Lesson 1.1 Introduction in Personal Care and Grooming Lesson 1.2 Scopes in Performing Personal and Grooming Care
Lesson 2.1 Stages of Progression for Dementia Lesson 2.2 Guidelines for Assisting Residents with Dementia Lesson 2.3 How to Manage Special Problem for Dementia
A. 25 CNA Flash Cards B. 25 Fill in the Blank Questions C. Mini Practice Test
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: Personal Care & Grooming Introduction to Personal Care and Grooming
What is Integumentary System? The integumentary system is made up of the skin and its appendages Skin is the largest organ of the body and contains glands, blood vessels, lymphatic vessels Appendages are classified as the overlying epidermis epiderm is including sweat glands, sebaceous glands, hair and nails. Skin becomes the foremost sensitive sensitive part of the body as an individual gets older. As an individual gets old, physical contact - touching, caressing, cleaning - are susceptible to irritation, infection and diseases.
Functions of the Skin
Protect the body from injury and m icroorganisms. Serve as the shield, protector of the body from excessive exposure of ultraviolet light. Balance the body temperature with to perspiration Storage of fats, vitamins and water. Serves as the sensory organ for heat and pressure stimuli.
Signs of Skin Aging and Breakdown
Skin pigmentation yellows. Hair color becomes gray then white. Loss of fatty tissue resulting to wrinkles. Wrinkled skin. Oil gland secretion decreases, skin becomes dry.
Effect of Skin Breakdown Older individuals, are more vulnerable to skin damage. The effect of skin damage:
Painful lesions called Pressure Ulcers. A serious health condition that may lead to death of an individual or patient.
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4 Stages of Skin Breakdown
Skin color is somewhat red or blue-gray discoloration.
The discolored skin contains blister or shallow crater.
Skin layers totally damaged making the ulcer deepen to subcutaneous tissues of the skin.
The damage skin extends not only in subcutaneous tissue but also in muscles, joint, and bones. *Surgical procedure is highly recommended.
If you are a Nursing Assistant, you must: 1. Always encourage your patient to drink plenty of water. 2. Keep the resident’s skin dry and clean. Other forms of moisture of the skin may irritate the resident. 3. Apply necessary skin lotion. Pat the lotion on your resident’s skin. Avoid rubbing to prevent 4. 5. 6. 7. 8. 9. 10.
irritation and damage. Make sure the bed linens are clean and dry. Encourage resident to have passive exercise everyday day. Do not drag the resident when they’re in bed. Use turning sheets or trapeze when m oving the resident. Check if resident’s braces, shoes, and restraints are not rubbing their skin. Use necessary briefs or underpads to keep the resident dry. Use pillows, wedges or layers of clothing to separate skin surface. If resident is in his or her wheelchair, do not forget to place a gel air cushion to avoid additional pressure on resident’s buttocks. Prevention is better than trying to cure skin damage. Immediately report any indications of inflammation or irritation.
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Before you perform personal care and grooming for your resident, you must follow b eginning and ending procedure actions. Obey the following:
1. Prepare your personal care and grooming kit. 2. Always knock on the door first before entering. 3. Introduce yourself to the resident. 4. Check resident’s bracelet or record chart for their name. And address them with respect. 5. If there is a visitor, politely ask them to wait outside. 6. Before starting, tell the resident what care you’ll be performing. And encourage residents to ask
questions if they want. 7. Close the door and window curtain for privacy. 8. Wash your hands. (Follow the correct procedure in washing hands.) 9. If your personal care has an exposure for any blood or body f luid, always use gloves. 10. If your personal care is cleaning or changing contaminated linens or contaminated blood/fluid, then use gown. 11. Always prepare your gloves, gown and eye protection. Be sure you follow correct procedure in infection control. 12. Keep in mind to elevate the bed and lower the side rails when performing care.
1. After finishing your personal and grooming care, check resident’s condition. 2. Remove your gloves. 3. Raise the resident’s side rails, if necessary, due to resident’s condition. 4. Remove other personal protective equipment (PPE) includes gowns and eye protection. 5. Discard them in a proper container. 6. Wash your hands again. (Follow the correct procedure in washing hands.) 7. Adjust the bed to the lowest position. 8. Open the curtain. Make sure the resident is in comfortable position. 9. Place the call signal and other resident’s personal item within his or her reach. 10. Wash hands again. (Follow the correct procedure in washing hands.) 11. If there is visitor inform them to come back inside the room. 12. Report the task completion and resident’s health condition.
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Making Bed 1. Always follow proper body mechanics to avoid back pain or injury. 2. In removing and changing linen, make sure you work one side of the bed first. 3. The bottom and draw sheet must be smooth and unwrinkled. 4. Be sure you follow resident’s health plan specifically in positioning the resident’s head and pillows. 5. Linen must be clean to avoid skin irritation.
Handling Linens 1. Wash your hands. Use gloves and other personal protective equipment if required. 2. Only bring linen that you need into resident’s room. 3. If linen touches the floor, it is already considered dirty and should not be used. 4. Avoid linens to have a contact with your uniform. Keep a distance when carrying and replacing the 5. 6. 7. 8. 9. 10.
soiled linen to the new one. Keep the soiled area on the inside when removing the soiled linen and immediately fold the linen at the center. Then immediately place it inside the laundry hamper or plastic bags. Do not shake the soiled linens because it contains microbes. Do not place the soiled linens in resident’s chairs or tables. The laundry hamper is only allowed two-thirds full of soiled linens. Hampers should be at least 2 rooms away from the clean linen carts. Return the laundry hamper cart in the utility room
There are more than three (3) personal care and grooming skills. To name a few, these includes:
Daily Hair Care 1. Follow the beginning procedure actions. 2. Prepare towel and comb or hair brush. 3. Assist resident to stay near you. If resident can sit, place towel around his or her shoulder. 4. Place the pillow with a clean towel, if resident can’t sit o r sit-up. 5. Remove eye glasses if resident uses. 6. Section the hair. 7. Carefully stroke resident’s comb or brush the hair. 8. Let the resident move the back of their head so that it will be combed and brushed. Check for any
scalp and skin abnormalities. 9. Finally, arrange the hair neatly. Braid long hairs. 10. Clean and replace the equipment according to facility policy. 11. Follow the completion (ending) procedure actions.
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Oral Hygiene For Conscious and Unconscious Person 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12.
Follow the beginning procedure. Prepare necessary equipment including disposable gloves, emesis basin, toothbrush, toothpaste, glass of water, hand towel, dental floss, disposable bed protector and more. Raise the head portion of the bed. Lower the side rails and position the over-bed table near resident’s lap. Place the bed protector on top of the over-bed table as well as the other needed equipment. Place a clean towel over resident’s chest. When care is done, drag the over-bed table to foot of bed. Clean the equipment and store according to facility policy. Any soiled linens must be placed in a laundry hamper or plastic bags. Dispose gloves and the disposable bed protector according to facility policy. Lower the bed and position the resident comfortably. Raise the side rails. Follow the completion (ending) procedure actions.
Foot and Toenail Care Follow the beginning procedure actions. Prepare necessary equipment including basin, soap, bath mat, bath thermometer, lotion, nail brush, disposable bed protector, bath towel, washcloth and orangewood stick. 3. Assist resident to sit in a chair. 4. Place the bath mat on the floor. Then fill in the basin with warm water. Place the basin on the mat infront of the resident. 5. Remove resident slippers and place it on the basin. Cover the basin with a clean towel. 6. Soak for about 20 minutes. If want to add warm water, just lift the feet. 7. After soaking, wash it with soap. 8. Remove the feet from the water. Then rinse and dry it. Check for any calluses and abnormalities. After, remove the basin. 9. Get the orangewood stick to clean the toenails. If nail is long, always tell the nurse. Follow necessary facility policy. 10. Put small amount of lotion in your palm. And apply gently to the feet. Avoid lotion between toes. Any excess lotion must be wiped off using a towel. 11. If resident has a ambulatory condition, use necessary socks or stockings. Then assist resident to go back to his or her bed. 12. Gather all equipment. Clean and store according to facility policy. 13. Follow ending procedure actions. 1. 2.
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Lesson 2: Communicating & Caring for Residents with Cognitive
Stage 1
Residents loose interest in participating social activities. Residents hygiene and grooming are starting to lose value for them. Residents are prone to depression and anxiety. Residents experience series of memory loss. Residents are not focus with their daily activities. Residents tend to be delusional.
Stage 2
Stage 1 behaviors are evidently occurring to the residents. Residents are necessary to undergo physical and emotional check up. Residents often seen wandering at all times. Residents experience hallucinations. Residents have difficulties in their bowel and bladder movement. Residents have changes when it comes to their sensory and perception towards their environment.
Stage 3
Residents badly need assistance from any of the facility medical workers. Residents become too dependent when it comes to their daily activities. Residents are unresponsive for any verbal or non-verbal communication. Residents are completely incontinent. Residents have problems with their mobility.
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1. Call your resident by his or her name. 2. When talking to your resident, use eye contact. This way, your resident knows that you are sincere and can be trusted health worker. 3. Make use of proper body language. If in case your resident has speech problems, be mindful for your resident facial expressions. With that, you will know what he/she wants to tell you. 4. Always assist your resident in a friendly manner. 5. Be compassionate. If you can laugh with them, just do it. 6. Accept your resident with all your heart. 7. You should not be judgmental and avoid arguing with them. 8. Be brief and concise when explaining. Lengthy explanation might cause your resident to be more confused. 9. If your resident is explaining or discussing something, do not interrupt. Listen to them carefully. Politely answer their queries 10. Do not talk negatively towards your resident. 11. You must be well aware that dementia residents normally do not know what they say or do. 12. Be creative in taking good care of your resident. This can be beneficial for you and your resident
How to Manage Special Problems for Dementia
2 Examples of Special Problems for Dementia Wandering and Pacing 1. 2. 3. 4. 5. 6.
Allow your resident to wander. Too much restraint might cause your resident to be anxious. Always check your resident’s place if it is safe and secure. You can ask your superior if you can walk with your resident to avoid getting lost inside the facility. Check your resident for any signs of fatigue. Let your resident sit to make them relax. Always use special chairs which are purposely designed for resident with Dementia. Update your resident’s food intake since wandering and pacing consumes energy.
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Delusions and Hallucinations 1. Always understand your resident’s perceptions and beliefs. 2. Avoid arguments with your resident.
BONUSES !!!
Instructions:
Here is the 25 CNA Flash Cards Print out the sample flash cards. Fold on the dotted lines.
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Instructions:
25 CNA questions. You may print it out or you may write down your answers on a piece of paper. Questions below serve as an assessment of your learning.
When the resident complains of pain, you should ________ the nurse. 2. If you’ve worn a gown to care for a resident in a _________, you must remove it before leaving resident’s room. 3. A CNA must wear ____ when doing peri-care. 4. With regards to aging, most people are ________ and ___________. 5. Brachial Artery is located at the _______. 6. You should correct an error in ______ by drawing a single line through it. 7. A diabetic resident asks you to cut his/her toenails. You should explain to the resident that you are ____ ______ to do it. But will refer the matter to the nurse. 8. Upon entering the resident’s room, you notice that he/she is not breathing. You should immediately ____ ______ _____. 9. If a resident’s elbows are dry and red, you should ________. 10. _______ on the skin is the common cause of decubitus ulcers. 11. Maintaining good interpersonal relationships depends on clear ___________. 12. You witness an employee in a healthcare facility hitting a resident. You should report it to _____ _______ immediately. 13. When arranging a resident’s room, you should do all the following EXCEPT administer ______. 14. __________ is the most serious problem that wrinkles in the bedclothes can cause. 15. A clean bed linen was placed in the resident’s room, but was not used. It should be put in the ____ _____ container. 16. At stage of 2 of _______ _______, the discolored skin also has an abrasion, blisters, or shallow center. 17. Storage of ____, _______, and ______ is one of the important of skin. 18. During stage one of skin breakdown, the color is _____ or ______ discoloration. 19. The _____ is the one who supervise CNAs. 20. The best way to identify a resident is to check his/her _______ ______. 21. Soiled linens removed from a resident’s bed should be _______ to prevent the spread of infection. 22. Veins carry oxygen and _____ blood. 23. The _______ system is made up of skin and its appendages. 24. Ventilation is a combination of ______ and __ ______. 25. _____ is a difficulty in breathing. 1.
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Instructions: This mini practice test represents our full version study guide practice tests The written CNA test is in multiple choice format. Take this practice test seriously since it will help familiarize you with the type of questions that may appear on the actual CNA certification exam. You can either print it out or just write down your answer in a piece of paper. Best of luck!
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How do you convert 9 ounces of juice to milliliters? a. 9 x 5 ml b. 9 / 5 ml c. 9 x 30 ml d. 9 /30 ml
If you come across a resident who is depressed and crying, you should: a. tell the resident to look on the brighter side b. call the resident’s family c. tell the resident to stop crying d. ask the resident is something is wrong
How should you handle soiled linens removed from a resident’s bed, to prevent the spread of infection? a. place them on a neat pile on the floor b. carry them close to your body c. put them in a dirty linen container d. spray them with antiseptic 3.
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A CNA must wear gloves for which of the following tasks: a. doing peri-care b. giving a back rub c. assisting with range or motion exercises d. feeding a resident
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Who supervises the work of a CNA? a. the doctor
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b. the nurse c. the state of nursing board d. the facility administrator
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Headaches, nausea, and pain are classified as: a. observations b. symptoms c. indicators d. side effects
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With regards to aging, which of the following statements is true: a. most older people lives in nursing homes b. most elderly people are often disoriented and confused c. most older people are frail and helpless d. most older people are alert and oriented
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It is a sitting or semi-sitting position with the head of the bed elevated: a. fowlers b. prone c. lateral d. supine
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Thinning of the fatty layer under the skin may cause the resident to walk: a. have difficulty in walking b. have slowed mental responses c. lose their appetite d. develop pressure sores
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A decrease in the size of muscle is called: a. hypokalemia b. decubitus c. atrophy d. hypertrophy
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Combative behavior in a resident is primarily caused by: a. confusion
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b. anger and fear c. stubbornness d. multiple personality disorder
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An increased pulse rate can be caused by: a. exercise b. depression c. tranquilizers d. sleep
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The fire alarm has been sounded. What should the CNA should do first? a. call the fire department b. run to the nurse for direction c. take the nearest fire extinguisher and attempt to put out the fire d. make sure all the residents are out of the hallway and closed all doors.
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Who do residents in the long term care facilities depend on for their safety? a. the safety/risk manager b. the director of nursing c. the CNA d. all the employees of the facility
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A new resident has been admitted to the facility. The CNA should: a. offer the resident for a snack b. introduce him/her to his/her roommate c. announce his/her arrival at dinner d. wait for the nurse’s instruction
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Hospice specializes in the care of persons who are:
a. chronically ill b. on medicare c. terminally ill d. on medicaid 17.
Constipation and indigestion can be result from: a. slowed circulation
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b. slowed mental response c. slowed brained activity d. slowed peristalsis
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The Heimlich maneuver is used on residents who are: a. need to be transferred b. have a blocked airway c. have fallen out of bed d. need to be restrained
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Exercises that move each muscle and joint: a. abduction b. adduction c. range of motion d. rotation
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How often should mouth care be given to unconscious person? a. once a day b. every four hours c. every two hours d. after every meal
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When answering resident on the intercom, you should: a. say, “What is it?” b. ask for the resident’s name c. say, “The nurse will answer you call” d. state your name position and say, “May I help you?”
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When helping a resident in and out of bed, a CNA should always: a. ask another CNA for help b. put the resident’s shoes on to prevent him/her from slipping c. use a gait belt d. use proper body mechanics
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When lifting a heavy object, the correct method would be to bend at the a. waist, keeping your leg straight
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b. waist, rounding your shoulder c. knees, helping your back straight d. knees and waist
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Resident’s with Alzheimer’s disease may show which of th e following signs/symptoms? a. extremely clear memory b. frequent pacing or wandering c. physical and mental wasting away d. B and C
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The resident asks to see a priest. The CNA should a. Inform the resident that he/she must make an arrangements himself/herself b. call the doctor c. tell the resident to ask his/her to make the arrangements d. ask the nurse to call a priest
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CNA Study Guide from CNAtestCoach.com
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Lesson 1: Long Term Care Introduction Lesson 2: The Nursing Assistant in LTC Lesson 3: Communicating with Health Care Staff Lesson 4a: The Long Term Care Resident Lesson 4b: Communication with Residents Lesson 5: Communication with and Caring for Residents with Cognitive Lesson 6: Resident/Client/Patient Rights Lesson 7a: Infections Lesson 7b: Infection Control Lesson 8: Safety and Emergencies Lesson 9: Personal Care and Grooming Lesson 10: Activity and Mobility Lesson 11: Restorative Care Lesson 12: Meeting the Resident’s Nutritional Needs Lesson 13: Meeting the Resident’s Elimination Needs Lesson 14: Cardiovascular and Respiratory System Lesson 15: Measuring and Recording Vital Signs, Height and Weight Lesson 16: Caring for the Person who is Dying Bonus 1: Printable 200 Practice Test Bonus 2: Seeking Employment Bonus 3: Printable 200 Fill in the Blanks Bonus 4: Printable 300 Flash Cards Bonus 5: CNA Skills 1 - 29
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