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A Guide for Nursing Assistants

Written by
Christina Spencer, BSN, RN,C
About the Author...
Christina Spencer, RNC, is a gruaduate of Seattle University with a Bachelor of Science degree in Nursing and certification in gerontological nursing. Christina has spent much of her professional career working in long term care as a charge nurse, staff development coordinator, director of nursing and care consultant. She has been educating nursing assistants since 1980 when she started Nursing Assistant Training Institute in Seattle, Washington.
Illustrations by Travis Treser
Copyright©1999
by Christina Spencer
Second Edition

The cover drawing: ©1996 The Learning Company Inc. and its licensors
 

Table of Contents

Chapter 1The Role of the Nursing Assistant1-17
The role and responsibilities of  the nursing assistant
Desirable characteristics of a nursing assistant
Code of ethics
Legal aspects of being a nursing assistant
Health care team
Privacy and confidentiality
OBRA law

Chapter 2Working in a Long Term Care Facility18-37
Resident's bill of rights
Basic human needs
Sexuality and the elderly
Cultural and religious needs
Physical aging changes
Psychosocial losses
Workplace violence
Coping with stress

Chapter 3Communication/Observations, and the Medical Record38-53
Verbal communication
Non-verbal communication
Communication with special needs patients (aphasic, hard of hearing, confused)
Communication with other health care team members
The medical record
Documentation
Observations and reporting

Chapter 4Medical Terminology and Abbreviations54-72
Medical terminology
Abbreviations

Chapter 5Safety and Emergency Procedures73-88
Falls and other types of accidents
Fire prevention and what to do in case of fire
Accident prevention
CPR
Heimlich maneuver

Chapter 6Restraints89-98
Physical and chemical restraints
OBRA law and restraint use
Negative results of restraint use
Alternatives to restraint use
Restraint monitoring
Applying a vest restraint
Siderails

Chapter 7Body Mechanics, Positioning and Ambulating Residents99-116
Preventing back injuries
Body mechanics
Assistive devices
Turning and transferring procedures
Proper positioning
Ambulation

Chapter 8Infection Control117-131
Microorganisms and their spread
The work environment and infection
Medical aseptic techniques
Standard precautions
Transmission based precautions
Personal protective equipment
Handwashing
Tuberculosis

Chapter 9Blood Borne Pathogens132-145
Blood borne pathogens
HIV/AIDS
HBV
Hepatitis A, C, D, and E

Chapter 10Assisting with Personal Care146-170
Activities of daily living
Bathing
bed bath
shower
tub bath
Back rubs
Shaving
Oral care
Fingernail care
Dressing
Foot care
Skin care
Decubitus prevention

Chapter 11Vital Signs171-184
What vitals tell us
Measuring body temperature
oral, rectal, axillary, and aural temperature
Measuring blood pressure
Measuring pulse
Measuring respirations

Chapter 12Nutrition185-196
Proper nutrition
food guide pyramid
Therapeutic diets
Mealtime assistance
feeding patients
adaptive self feeding devices
mealtime assistance
dysphagia management
Alternate feeding measures
tube feedings
intravenous feeding
Progressive self feeding programs

Chapter 13Fluids, and Intake and Output197-203
Why fluids are important
Maintaining fluid balance
edema
dehydration
Measuring fluid intake and output
Calculating measurements

Chapter 14Gastrointestinal and Urinary Systems204-220
Anatomy and physiology of urinary system
Urinary system changes associated with aging
Urinary elimination
Bladder retraining program
Urinary tract infections
Catheter care
Anatomy and physiology of the gastrointestinal tract
Digestive changes related to aging
Bowel elimination
Constipation, impactions and diarrhea
Bowel retraining

Chapter 15The Resident's Environment221-230
The resident's unit and equipment
Bedmaking
unoccupied bed
occupied bed
Handling linen

Chapter 16Rehabilitation and Restorative Concepts231-242
Hazards of immobility
Rehabilitation
Adaptive/assistive devices
Rehabilitation team
Restorative programs
Contractures and their prevention
Range of motion
Restorative equipment
Prosthesis

Chapter 17Dementia Care243-255
Causes of dementias and cognitive impairment
Alzheimer disease
Communication with the dementia resident
Conducive environment for the dementia resident
Dealing with behavioral disturbances
Validation therapy

Chapter 18Death, Dying and Grieving256-261
Death and dying
Grief
Signs of approaching death
Meeting resident's needs
Maintaining comfort
Post mortem care

Chapter 19Special Care and Procedures262-268
Specimen collection
Applying elastic hose
Measuring heights and weights
Use of oxygen
Special needs of a resident with a cast

Chapter 20Common Health Problems269-279
Seizures
Osteoporosis
Congestive heart failure
Diabetes mellitus
Chronic obstructive pulmonary disease
Cerebrovascular accident
Transient ischemic attacks



Review for Final Test280-285

Reference286

Index287-292