A bedridden client can quickly develop pressure sores if allowed to remain in one position. To prevent the skin from breaking down, reposition the client at least every two hours. Use pillows to support the client and to relieve places where skin can rub, such as between the legs or at the tailbone. Always keep the skin clean and dry. A sheepskin on the bed or wheelchair provides extra padding, but does not replace repositioning. Observe the skin for reddened areas and report them to the nurse. Special beds and flotation mattresses are helpful in preventing pressure sores.
Medical and pharmacy measurements use the metric system. One ounce equals 30 cc or 30 ml. 16 ounces = 480 cc or ml.
Weight is a good indicator of a resident's nutrition and calorie intake. It should stay within a range of a few pounds. Residents who have heart failure may be weighed daily to see if they are retaining fluid. Report any sudden weight gain or loss to the nurse.
Every staff member is responsible for keeping clients safe at all times. This includes monitoring all equipment and reporting when anything needs repair. Never use broken equipment or try to create a temporary solution if equipment is not working properly. Tag the broken bed and move it so that another client can't use it. Replace it immediately with one that has functioning side rails.
A balanced diet is essential for health. When nutrients are taken in the right combination of calories, the client's desired weight is maintained. Carbohydrates supply fuel for the body, so 45-65% of calories should come from carbohydrates. The energy is stored in the muscles and the liver for immediate or future use, as well as for the brain to function. Fat and protein have important roles, but are not good for energy sources.
When a client is unable to speak clearly or has trouble forming words, a speech therapist can help improve problems from strokes, physical defects, and swallowing disorders. Speech therapists work with both adults and children. They are qualified to evaluate, diagnose, and treat clients.
A reddened area is the first sign of skin breakdown. It means that there is pressure and a lack of blood circulation to the area. The nurse aide should immediately reposition the client to eliminate pressure. Clients who are not mobile need to be repositioned at least every two hours. Never massage a reddened area, as this will increase the damage. Keep the client clean from perspiration, urine, and feces. Continue to observe the skin and report to the nurse if the marks do not quickly disappear.
This nursing care plan means that the client is receiving oxygen at a constant rate of 3 liters per minute, using a nasal cannula. If the client has difficulty breathing, the CNA can assist the client to sit in a Fowler's (upright) position. Every facility has a list of approved abbreviations. The CNA should become familiar with these, for reading care plans and for doing documentation.
NPO is a common medical term that means the client can not eat or drink anything, including water or ice chips. A doctor orders a patient to be NPO at midnight for situations such as before surgery or certain lab work. The nurse aide can provide mouth care for a client who is NPO. Placing a "NPO" sign over the client's bed and on the client's door will remind all staff members not to give the client anything to eat or drink.
Hypertension is diagnosed when a person has consistent blood pressure measurements of 140/90 or greater. Hypertension has no symptoms as it develops; it can be present for years without a person knowing it. If untreated, it can cause hart failure and stroke.
An embolism is usually a blood clot that travels through the bloodstream and becomes stuck in an artery or vein. It blocks blood flow, leading to tissue damage and possibly death. Fat or air can also cause an embolism. An embolism is a medical emergency.
An occupational therapist helps patients who are disabled or who have been injured develop or regain the skills needed for daily activities. They may teach a resident who has had a stroke to get dressed or use special devices to assist with eating.
To remove an isolation gown, untie the gown and hold it on the front and pull it away from your body. When it is away from your body, roll the gown into a ball, keeping your gloves and wrists inside the sleeves. Pull one hand out of a sleeve, causing the inside of the gown to face you. Pull the other hand out and hold the inside of the gown to discard it in the appropriate receptacle.
Clinical standards state that all health care professionals must identify the client by checking the ID band or tag before providing care. They should wash their hands before and after an encounter with a client. They should also explain what they are going to do and give the client an opportunity to ask questions before proceeding.
When a client has an indwelling Foley catheter, the nurse aide should check that the tubing is open so that the urine can flow from the bladder. After each position change or when the client returns to the bed or chair after being up, ensure that the tubing is not kinked or closed. The bag should be lower than the bladder to prevent backflow.
One of the primary responsibilities of a nurse aide is to monitor the client's skin for any signs of breakdown. During baths, dressing, or position changes, inspect the skin for redness, pallor, warmth, or bruising. Reposition at least every two hours, protecting areas that rub together, as well as the bony prominences. Massages to the back and buttocks can promote circulation. Range-of-motion exercises are also helpful. Always report any signs of breakdown to the nurse.
