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Assisting in Long-term Care,9781401899547
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Assisting in Long-term Care

by ;
Edition:
5th
ISBN13:

9781401899547

ISBN10:
1401899544
Format:
Paperback
Pub. Date:
7/27/2006
Publisher(s):
Cengage Learning
List Price: $209.66

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Summary

This comprehensive, user-friendly book provides the theoretical knowledge and skills content you need to successfully complete a nursing assistant certification exam. The book meets OBRA guidelines and prepares you to work in a variety of long-term care settings or sub-acute units in the hospital. A major goal of this resource is to help you develop an understanding of the principles of safe and effective care of residents in long-term care. Special emphasis is placed on residents' rights, nutrition and hydration, restorative care, resident mobility, and maintaining a safe environment.From Doody's Book Review"This book, written to meet the needs of persons who wish to become CNAs and work in long term care (LTC), provides core concepts and clearly explains the basic principles of nursing care of the elderly.Weighted Numerical Score: 100 - 5 Stars!"

Table of Contents

List of Proceduresp. xxi
About the Authorsp. xxvi
Prefacep. xxvii
Acknowledgmentsp. xxxi
How to Use This Bookp. xxxii
The Long-Term Care Settingp. 1
The Long-Term Care Facilityp. 2
Community Health Care Facilitiesp. 3
Types of Long-Term Care Facilitiesp. 7
Functional Areas in a Long-Term Care Facilityp. 9
Standards and Regulationsp. 13
Health Insurance Portability and Accountabilityp. 13
OBRA Legislationp. 13
Financing in Long-Term Carep. 14
The Surveyp. 16
The Caregiversp. 20
The Interdisciplinary Team Membersp. 21
Administrative Organizationp. 27
Educational Servicesp. 28
The Nursing Assistant in Long-Term Carep. 30
Professionalismp. 31
Personal Characteristicsp. 31
Attitudep. 32
Personal Hygienep. 33
Uniformsp. 33
Duties and Responsibilities: The Job Descriptionp. 35
Staff Relationsp. 35
Assignmentsp. 35
Specific Dutiesp. 38
Organization of Timep. 39
Workplace Environmentp. 39
Self-Carep. 41
Sexual Harassmentp. 42
Continue to Growp. 42
Communication Skillsp. 47
Communication and Interpersonal Skillsp. 48
The Communication Processp. 49
Communicating with Staff Membersp. 50
Oral Communicationsp. 50
Written Communicationsp. 52
Communicating with Residentsp. 56
Guidelines for Communicating with Residentsp. 57
Communicating Through the Use of Touchp. 58
Communicating with Residents Who Have Special Needsp. 59
Communicating with the Potentially Violent Residentp. 63
The Language of Health Carep. 67
The Language of Health Carep. 68
Word Partsp. 68
Expanding Your Vocabularyp. 70
Abbreviationsp. 71
Understanding the Bodyp. 71
Anatomic Termsp. 71
Organization of the Bodyp. 78
Cellsp. 79
Tissuesp. 79
Organsp. 79
Systemsp. 79
Membranesp. 79
Cavitiesp. 81
Observation, Documentation, and Reportingp. 85
Observationp. 86
Reportingp. 91
Documentationp. 92
The Interdisciplinary Health Care Team Processp. 95
Protecting Residents' Rights and Safetyp. 99
Residents' Rightsp. 100
Purpose of the Residents' Rights Documentp. 101
Residents' Rightsp. 104
Legal Aspects of Health Carep. 116
Ethics and the Health Care Providerp. 117
Safetyp. 121
Safety in Health Care Facilitiesp. 122
Employee Safetyp. 122
Guidelines for Using Ergonomic Techniques to Reduce the Risk of Having an Incidentp. 123
Hazards in the Work Environmentp. 124
Resident Safetyp. 127
Guidelines for Using Restraintsp. 132
Wheelchair Safetyp. 136
Fire Safetyp. 136
Safety Issues for Disasters/Threatsp. 137
Emergenciesp. 141
General Measures to Follow for Emergenciesp. 142
Cardiac Arrestp. 142
Guidelines for Responding to an Emergencyp. 143
Foreign Body Airway Obstruction (Choking)p. 144
Assisting the Conscious Person with Obstructed Airway-Heimlich Maneuverp. 145
The Recovery Positionp. 145
Early Defibrillationp. 146
Hemorrhagep. 146
Obstructed Airway, Unconscious Personp. 147
Resident Fallsp. 148
One-Rescuer CPR, Adultp. 149
Seizuresp. 149
Positioning the Resident in the Recovery Positionp. 150
Hemorrhagep. 150
Care of Falling Residentp. 151
Burnsp. 152
Orthopedic Injuriesp. 153
Accidental Poisoningp. 153
Faintingp. 153
Infectionp. 156
Infectious Diseasep. 157
Microbesp. 157
The Chain of Infectionp. 158
Normal Body Florap. 159
Natural Body Defenses Against Diseasep. 160
Immunityp. 161
Serious Infections in Health Care Facilitiesp. 162
Bacterial Infectionsp. 162
Viral Infectionsp. 164
Other Important Infectionsp. 168
Why Older Residents in Long-Term Care Are at Risk for Infectionsp. 169
General Measures to Prevent Infectionsp. 169
Outbreak of Infectious Disease in a Long-Term Care Facilityp. 170
Infection Controlp. 173
Medical Asepsisp. 174
Handcarep. 177
Handwashingp. 177
Protecting Yourselfp. 178
Standard Precautionsp. 179
Transmission-Based Precautionsp. 179
Guidelines for Standard Precautionsp. 180
Guidelines for Environmental Proceduresp. 182
Disinfection and Sterilizationp. 188
Donning a Mask and Glovesp. 189
Removing Contaminated Glovesp. 189
Donning a Gownp. 190
Removing Contaminated Gloves, Mask, and Gownp. 191
Caring for Linens in Isolation Unitp. 194
Measuring Vital Signs in Isolation Unitp. 194
Serving a Meal Tray in Isolation Unitp. 195
Specimen Collection from Resident in Isolation Unitp. 196
Transferring Nondisposable Equipment Outside of Isolation Unitp. 198
Transporting Resident to and from Isolation Unitp. 198
Sterile Proceduresp. 199
Opening a Sterile Packagep. 200
Characteristics of the Long-Term Care Residentp. 203
The Long-Term Care Residentp. 204
About Agingp. 205
The Process of Normal Agingp. 205
Changes Caused by Agingp. 205
Illness and Disabilityp. 206
Stereotypes and Mythsp. 210
The Younger Resident in the Long-Term Care Facilityp. 213
Guidelines for Caring for Residents with Huntington's Diseasep. 214
Comfort, Rest, and Sleepp. 214
The Psychosocial Aspects of Agingp. 219
Basic Human Needsp. 220
Cultural Influencesp. 222
Spiritualityp. 223
Religionp. 223
Sexuality and Intimacyp. 223
Major Challenges to Adjustmentsp. 225
Using Defense (Coping) Mechanismsp. 226
Meeting Residents' Psychosocial Needsp. 227
Stress Reactionsp. 228
Reactive Behaviorsp. 228
Alternative and Culturally Based Health Behaviorsp. 232
Scientific (Western) Approach to Health Carep. 233
Alternative and Adjunctive Therapiesp. 233
Cultural Sensitivityp. 238
Importance for the Nursing Assistantp. 240
Meeting the Residents' Basic Needsp. 243
Care of the Residents' Environmentp. 244
Resident Environmentp. 245
Personal Spacep. 245
Resident Unitp. 246
Extended Resident Environmentp. 247
Guidelines for Ensuring a Safe and Comfortable Environmentp. 249
Critical Procedure Actionsp. 250
Bedmakingp. 250
Guidelines for Handling Linens and Making the Bedp. 253
Unoccupied Bed: Changing Linensp. 254
Occupied Bed: Changing Linensp. 258
Caring for the Residents' Personal Hygienep. 262
Epidermisp. 263
Dermisp. 263
Skin Functionsp. 264
Skin Changes Caused by Agingp. 264
Skin Lesionsp. 265
Guidelines for Preventing Skin Breakdownp. 268
Backrubp. 272
Bathing Residentsp. 272
Backrubp. 272
Bed Bath Using Basin and Waterp. 275
Bed Bath Using a Rinse-Free Cleanser and Moisturizerp. 278
Tub Bath or Showerp. 279
Partial Bathp. 281
Hair Carep. 282
Female Perineal Carep. 282
Male Perineal Carep. 284
Facial Hairp. 286
Hand and Fingernail Carep. 287
Daily Hair Carep. 287
Shaving Male Residentp. 288
Foot and Toenail Carep. 288
Hand and Fingernail Carep. 289
Foot and Toenail Carep. 290
Oral Hygienep. 290
Assisting Resident to Brush Teethp. 292
Cleaning and Flossing Resident's Teethp. 292
Caring for Denturesp. 294
Assisting with Oral Hygiene for the Unconscious Residentp. 295
Dressing Residentp. 295
Dressing and Undressing Residentp. 296
Meeting the Residents' Nutritional Needsp. 300
The Digestive Systemp. 301
The Digestive Processp. 302
Aging Changesp. 304
Nutrientsp. 304
Electrolyte Balancep. 305
The 2005 Dietary Guidelines for Americansp. 305
Nutritional Statusp. 308
Dehydrationp. 309
Intake and Output (I&O)p. 310
Measuring and Recording Fluid Intakep. 311
Dietsp. 312
Nursing Assistant Responsibilitiesp. 314
Assisting the Resident Who Can Feed Selfp. 316
Feeding the Dependent Residentp. 319
Nourishments and Supplementsp. 320
Alternate Methods of Feedingp. 321
Disorders of the Digestive Systemp. 322
Meeting the Residents' Elimination Needsp. 328
Introductionp. 329
The Continent Residentp. 329
Equipment to Assist Eliminationp. 330
Giving and Receiving the Bedpanp. 331
Giving and Receiving the Urinalp. 333
Assisting with Use of the Bedside Commodep. 334
Assisting Resident to Use the Bathroomp. 335
Elimination from the Lower Digestive Tractp. 336
The Resident with Constipationp. 336
Bowel Aidsp. 337
Giving an Oil-Retention or Commercially Prepared Enemap. 338
Giving a Soapsuds Enemap. 339
Rectal Tube and Flatus Bagp. 342
Inserting a Rectal Tube and Flatus Bagp. 342
Ostomiesp. 343
Giving Routine Stoma Care (Colostomy)p. 344
Fecal Incontinencep. 347
Collecting a Stool Specimenp. 347
Collecting a Stool Specimenp. 347
Urinary Systemp. 349
Urine Eliminationp. 350
Changes in the Urinary System Caused by Agingp. 351
Urinary Retention and Incontinencep. 351
Internal Urinary Catheter Drainagep. 352
Giving Indwelling Catheter Carep. 353
Intake and Output (I&O)p. 355
Emptying a Urinary Drainage Unit and Disconnecting the Catheterp. 355
Measuring and Recording Fluid Outputp. 357
Leg Bag Drainagep. 359
Connecting Catheter to Leg Bag and Emptying the Leg Bagp. 360
Collecting a Routine or Clean-Catch Urine Specimenp. 361
External Urinary Drainage (Male)p. 364
Common Conditionsp. 364
Applying a Condom for Urinary Drainagep. 364
Special Nursing Assistant Activitiesp. 369
Measuring and Recording Residents' Datap. 370
Measuring Vital Signsp. 371
Temperaturep. 371
Measuring an Oral Temperature (Glass Thermometer)p. 374
Measuring a Rectal Temperature (Glass Thermometer)p. 376
Measuring an Axillary Temperature (Glass Thermometer)p. 377
Measuring an Oral Temperature (Electronic Thermometer)p. 378
Measuring a Rectal Temperature (Electronic Thermometer)p. 378
Measuring an Axillary Temperature (Electronic Thermometer)p. 379
Measuring a Tympanic Temperaturep. 379
Pulse and Respirationp. 381
Counting the Radial Pulse Ratep. 382
Counting the Apical-Radial Pulsep. 383
Blood Pressurep. 384
Counting Respirationsp. 384
Guidelines for Preparing to Measure Blood Pressurep. 387
Taking Blood Pressurep. 388
Weighing and Measuring the Residentp. 389
Weighing and Measuring the Resident Using an Upright Scalep. 391
Measuring Weight with an Electronic Wheelchair Scalep. 392
Weighing the Resident in a Chair Scalep. 393
Measuring and Weighing the Resident in Bedp. 394
Recording Vital Signsp. 395
Admission, Transfer, and Dischargep. 398
Admitting the Residentp. 399
Admitting the Residentp. 402
Transferring the Residentp. 404
Transferring the Residentp. 407
Discharging the Residentp. 407
Discharging the Residentp. 408
Warm and Cold Applicationsp. 415
Safetyp. 416
Commercial Preparationsp. 416
Use of Warm Applicationsp. 417
Applying an Aquamatic K-Padp. 418
Use of Cold Applicationsp. 419
Applying a Disposable Cold Packp. 419
Applying an Ice Bagp. 420
Assisting with the Application of a Hypothermia Blanketp. 421
Introduction to Restorative Carep. 425
Restorative and Rehabilitative Care of the Residentp. 426
Restorative Care and the Interdisciplinary Healthcare Teamp. 428
Purposes of Restorative and Rehabilitative Carep. 429
Preventing Complications from Inactivityp. 430
Activities of Daily Livingp. 430
Setting Up Restorative Programsp. 433
The Restorative and Rehabilitative Environmentp. 435
Guidelines for Nursing Assistant Responsibilities in General Restorative Programp. 439
Progressive Mobilizationp. 440
Range of Motionp. 440
Guidelines for Passive Range-of-Motion Exercisesp. 441
Passive Range-of-Motion Exercisesp. 443
Self Range-of-Motion Exercisesp. 451
Active Range-of-Motion Exercisesp. 451
Positioning the Residentp. 451
Guidelines for Positioningp. 452
Turning the Dependent Resident with a Turning Sheetp. 456
Moving the Resident in Bedp. 456
Turning the Resident to the Sidep. 458
Logrolling the Resident onto the Sidep. 459
Positioning the Dependent Residentp. 460
Supine Positionp. 461
Semisupine or Tilt Positionp. 461
Lateral (Side-Lying) Positionp. 462
Lateral Position on the Affected Sidep. 463
Semiprone Positionp. 463
Fowler's Positionp. 464
Chair Positioningp. 466
Repositioning a Resident in a Wheelchairp. 467
Wheelchair Activities to Relieve Pressurep. 467
Independent Bed Movementp. 468
Assisting with Independent Bed Movementp. 468
Continuing with Progressive Mobilizationp. 469
Bowel and Bladder Programsp. 469
Guidelines for Bowel and Bladder Programsp. 470
Restoring Residents' Mobilityp. 475
Transfersp. 476
Guidelines for Transfersp. 477
Using a Transfer Belt (Gait Belt)p. 477
Bringing the Resident to a Sitting Position at the Edge of the Bedp. 479
Assisted Standing Transferp. 480
Transferring the Resident from Chair to Bedp. 482
Assisted Standing Transfer/Two Assistantsp. 482
Wheelchair to Toilet and Toilet to Wheelchair Transfersp. 483
Transferring to Tub Chair or Shower Chairp. 485
Transferring a Nonstanding Resident from Wheelchair to Bedp. 486
Using Mechanical Liftsp. 486
Transferring Resident with a Mechanical Liftp. 487
Sliding Board Transferp. 489
Ambulationp. 489
Guidelines for Sliding Board Transfersp. 490
Sliding Board Transferp. 490
Using a Wheelchairp. 493
Guidelines for Ambulationp. 496
Ambulating a Residentp. 496
Assisting Resident to Ambulate with Cane or Walkerp. 496
Special Maneuvers with Wheelchairsp. 498
Positioning the Dependent Resident in the Wheelchairp. 501
Wheelchair Activityp. 503
Residents with Specific Disordersp. 507
Caring for Residents with Cardiovascular Disordersp. 508
Introductionp. 509
The Heartp. 510
Blood Vesselsp. 511
Lymphp. 512
The Bloodp. 512
Disorders of the Bloodp. 513
Disorders of the Blood Vessels and Circulationp. 513
Guidelines for Caring for Residents with Peripheral Vascular Diseasep. 517
Heart Diseasep. 517
Applying Elasticized Stockingsp. 521
Caring for Residents with Respiratory System Disordersp. 525
Introductionp. 526
The Respiratory Structuresp. 526
Voice Productionp. 527
Changes Caused by Agingp. 527
Introduction to Pathologyp. 528
Collecting a Sputum Specimenp. 530
Chronic Obstructive Pulmonary Diseasep. 530
Treatment and Care of Residents with COPDp. 531
Refilling the Humidifier Bottlep. 535
Caring for Residents with Endocrine System Disordersp. 538
Introductionp. 539
Endocrine Glandsp. 539
Aging Changesp. 541
Glucose Metabolismp. 541
Diabetes Mellitusp. 542
Caring for Residents with Reproductive System Disordersp. 548
Introductionp. 549
The Male Reproductive Systemp. 549
The Female Reproductive Systemp. 551
Menstrual Cyclep. 552
Menopausep. 553
Changes in the Reproductive System as a Result of Agingp. 553
Related Conditionsp. 553
Sexually Transmitted Diseasesp. 555
Caring for Residents with Musculoskeletal System Disordersp. 559
The Musculoskeletal Systemp. 560
Changes in the Musculoskeletal System Caused by Agingp. 561
Conditions Affecting the Musculoskeletal Systemp. 563
Caring for Residents with Nervous System Disordersp. 573
Components of the Nervous Systemp. 574
Central Nervous Systemp. 576
Autonomic Nervous Systemp. 578
Sense Organsp. 578
Changes in the Nervous System Caused by Agingp. 580
Causes of Severe Vision Impairmentp. 580
Care of Eyeglassesp. 580
Guidelines for Assisting Visually Impaired Residentsp. 581
Hearing Lossp. 582
Applying and Removing In-the-Ear or Behind-the-Ear Hearing Aidsp. 584
Nervous System Disordersp. 584
Guidelines for Caring for Residents with Parkinson's Diseasep. 586
Guidelines for Caring for Residents Who Have Had a Strokep. 588
Guidelines for Caring for Residents with Multiple Sclerosisp. 589
Guidelines for Caring for Residents with Huntington's Diseasep. 591
Guidelines for Caring for Residents Who Have Amyotrophic Lateral Sclerosisp. 591
Guidelines for Caring for Residents Who Have Myasthenia Gravisp. 592
Residents with Special Needsp. 597
Alzheimer's Disease and Related Disorders (Caring for the Cognitively Impaired Resident)p. 598
Definition of Alzheimer's Diseasep. 599
Stages and Symptoms of Alzheimer's Diseasep. 600
Caring for Residents with Dementiap. 603
Guidelines for Caring for Residents with Alzheimer's Diseasep. 605
Guidelines for Activities of Daily Livingp. 607
Special Problemsp. 610
Special Management Techniquesp. 611
Caring for Residents with Developmental Disabilitiesp. 615
Characteristics of a Developmental Disabilityp. 616
Mental Retardationp. 618
Other Forms of Developmental Disabilitiesp. 619
Caring for Residents with Developmental Disabilitiesp. 622
Caring for the Dying Residentp. 625
Introductionp. 626
Hospice Carep. 626
The Dying Processp. 627
Signs of Approaching Deathp. 634
Postmortem Carep. 635
Giving Postmortem Carep. 636
Caring for the Person in Subacute Carep. 639
Description of Subacute Carep. 640
Special Procedures Provided in the Subacute Care Unitp. 644
Care of the Surgical Patientp. 644
Guidelines for Electronic Blood Pressure Monitoringp. 645
Pulse Oximetryp. 645
Taking Blood Pressure with an Electronic Blood Pressure Apparatusp. 646
Intravenous Therapyp. 647
Using a Pulse Oximeterp. 648
Guidelines for Caring for Residents with Intravenous Linesp. 651
Pain Management Proceduresp. 651
Changing a Gown on a Resident with a Peripheral Intravenous Line in Placep. 653
Caring for Residents with Tracheostomiesp. 654
Caring for the Resident Receiving Dialysis Treatmentsp. 655
Oncology Treatmentsp. 657
Caring for the Person in the Home Settingp. 661
Benefits of Home Health Carep. 663
The Home Health Care Teamp. 663
Characteristics of the Home Health Nursing Assistantp. 664
Home Health Nursing Assistant Dutiesp. 664
Time Managementp. 666
Safety in the Homep. 666
Home Managementp. 669
Communication and Documentationp. 670
Employmentp. 677
Seeking Employmentp. 678
Congratulations Are in Orderp. 679
Self-Appraisalp. 679
Job Searchp. 679
The Resumep. 680
Referencesp. 681
Taking the Stepp. 681
The Interview (Putting Your Best Foot Forward)p. 682
Keeping the Jobp. 683
Growingp. 683
Resigningp. 685
Glossaryp. 689
Indexp. 711
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