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Assisting in Long Term Care

by
Edition:
4th
ISBN13:

9780766834798

ISBN10:
0766834794
Format:
Paperback
Pub. Date:
9/5/2001
Publisher(s):
Cengage Learning
List Price: $162.66

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This is the 4th edition with a publication date of 9/5/2001.
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Summary

This best-selling resource provides the theoretical and skills content nursing assistants require for the successful completion of the certification test. A major goal of the content is to help nursing assistants develop an understanding of the principles on safe and effective care of residents in long-term care. Core values stressed include empathy, caring, communication skills, and respect for residents and their families. Special emphasis is placed on ensuring resident's rights, adequate nutrition and hydration, maintenance of mobility, psychosocial interactions, and a safe environment. Liberal illustrations aid in visual learning.

Author Biography

Barbara Robinson Hegner, RN, MSN, was a graduate of a three-year diploma nursing program where direct and total care was the focus. She earned a BSN at Boston College and an MS in nursing from Boston University, with a minor in biologic sciences. She was Professor Emeritus of Nursing and Life Sciences at Long Beach City College, Long Beach (CA). Throughout her professional career, she had a deep interest in both hospital-based and long-term care nursing. Ms. Hegner believed that to ensure the rights and well-being of residents in long-term care requires the care of competent, caring nursing assistants under the supervision of professional nurses. The nursing assistants who provide this care should be thoroughly trained and consistently encouraged, evaluated, and given the opportunity for continued learning. Providing the tools to prepare these health care providers in the most effective and efficient way is the goal of Assisting in Long-Term Care, fourth edition. Other texts by Barbara R. Hegner, also from Delmar Publishers are: Geriatrics, A Study of Maturity, fifth edition, and Nursing Assistant, A Nursing Process Approach, eighth edition. Joan Fritsch Needham, MSEd, RNC, is a contributing author to the fourth edition of Assisting in Long-Term Care. She also graduated from a three-year diploma nursing program. She received her BS from the College of Saint Francis and her MS from Northern Illinois University. She is certified by the American Nurses Association in Gerontological Nursing. Ms. Needham was Director of Education at a long-term care facility where she was responsible for staff development, curriculum development and instruction for basic and advanced nursing assistant training, and development and instruction in continuing education courses for licensed nurses. In addition, she is a consultant on nursing assistant education and nursing continuing education. She contributed to Nursing Assistant, A Nursing Process Approach, sixth, seventh, and eighth editions and is the author of Gerontological Nursing -- A Restorative Approach (Delmar) and Plans of Care for Specialty Practice, Gerontological Nursing (Delmar).

Table of Contents

About the Authors xix
Preface xxi
Acknowledgments xxiii
About This Book xxiv
Section 1 The Long-Term Care Setting 1(48)
The Long Term Care Facility
3(18)
Community Health Care Facilities
4(4)
Types of Long-Term Care Facilities
8(2)
Functional Areas in a Long-Term Care Facility
10(4)
Standards and Regulations
14(1)
OBRA Legislation
14(1)
Financing in Long-Term Care
15(1)
The Survey
16(5)
The Caregivers
21(12)
The Interdisciplinary Team Members
22(6)
Administrative Organization
28(1)
Educational Services
29(4)
The Nursing Assistant in Long-Term Care
33(16)
Professionalism
34(1)
Personal Characteristics
34(1)
Attitude
35(1)
Personal Hygiene
36(1)
Uniforms
36(1)
Duties and Responsibilities: The Job Description
37(2)
Staff Relations
39(1)
Assignments
40(1)
Specific Duties
40(1)
Organization of Time
41(1)
Violence in the Workplace
42(1)
Self-Care
43(1)
Sexual Harassment
44(1)
Continue to Grow
44(5)
Section 2 Communication Skills 49(50)
Communication and Interpersonal Skills
51(16)
The Communication Process
52(1)
Communicating with Staff Members
53(1)
Oral Communications
53(2)
Written Communications
55(1)
Communicating with Residents
56(4)
Guidelines for Communicating with Residents
58(2)
Communicating Through the Use of Touch
60(1)
Communicating with Residents Who Have Special Needs
61(3)
Communicating with the Potentially Violent Resident
64(3)
The Language of Health Care
67(18)
The Language of Health Care
68(1)
Word Parts
68(1)
Expanding Your Vocabulary
69(1)
Common Word Parts
69(3)
Common Abbreviations
72(4)
Understanding the Body
76(1)
Anatomic Terms
76(2)
Organization of the Body
78(1)
Cells
78(1)
Tissues
79(1)
Organs
79(1)
Systems
79(1)
Membranes
79(2)
Cavities
81(4)
Observation, Documentation, and Reporting
85(14)
Observation
86(5)
Reporting
91(1)
Documentation
92(2)
The Interdisciplinary Health Care Team Process
94(5)
Section 3 Protecting Residents' Rights and Safety 99(98)
Residents' Rights
101(22)
Purpose of the Residents' Rights Document
102(1)
Residents' Rights
103(14)
Legal Aspects of Health Care
117(1)
Ethics and the Health Care Provider
118(5)
Safety
123(16)
Safety in Health Care Facilities
124(1)
Employee Safety
124(3)
Guidelines for Using Ergonomic Techniques to Reduce the Risk of Having an Incident
125(2)
Hazards in the Work Environment
127(3)
Resident Safety
130(5)
Guidelines for the Use of Restraints
132(3)
Wheelchair Safety
135(1)
Fire Safety
135(4)
Emergencies
139(16)
General Measures to Follow for Emergencies
140(1)
Guidelines for Responding to an Emergency
140(1)
Cardiac Arrest
141(1)
Foreign Body Airway Obstruction (Choking)
142(1)
The Recovery Position
143(1)
Early Defibrillation
143(1)
Assisting the Conscious Person with Obstructed Airway---Heimlich Maneuver
143(2)
Obstructed Airway, Unconscious Person
145(2)
One-Rescuer CPR, Adult
147(1)
Positioning the Resident in the Recovery Position
148(1)
Hemorrhage
148(1)
Resident Falls
148(1)
Seizures
148(1)
Hemorrhage
149(1)
Care of Falling Resident
150(1)
Burns
151(1)
Orthopedic Injuries
152(1)
Accidental Poisoning
152(1)
Fainting
152(3)
Infection
155(14)
Infectious Disease
156(1)
Microbes
156(1)
The Chain of Infection
157(1)
Body Flora
158(1)
Natural Body Defenses Against Disease
158(1)
Immunity
159(1)
Inmmunizations
160(1)
Serious Infections in Health Care Facilities
160(1)
Bacterial Infections
160(2)
Viral Infections
162(3)
Other Important Infections
165(1)
Why the Elderly in Long-Term Care Are at Risk for Infections
165(1)
General Measures to Prevent Infections
166(1)
Outbreak of Infectious Disease in a Long-Term Care Facility
167(2)
Infection Control
169(28)
Medical Asepsis
170(2)
Handwashing
172(1)
Handwashing
172(2)
Protecting Yourself
174(1)
Standard Precautions
174(4)
Guidelines for Standard Procautions
175(1)
Guidelines for Environmental Procedures
176(2)
Transmission-Based Precautions
178(5)
Putting on a Mask and Gloves
183(1)
Removing Contaminated Gloves
183(1)
Putting on a Gown
184(1)
Removing Contaminated Gloves, Mask, and Gown
185(3)
Caring for Linens in Isolation Unit
188(1)
Measuring Vital Signs in Isolation Unit
188(1)
Serving a Meal Tray in Isolation Unit
189(1)
Specimen Collection from Resident in Isolation Unit
190(2)
Transferring Nondisposable Equipment Outside of Isolation Unit
192(1)
Transporting Resident to and from Isolation Unit
192(1)
Disinfection and Sterlization
193(1)
Sterile Procedures
194(1)
Opening a Sterile Package
194(3)
Section 4 Characteristics of the Long-Term Care Resident 197(38)
The Long-Term Care Resident
199(14)
About Aging
200(1)
The Process of Normal Aging
200(1)
Changes Caused by Aging
200(3)
Illness and Disability
203(2)
Stereotypes and Myths
205(3)
The Younger Resident in the Long-Term Care Facility
208(1)
Guidelines for Caring for Younger Residents
209(1)
Comfort, Rest, and Sleep
209(4)
The Psychosocial Aspects of Aging
213(14)
Basic Human Needs
214(2)
Cultural Influences
216(1)
Spirituality
216(1)
Religion
217(1)
Sexuality and Intimancy
217(2)
Major Challenges to Adjustments
219(1)
Using Defense (Coping) Mechanisms
220(1)
Meeting Residents' Psychosocial Needs
221(1)
Stress Reactions
222(1)
Reactive Behaviors
222(5)
Alternative Health Practices
227(8)
Scientific (Western) Approach to Health Care
228(1)
Alternative and Adjunctive Therapies
228(4)
Importance for the Nursing Assistant
232(3)
Section 5 Meeting the Residents' Basic Needs 235(132)
Care of the Residents' Environment
237(18)
Resident Environment
238(1)
Personal Space
238(1)
Resident Unit
239(1)
Extended Resident Environment
240(2)
Guidelines for Ensuring a Safe and Comfortable Environment
242(1)
Critical Procedure Actions
242(3)
Bedmaking
245(1)
Guidelines for Handling Lines and Making the Bed
245(1)
Unoccupied Bed: Changing Linens
246(4)
Occupied Bed: Changing Linens
250(5)
Caring for the Residents' Personal Hygiene
255(36)
Epidermis
256(1)
Dermis
256(1)
Skin Functions
257(1)
Skin Changes Caused by Aging
257(1)
Skin Lesions
257(7)
Guidelines for Preventing Skin Breakdown
261(3)
Backrub
264(1)
Bathing Residents
264(1)
Backrub
265(2)
Bed Bath Using Basin and Water
267(3)
Bed Bath Using a Rinse-Free Cleanser and Moisturizer
270(1)
Tub Bath or Shower
271(1)
Partial Bath
272(2)
Female Perineal Care
274(1)
Male Perineal Care
275(1)
Daily Hair Care
276(1)
Facial Hair
277(1)
Daily Hair Care
278(1)
Shaving Male Resident
279(1)
Hand and Fingernail Care
279(1)
Hand and Fingernail Care
280(1)
Foot and Toenail Care
280(1)
Foot and Toenail Care
281(1)
Oral Hygiene
281(2)
Assisting Resident to Brush Teeth
283(1)
Cleaning and Flossing Resident's Teeth
284(1)
Caring for Dentures
285(1)
Assisting with Oral Hygiene for the Unconscious Resident
286(1)
Dressing Resident
286(1)
Dressing and Undressing Resident
287(4)
Meeting the Residents' Nutritional Needs
291(28)
The Digestive System
292(1)
The Digestive Process
293(2)
Aging Changes
295(1)
Nutrients
295(1)
Electrolyte Balance
296(1)
Food Groups
297(2)
Nutritional Status
299(1)
Dehydration
300(1)
Intake and Output (I&O)
301(1)
Measuring and Recording Fluid Intake
302(1)
Diets
303(2)
Nursing Assistant Responsibilities
305(2)
Assisting the Resident Who Can Feed Self
307(2)
Feeding the Dependent Resident
309(1)
Nourishments and Supplements
310(1)
Alternate Methods of Feeding
311(1)
Disorders of the Digestive System
312(7)
Meeting the Residents' Elimination Needs
319(48)
Introduction
321(1)
The Continent Resident
321(1)
Equipment to Assist Elimination
321(2)
Giving and Receiving the Bedpan
323(2)
Giving and Receiving the Urinal
325(1)
Assisting with Use of the Bedside Commode
326(1)
Assisting Resident to Use the Bathroom
326(1)
Elimination from the Lower Digestive Tract
327(1)
The Resident with Constipation
328(1)
Bowel Aids
328(2)
Giving an Oil-Retention Enema or Commercially Prepared Enema
330(1)
Giving a Soapsuds Enema
331(6)
Rectal Tube and Flatus Bag
337(1)
Inserting a Rectal Tube and Flatus Bag
338(1)
Ostomies
338(2)
Giving Routine Stoma Care (Colostomy)
340(2)
Fecal Incontinence
342(1)
Collecting a Stool Specimen
343(1)
Collecting a Stool Specimen
343(1)
Urinary System
344(2)
Changes in the Urinary System Caused by Aging
346(1)
Urine Elimination
347
Changes in the Urinary System Caused by Aging
346(1)
Urine Elimination
347(1)
Urinary Retention and Incontinence
347(1)
Internal Urinary Catheter Drainage
347(2)
Giving Indwelling Catheter Care
349(3)
Emptying a Urinary Drainage Unit and Disconnecting the Catheter
352(1)
Intake and Output (I&O)
352(1)
Measuring and Recording Fluid Output
353(3)
Leg Bag Drainage
356(1)
Connecting Catheter to Leg Bag and Emptying the Leg Bag
357(3)
Collecting a Routine or Clean-Catch Urine Specimen
360(1)
External Urinary Drainage (Male)
361(1)
Applying a Condom for Urinary Drainage
362(1)
Common Conditions
363(4)
Section 6 Special Nursing Assistant Activities 367(60)
Measuring and Recording Residents' Data
369(32)
Measuring Vital Signs
370(1)
Temperature
371(2)
Measuring an Oral Temperature (Glass Thermometer)
373(2)
Measuring a Rectal Temperature (Glass Thermometer)
375(1)
Measuring an Axillary Temperature (Glass Thermometer)
376(1)
Measuring an Oral Temperature (Electronic Thermometer)
377(1)
Measuring a Rectal Temperature (Electronic Thermometer)
378(1)
Measuring an Axillary Temperature (Electronic Thermometer)
379(1)
Measuring a Tympanic Temperature
380(1)
Pulse and Respiration
381(1)
Counting the Radial Pulse Rate
382(1)
Counting the Apical-Radial Pulse
383(2)
Counting Respirations
385(1)
Blood Pressure
385(4)
Guidelines for Preparing to Measure Blood Pressure
387(2)
Taking Blood Pressure
389(2)
Weighing and Measuring the Resident
391(2)
Weighing and Measuring the Resident Using an Upright Scale
393(1)
Measuring Weight with an Electronic Wheelchair Scale
394(1)
Weighing the Resident in a Chair Scale
395(1)
Measuring and Weighing the Resident in Bed
396(1)
Recording Vital Signs
396(5)
Admission, Transfer, and Discharge
401(16)
Admitting the Resident
402(3)
Admitting the Resident
405(2)
Transferring the Resident
407(2)
Discharging the Resident
409(1)
Transferring the Resident
410(1)
Discharging the Resident
411(6)
Warm and Cold Applications
417(10)
Safety
418(1)
Commercial Preparations
418(1)
Use of Warm Applications
419(1)
Applying an Aquamatic K-Pad
420(1)
Use of Cold Applications
421(1)
Applying a Disposable Cold Pack
421(1)
Applying an Ice Bag
422(1)
Assisting with the Application of a Hypothermia Blanket
423(4)
Section 7 Introduction to Restorative Care 427(90)
Restorative/Rehabilitative Care of the Resident
429(54)
Restorative Care and the Interdisciplinary Health Team
431(1)
Purposes of Restorative/Rehabilitative Care
432(1)
Preventing Complications from Inactivity
433(3)
Activities of Daily Living
436(1)
Setting Up Restorative Programs
437(7)
Guidelines for Nursing Assistant Responsibilities in General Restorative Program
443(1)
The Restorative/Rehabilitative Environment
444(1)
Progressive Mobilization
445(1)
Range of Motion
445(3)
Guidelines for Passive Range of Motion Exercises
445(3)
Passive Range of Motion Exercises
448(8)
Self Range of Motion Exercises
456(1)
Active Range of Motion Exercises
456(1)
Positioning the Resident
457(4)
Guidelines for Positioning
457(4)
Turning the Dependent Resident with a Turning Sheet
461(1)
Moving the Resident in Bed
462(2)
Turning the Resident to the Side
464(1)
Logrolling the Resident onto the Side
465(2)
Positioning the Dependent Resident
467(1)
Supine Position
467(1)
Semisupine or Tilt Position
468(1)
Lateral (Side-Lying) Position
468(1)
Lateral Position on the Affected Side
469(1)
Semiprone Position
470(1)
Fowler's Position
470(2)
Chair Positioning
472(1)
Repositioning a Resident in a Wheelchair
473(1)
Wheelchair Activities to Relieve Pressure
474(2)
Independent Bed Movement
476(1)
Assisting with Independent Bed Movement
476(1)
Continuing with Progressive Mobilization
477(1)
Bowel and Bladder Programs
477(6)
Guidelines for Bowel and Bladder Programs
478(5)
Restoring Residents' Mobility
483(34)
Transfers
484(1)
Guidelines for Transfers
485(1)
Using a Transfer Belt (Gait Belt)
485(2)
Bringing the Resident to a Sitting Position at the Edge of the Bed
487(2)
Assisted Standing Transfer
489(1)
Transferring the Resident from Chair to Bed
490(1)
Assisted Standing Transfer/Two Assistants
491(1)
Wheelchair to Toilet and Toilet to Wheelchair Transfers
492(2)
Transferring to Tub Chair or Shower Chair
494(1)
Transferring a Nonstanding Resident from Wheelchair to Bed
495(1)
Using Mechanical Lifts
496(1)
Transferring Resident with a Mechanical Lift
496(3)
Sliding Board Transfer
499(1)
Guidelines for Sliding Board Transfers
499(1)
Sliding Board Transfer
499(1)
Ambulation
500(4)
Guidelines for Ambulation
504(1)
Ambulating a Resident
504(1)
Assisting Resident to Ambulate with Cane or Walker
505(1)
Using a Wheelchair
506(1)
Special Maneuvers with Wheelchairs
507(4)
Positioning the Dependent Resident in the Wheelchair
511(2)
Wheelchair Activity
513(4)
Section 8 Residents with Specific Disorders 517(98)
Caring for Residents with Cardiovascular System Disorders
519(20)
Introduction
520(1)
The Heart
521(1)
Blood Vessels
522(1)
Lymph
523(3)
The Blood
526(1)
Disorders of the Blood
526(1)
Disorders of the Blood Vessels and Circulation
526(5)
Guidelines for Caring for Residents with Peripheral Vascular Disease
529(2)
Heart Disease
531(2)
Applying Elasticized Stockings
533(6)
Caring for Residents with Respiratory System Disorders
539(12)
Introduction
540(1)
The Respiratory Organs
540(1)
Voice Production
541(1)
Changes in the Respiratory System Caused by Aging
542(1)
Introduction to Pathology
542(2)
Collecting a Sputum Specimen
544(1)
Chronic Obstructive Pulmonary Disease
545(1)
Treatment and Care of Residents with COPD
545(3)
Refilling the Humidifier Bottle
548(3)
Caring for Residents with Endocrine System Disorders
551(12)
Introduction
552(1)
Endocrine Glands
553(1)
Aging Changes
554(1)
Glucose Metabolism
555(1)
Diabetes Mellitus
556(7)
Caring for Residents with Reproductive System Disorders
563(14)
Introduction
564(1)
The Male Reproductive System
564(2)
The Female Reproductive System
566(2)
Menstrual Cycle
568(1)
Menopause
568(1)
Changes in the Reproductive System as a Result of Aging
568(1)
Related Conditions
569(2)
Sexually Transmitted Diseases
571(6)
Caring for Residents with Musculoskeletal System Disorders
577(14)
The Musculoskeletal System
578(3)
Changes in the Musculoskeletal System Caused by Aging
581(1)
Conditions Affecting the Musculoskeletal System
581(10)
Caring for Residents with Nervous System Disorders
591(24)
Components of the Nervous System
593(1)
Central Nervous System
594(2)
Autonomic Nervous System
596(1)
Sense Organs
596(2)
Changes in the Nervous System Caused by Aging
598(1)
Causes of Severe Vision Impairment
598(1)
Care of Eyeglasses
599(1)
Guidelines for Assisting Visually Impaired Residents
600(1)
Hearing Loss
600(2)
Applying and Removing In-the-Ear or Behind-the-Ear Hearing Aids
602(1)
Nervous System Disorders
602(13)
Guidelines for Caring for Residents with Parkinson's Disease
604(2)
Guidelines for Caring for Residents Who Have Had a Stroke
606(2)
Guidelines for Caring for Residents with Multiple Sclerosis
608(1)
Guidelines for Caring for Residents with Huntington's Disease
609(1)
Guidelines for Caring for Residents Who Have Amyotrophic Lateral Sclerosis Amyotrophic Lateral Sclerosis
610(1)
Guidelines for Caring for Residents Who Have Myasthenia Gravis
610(5)
Section 9 Residents with Special Needs 615(50)
Alzheimer's Disease and Related Disorders (Caring for the Cognitively Impaired Resident)
617(16)
Definition of Alzheimer's Disease
618(2)
Stages and Symptoms of Alzheimer's Disease
620(2)
Caring for Residents with Dementia
622(6)
Guidelines for Caring for Residents with Alzheimer's Disease
623(3)
Guidelines for Activities of Daily Living
626(2)
Special Problems
628(1)
Special Management Techniques
629(4)
Caring for Residents with Developmental Disabilities
633(10)
Characteristics of a Developmental Disability
634(1)
Mental Retardation
635(2)
Other Forms of Developmental Disabilities
637(2)
Caring for Residents with Developmental Disabilities
639(4)
Caring for the Dying Resident
643(10)
Introduction
644(1)
Hospice Care
644(1)
The Dying Process
644(4)
Signs of Approaching Death
648(1)
Postmortem Care
648(2)
Giving Postmortem Care
650(3)
Caring for the Person in Subacute Care
653(12)
Description of Subacute Care
654(1)
Special Procedures Provided in the Subacute Care Unit
655(1)
Care of the Surgical Patient
655(1)
Pulse Oximetry
655(1)
Pain Management Procedures
655(1)
Intravenous Therapy
656(2)
Guidelines for Caring for Residents with Intravenous Lines
658(1)
Changing a Gown on a Resident with a Peripheral Intravenous Line in Place
658(2)
Caring for Residents with Tracheostomines
660(1)
Caring for the Resident Receiving Dialysis Treatments
661(1)
Oncology Treatments
662(3)
Section 10 Employment 665(20)
Seeking Employment
667(18)
Congratulations Are in Order
675(1)
Self-Appraisal
676(1)
Possibility Search
676(1)
The Resume
677(1)
References
678(1)
Taking the Step
678(1)
The Interview (Putting Your Best Foot Foreward)
678(1)
Keeping the Job
679(1)
Growing
680(1)
Resigning
681(4)
Glossary 685(20)
Index 705


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