rinse dentures cup placing each of these on the paper towel, wet toothbrush and then put on tooth paste, brushing dentures inside and out - looking for broken teeth or cracks |
| When looking at the food tray what all will you see | name plate, paper plate, cup with water, napkin, spoon, chair for you to sit in, 3 pieces of candy for options to pt |
| What supplies are needed when doing foot care | incontent pad, bath towel, hand towel, basin, 1 wash cloth, soap, gloves, lotions |
| What are you looking for when doing foot care | looking for cracks and open sores |
| What is the incontient pad and bath towel for when doing foot care | incontient pad is barrier for NAC, bath towel is used for barrier for basin |
| What supplies are needed when providing mouth care for pt | hand towel, emesis basin, tooth brush, tooth paste, gloves, paper towel, can cup of water |
Created by:
bdeebrian