When lifting a heavy object, the nurse aide should be positioned to support the client by using the legs. Keep your back straight and locked; do not turn or twist. Do not attempt to lift by bending forward. Bend hips and knees to squat down. Keep the load close to your body and straighten your legs as you lift. If you have any doubts, always ask for assistance from a co-worker.
When giving oral care to an unconscious client, place the client in a lateral (side-lying) position, with their head turned toward you. The bed can remain flat or the head can be raised to a semi-Fowler's position. With a lateral position, the fluids can drain out of the mouth into the mouth basin, rather than down the client's throat. Aspiration can be serious, leading to pneumonia. Always have a bulb syringe available to clear the client's mouth as needed.
Meals should be pleasant and unhurried for all clients. Food should be served at proper temperatures, so leave the tray in the food cart until you are ready to serve it. Since feeding a client can go slowly, allow sufficient time for the client to eat.
Elastic stockings, or anti-embolism stockings, are used for patients who have had surgery or are unable to ambulate. Make sure the size is correct for the patient before starting. Assist the patient to lie down in a supine position. The patient's feet and legs should be dry. Roll the stocking inside out all the way to the heel. Fit it on the foot and heel, then roll it up onto the patient's leg. Smooth any wrinkles and make sure the stockings are straight. Talcum powder can be helpful to prevent friction and rubbing on the skin.
After helping a client to the commode, giving care, or when leaving the client's room, always ensure that the client's call signal is within reach. Clients must always have access to their care givers. Restraints may never be applied without an order from the client's doctor.
The nurse aide should provide oral care at least every two hours to make the client comfortable. Even if you are not certain if the client can hear, explain what you are going to do. Proceed to give oral care after opening the mouth with a padded tongue blade. (Do NOT use your fingers, in case the client suddenly bites down.) Use mouth swabs or soft toothbrush to clean the teeth, gums, tongue, and inside of the mouth. Gently rinse with water. Finish with a lip lubricant.
Allowing a customer who is blind or has low vision to grab your arm can enable you to lead them while providing assistance. In order for them to move their hand and find your upper arm, touch the back of your hand to the back of theirs. They should follow you by one stride and grasp on just above your elbow. Set a comfortable pace for the two of you as you walk.
If a patient is competent, they can refuse care or treatment. A patient who has dementia may simply need a different approach to bathing that day. In either case, try to reschedule the shower or offer a bed bath. If the patient continues to refuse, document what was offered. If the patient gave a reason, include their statement. The nurse aide should show that care was offered and refused, not that the care was skipped.
Dentures are improtant for the client's nutrition, as well as for their appearance and self-esteem. They are expensive to replace, so ensure they are not damaged while you clean them. Before cleaning the dentures, place a paper towel or washcloth in the sink to provide a cushion in case the dentures fall. Hold the dentures over the sink, brush them with toothpase, and rinse under running water.
Every person should be encouraged to be as independent and active as possible. Participating in their own ADL is important, and often tasks can be adapted to accommodate disabilities. Even people who must remain in bed can often still participate in their care. They can move and turn in bed during the linen change.
Lotion should be warmed before applying it to a patient's back. You can rub it between your hands or place it in hot water to get it warm.
Unconcsious clients are not able to keep their mouths moist and clean. The nurse aide should provide oral care at least every two hours to make the client comfortable. Even if you are not certain if the client can hear, explain what you are going to do. Proceed to give oral care. Finish by applying a lip moisturizer to prevent the lips from becoming dry and cracked.
Washing hands before eating is important for everyone. The CNA should wash their own hands, as well as the client's. A client's hands can be soiled from touching objects, as well as their noses and mouths between meals. Even if the client is being fed, they may touch the food or their mouths during the meal, increasing the risk of spreading germs. Be sure to wash under fingernails, which can carry the most germs.
Showers and baths present a risk for falls. If there is any doubt about a client's ability to maintain balance, use a shower chair. Sitting in a chair lets the client be safe while enjoying the warm spray. Before having the client sit, make sure the shower chair is clean and sturdy. The client's feet should touch the floor.
A contracture is a shortening of muscles, tissues, tendons, and skin at the joints, due to lack of movement and exercise. When joints remain bent over time, they can no longer be straightened. Range of motion (ROM) exercises provide a way to maintain joint flexibility. In passive ROM, someone moves the joints with no assistance from the client. In active ROM, the client does the exercises alone or with the help of devices, such as a strap. Supportive devices, such as splints, wedges, and bedrolls can maintain alignment and position. Proper body alignment is also important.
Residents with diabetes can have complications from nerve damage and poor circulation. This means they may not even know their feet are injured. Wounds can be very slow to heal. Even a small cut on their feet can develop into a severe foot infection. Diabetics should always wear shoes and socks, and their feet should be checked daily for any signs of injury. Many facilities provide professional foot care specialists for their diabetic patients.
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CNA Safety And Emergency Procedures #1
