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Nursing Assistant - Long-Term Care Resident
Nursing Assistant - Long-Term Care Resident
Nursing Assistant - Long-Term Care Resident
Environmental/Physical
Safety
Shelter
Appropriate living situation
Environmental control (heat/air-conditioning)
Nourishment
Balanced diet
Adequate fluids
Psychological Needs
Maintain
self-esteem
Respectful treatment
Recognition of individual differences
Adjustment
Social needs
Social interactions
Encourage family involvement
Encourage social/community activities
Adjustment to losses
Encourage verbalization/reminiscing
Encourage new social contacts
Death of spouse/friends
Financial
Changes in income
Refer to social service
Recreational Needs
Diversion
Encourage hobbies
Involve in facility/community events
Encourage family involvement
Self-esteem
Encourage involvement
Give compliments
Reinforce positive traits or abilities
Spiritual Needs
Provide
Community Resources
Causes
Alzheimers disease causes plaques & tangles in the brains
nervous system. Brain decreases in size as cells are lost.
Incurable. Progressive
Multi-infarction dementia
Parkinsons disease
Syphilis
AIDS
Nutrition & medication problems
Depression & metabolic disorders
Schizophrenia
Hypochondriasis
Resident
Depression
Most
Suicidal Resident
Developmentally Disabled
Cerebral palsy
Alcoholism/Drug Abuse
Occurs when healthy coping mechanisms have
failed
15% of elderly suffer from this
Often triggered by
Retirement
Loss of self-esteem
Loneliness
Chronic pain
Decline in health
Stress
Agitated Resident
Agitation continued
Cell
Basic unit for structure, building block
Function, size, shape of cells differ
Need food, water, oxygen to survive
Tissues
Groups of cells with similar functions
Epithelial protective
Connective support & connect
Muscle shorten & lengthen
Nerve carry electrical messages
Organs
Made of different tissues & perform special functions
Integumentary System
Function
Skin Lesions/Wounds
Change
Reversible, red area that does not go away after 30 minutes (may
look blue or black)
Stage Two
Reddened skin with abrasions, blisters, or shallow crater. Can
involve dermis & epidermis
Stage Three
All layers of skin destroyed, deep crater forms
Stage Four
Ulcer extends through skin & subq tissue. Bone, muscle, &
structures may be involved
NA duties cont
Mechanical aids
Sheepskin
Alternation- pressure mattress
Pillows
Gel & air cushions
Heel protectors
Rash
Normal changes of
integumentary system
Skin
Respiratory System
Nose
Trachea
Bronchi
Lungs
alveoli
Respiratory Diseases
Fever
Runny nose & eyes
Cough
Sore throat
NA duties
Encourage rest & fluids
Dispose of tissues promptly to avoid spread
Report fever, dyspnea, change in rate or rhythm of resp, change in
mucus color from clear to green, yellow, or blood-tinged
Pallor, cyanosis
Signs that infection is moving to chest or lungs
Pneumonia
NA duties
As with URI
Monitor VS carefully, esp temp & resp
Orthopneic position as needed
COPD
Results
Wheezing
Tight airways
Mucus blocks pathways
Labored breathing
Frequent cough
COPD cont
Chronic
bronchitis prolonged
inflammation in the bronchi due to
infection or irritants
Persistent cough
Sputum production, esp in a.m.
Respiratory distress
COPD cont
Tuberculosis
Fatigue
Night sweats
Hemoptysis
Coughing
Fever
Loss of appetite & weight
Tuberculosis cont
NA duties
& observations
Annual PPD
Use of barriers if productive cough
Discard tissues & sputum promptly
Related subjects
Tracheostomy
Esophageal speech & electronic speech
SARS
Malignancies
Aging changes
Lung capacity decreases due to increased rigidity
in lungs
Coughing less effective
Gas exchange in lungs less effective
Cardiovascular System
Transportation
Myocardial Infarction
NA duties with MI
Remain
with resident
Notify LVN if signs & symptoms
Monitor VS
Prepare to transfer to acute care facility
CHF
Hemoptysis
Cough
Dyspnea & orthopnea
Fatigue, confusion, cyanosis
Edema in extremities
Moist respirations
HTN
Irregular heartbeat
NA role in CHF
Anemia
Lethargy
Pale or jaundiced
Dyspnea
Digestive problems
Rapid pulse, increased resp rate
Cold
Dizzy
& symptoms
BP
Assist with stress management
techniques
Low sodium diet
Assist with weight loss efforts
Encourage regular exercise
Notify nurse for signs & symptoms
Related subjects
Pacemakers
Angina
Varicose veins
Atherosclerosis
Internal defib
Aging changes
Musculoskeletal System
Forms
Arthritis
Inflammation of joints
Rheumatoid
Joint tissue lining affected
Osteoarthritis
Cartilage covering ends of bones deteriorates &
ends of bones rub together
Gout
Metabolic disease caused by deposits of crystal at
joint
Arthritis
NA duties
Fractures
NA duties
Osteoporosis
Hip fracture
Fx
Pre-op
Avoid moving pt unless instructed by nurse
Use sheet or back board to move
Post-op
Related subjects
Endocrine System
Diabetes Mellitus
Chronic
Hyperglycemia
Develops slowly over 24 hours
Confusion, drowsiness, slow slippage into coma
Headache
Sweet fruity odor to breath
Deep breathing
Low blood pressure
N&V
Flushed, dry, hot skin
Unconsciousness
Sugar in urine & high sugar in blood
Hypoglycemia
Occurs when blood glucose in below normal
Most common from insulin OD
Symptoms occur rapidly
NA duties with
hypo/hyperglycemia
More NA duties
Related subejcts
Hypo
& hyperthyroidistm
Cushing & Addisons disease
Glucose monitoring
Aging changes in endocrine system
Decrease in sex hormones
Body less able to handle sugar
Metabolism & body functions slow
Nervous System
Brain
Spinal cord
Peripheral Nerves
Sensory organs eye, nose, tongue, skin, ears
Dementia
dependent
Verbally unresponsive
May have seizures
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Realize
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Avoid over-fatigue
Encourage resident to stay awake in day
Evening meal should be at least 2 hours before bedtime
Eliminate caffeine
Evening activities should be calm & quiet
Soft music is calming
Give massage/back rub
Light bedtime snack
Follow bedtime routine
Check lighting shadows & reflections can be scary
More NA duties
Discourage
More NA duties
More NA duties
More NA duties
CVA
Loss of sensation
Paralysis/hemiplegia
Aphasia
Dysphagia
Emotional liability
Loss of consciousness/confusion
Cognitive impairments
stroke
Parkinsons Disease
Seizure disorder
long period
Serious medical emergency
Life threatening
Death may result
During seizure
to sleep
Clean if incontinence has occurred
Check VS
Vision impairments
Cataracts
Glaucoma
Eye pain
Difficulty adjusting to darkness
Unable to see color
May see halos
HA
Fatigue
Blurred vision
Hearing impairments
Gastrointestinal System
Malignancies of GI system
Vomiting
Extreme abd discomfort
Indigestion
Constipation
Blood in stool
Flatus
No bowel movement at all
Standard precautions
Remove appliance gently to prevent skin irritation
Empty bag & wash if reusable with soap & water
Secure clamp at base
Discard disposable bag in biohazardous waste bag & replace
Observe stoma for redness, irritation, & skin breakdown
Wipe area around stoma gently, wash with soap & water
Apply creams, fit opening of appliance to stoma
Seal well to prevent leakage
Observe color, character, amt, freq of stools
Constipation
Fecal impaction
Stool
Diarrhea
Liquid
Anal incontinence
Inability
gas
possible cause due to injury or
diseases of nervous system or sphincer
damage
May result when residents do not
receive the assistance they need in a
timely manner
Flatulence
Excessive
Related subjects
Gall
bladder disease
Hernias
Ulcerations
Bowel training
Enemas
Rectal tube
Hemorrhoids
Urinary System
Filters
Cystitis
Dysuria, burning
Frequent urination
Cloudy urine
Hematuria
Bladder spasm
Loss of appetite
Fever
Confused resident may become agitated
fluids
Observe urine
Siz bath
Perineal care
Always wipe front to back
Rest
Urinary incontinence
Signs
Unable to control urination
Stress incontinence
NA duties
Bladder training
Toilet regularly
Answer call light promptly
Be positive when changing, not critical
Perineal care
Avoid liquids after dinner
Reproductive system
Produces
Common diseases of
reproductive system
Male
Enlarged prostate gland urethra passes through
prostate, as it enlarges, it strangles urethra, causing
difficulty in starting stream & emptying bladder
CA of prostate or testes
Female
Cystocele weakening of muscles between bladder
& vagina
Urinary incontinence
Frequent UTI
Female disorders
Prolapsed uterus
Malignancies breast, ovarian, uterine, cervical
NA duties
Supportive care
Notify nurse if distress
STD
Flu-like
Fever
Night sweats
Fatigue
Swollen lymph nodes
Sore throat
GI upset
HA
Kaposkis sarcoma
Pneumocystis carinii pneumonia
Aging changes
Male
Scrotum less firm
Increase in size of prostate gland
Hormone production decreases
Female
Immune System
Protects
AIDS
Caused
by HIV
Spread through body fluids
Blood
Semen
Vaginal secretions
Breast milk
Affects
S & S of AIDS
Loss of appetite
Weight loss
Fever & night sweats
Diarrhea
Painful or difficult swallowing
Extreme & constant fatigue
Skin rashes
Swollen lymph nodes
Cough
Sores or white patches in mouth or on tongue
Purple blotches or bumps on skin
Confusion & forgetfulness
dementia