Flashcards
Chapter 3 and 4
Cards in this deck (113)
- 1Ethicsthe knowledge of right and wrong.
"what should you do" - 2Lawsrules set by the government ti help people live peacefully together and to ensure order and safety
"what must you do?" - 3define Omnibus Budget Reconciliation. (OBRA)law passed by the federal government that includes minimum standards for nursing assistant training, resident assessment instructions , staffing requirements, and information on rights for residents.
- 4Minimum Data Set (MDS)a detailed form with guidelines for assessing residents in long-term care facilities
- 5what's the minimum standards fir NA training (OBRA)75 hours
- 6what are requirement competency exam for NAs (OBRA)exam includes a written portion and demonstrated nursing skills
- 7how many hours and what kind of training does NAs need (OBRA)requires regular in-service training for NAs (12 hours annually)
- 8what are some examples of legal and ethical behavior?1. be honest
2. protect resident privacy
3. keep staff information confidential
4. report abuse or suspected abuse of residents
5. follow the care plan and your assignment
6. do not perform any task outside your scope of practice
7. report all resident observations and incidents to the nurse
8. document accurately
9. follow rules on safety and infection prevention
10. do not accept gifts or tips
11. do not get personally or sexually involved with residents or their family - 9Each NA has a _______ to promote ______ and ______ behavior in the workplaceresponsibility, legal, ethical
- 10residents' rightsnumerous rights identified in the OBRA law that relate to how resident must be treated while living in facility; they provide an ethical code of conduct for healthcare workers.
- 11informed consentthe process in which a person, with the help of a doctor, makes informed decisions about his or her health care.
- 12resident have a legal right to (list 10))1. quality of life
2. services and activities to maintain a high level of wellness
3. be fully informed regarding rights and services
4. participate in their own care
5. make independent choices
6. privacy and confidentiality
7. dignity, respect, and freedom
8. security of possessions
9. be informed and consent to transfers and discharges
10. voice complaints
11. have visits
12. have access to social services - 13what are some specific examples of ways NAs can promote residents' rights (q?)explain residents' rights and discuss why they are important
1. do you ever think about all the decisions you make in one day?
2.how would you feel if you lost the ability to take care
3.how do you think residents feel about the number of choices they can no longer make for themselves - 14Americans with Disability actprohibits discrimination because of disability
- 15what must providers (including LTFs) provide?provide equal opportunities, which may include making some changes to their services
- 16neglectthe failure to provide needed care that results in physical, mental, or emotional harm to a person.
- 17active neglectthe purposeful failure to provide needed care, resulting in harm to a person
- 18passive neglectthe unintentional failure to provide needed care, resulting in physical, mental, or emotional harm to a person.
- 19negligenceactions, or the failure to act or provide the proper care, that result in unintended injury to a person.
- 20abusepurposeful mistreatment that causes physical mental, or emotional pain or injury to someone
- 21physical abuseany treatment, intentional or not, that causes harm to a person's body
- 22psychological abuseemotional harm caused by threatening, scaring, humiliating, intimidating, isolating, or insulting a person, or treating him as a child; also includes verbal abuse
- 23verbal abusethe use of spoken or written words, pictures, or gestures that threaten, embarrass, or insult a person
- 24assaulta threat to harm a person, resulting in the person feeling fearful that he or she will be harmed.
- 25batterythe intentional touching of a person without his or her consent.
- 26sexual abusethe forcing of a person to perform or participate in sexual acts against his or her will; includes unwanted touching, exposing oneself, and sharing of pornographic material
- 27financial abusethe improper or illegal use of a person's money, possessions, property or other assets
- 28domestic violencephysical, sexual, or emotional abuse by spouses, intimate partners, or family members
- 29workplace violenceverbal, physical, or sexual abuse of staff by other staff members, residents, or visitors
- 30false imprisonmentthe unlawful restraint of someone which affects the person's freedom of movement; includes both the threat of being physically restrained and actually being physically restrained.
- 31involuntary seclusionthe separation of a person from others against the person's will
- 32sexual harassmentany unwelcome sexual advance or behavior that creates an intimidating, hostile, or offensive working environment
- 33substance abusethe repeated use of legal or illegal substances in a way that is harmful to oneself or others
- 34mandated reporterspeople who are legally required to report suspected or observed abuse or neglect because they have regular contact with vulnerable populations, such as the elderly in care facilities
- 35suspicious injuries and should be reported: 11 lists1. poisoning or traumatic injury
2. teeth marks
3. belt buckle or strap marks
4. bruises, contusions, or welts
5. scars
6. fractures, dislocations
7. burns of unusual shape and in unusual location; cigarette burns
8.scratches and puncture wounds
9. scalp tenderness, patches of missing hair
10.swelling in the face, broken teeth, nasal discharge
11. Bruises, bleeding, or discharge from the vaginal area - 36signs of abuse signs that could indicate abuse include the following ....yelling obscrenities
2. fear, apprehension, fear of being alone
3. poor self control
4. constant pain
5. threatening to hurt others
6. withdrawal or apathy
7. alcohol or drug abuse
8. agitation or anxiety, signs of stress
9. low self-esteem
10. mood changes, confusion, disorientation
11. private conversation is not allowed
12. reports of questionable care by resident/family - 37signs of neglect signs that could indicate neglect include the following1. pressure ulcers,
2.unclean body,
3.body lice,
4. unanswered call lights,
5.soiled bedding or incontinence briefs not being changed
6. poorly fitting clothing
7. unmet needs relating to hearing aids, eyeglasses, etc...
8. weight loss, poor appetite
9. uneaten food
10. dehydration
11. fresh water or beverages not being offered regularly - 38some people are more vulnerable to adult abuse or neglect than others. They include the followingthe elderly, physically ill or disabled, developmentally disabled, mentally il or disabled, people with communication problems, such as hearing speech, and vision impairments
- 39why would some people are more vulnerable to adult abuseunable to stand for self, don't know they have rights, care is demanding, caregiver stress, improper caregiver training, lack of understanding of disease process
- 40what do you follow when reporting abusefollow the chain of command
- 41federal laws relation to Residents' Rights , which forbid abuse and neglectsome states have vulnerable adults acts or adult protective services laws.
2. the elder justice act of 2010 is the first federal law designed specifically to combat elder abuse - 423 informations that NA should know when a complaint of abuse is made against a NA1. if facility staff believe abuse has occurred, a report must be made to the relevant state agency
2. NA can request a hearing with the state agency, which will investigate the claim
3. if the state agency finds abuse occurred, this is noted in the state's nurse aide registry. The NA's certification may be revoked - 43ombudsmana legal advocate for residents in long-term care facilities who helps resolve disputes and settle conflicts
- 44typical tasks for an ombudsman1. advocates for residents' rights and quality care
2. educates consumers and care providers
3. investigates and resolves complaints
4. appears in court
5. works with investigators
6. give information to public - 45HIPPA Confidentialitythe legal and ethical principle of keeping information private
- 46protected health information (PHI) HIPPAa person's private health information (names, address, number, social security number, email address, and medical record number
- 47patient self determination act (PSDA) advance directives?legal documents that allow people to decide what medical care they wish to have if they are unable to make those decisions themselves
- 48patient self determination act (PSDA) Living willa document that outlines the medical care a person wants. or does not want, in case he or she becomes unable to make those decisions
- 49patient self determination act (PSDA) durable power of attoney for health carea signed, dated, and witnessed legal doc that appoints someone else to make the medical decisions for a person in the event he or she become unable to do so
- 50patient self determination act (PSDA) do-not- resuscitate (DNR)a medical order that instructs medical professionals not to perform cardiopulmonary resuscitation in the event of cardiac or respiratory arrest
- 51patient self determination act (PSDA) physician orders for life-sustaining treatmenta medical order that specifics the treatments a person wishes to receive, not what he wishes to avoid, when he is very ill; decisions are based on conversations between the patient and his healthcare providers
- 52according to PSDA, the following rights must be communicated to residents at the time of admissionthe right to participate in and direct healthcare decisions
the right to accept or refuse treatment
the right to prepare an advanced directive
information on the facility's policies that govern these rights - 53communicationthe process of exchanging information with others by sending and receiving messages
- 543 step communication processsender sends message, receiver receives message, and receiver provides feedback
- 55during the conversation the process is ______ over _____overrepeated, and
- 56verbal communicationcommunication involving the use of spoken or written words or sounds
- 57nonverbal communicationcommunication without using words
- 58cultural diversitythe different groups of people with varied backgrounds and experiences who live together in the world
- 59biasprejudice
- 60culturea system of learned beliefs and behaviors that is practiced by a group of people and is often passed on from one generation to the next.
- 61cultural background can affect all of these communication issuesDistance/personal space, eye contact, touch, personal space
- 62clichesphrases that are used over and over again do not really mean anything
- 63what some 8 examples that barriers to communication1. words are not understood
2. cliche is used
3. yes/no answers to end a conversation
4. why questions make resident defensive
5. nonverbal communication changes the message
6. NA cannot understand resident
7. Resident cannot hear NA
8. resident speaks different language - 64these 4 techniques can help an NA communicate clearly and effectively1. be a good listener
2. provide feedback
3. bring up topics of concern,
4. allow pauses
5. tune in to other cultures
6. accept residents' religion or lack of religion
7. understand the importance of touch
8. ask for more information
9. make sure communication aids are clean and working - 65with whom does NA need to communicate?residents, family members, care team, and providers
- 66The following tips are helpful in building positive relationships1.avoid changing the subject
2.do not ignore requests
3.do not talk down to people
4.sit or stand near the resident
5. lean forward to show you are interested
6. have time for residents' families and friends
7.be empathetic
8. talk directly to the resident you are assisting - 67objective informationinformation based on what a person sees, hears, touches, or smells; also called signs
- 68subjective informationinformation that a person cannot or did not observe, but is based on something reported to the person that may or may not be true; also called symptoms
- 69smell is used for whatresident's body or breath odor
- 70sights used for whatchanges in resident's appearance
- 71hearing used for whatresident's words, tone , and breathing
- 72touch is used for whatresident's skin and pulse
- 73NAs should keep the following in mind when communication with their fellow team members1. keep the nurse informed of all important issues during the shift
2. communicate with other care team members as needed to provide quality care
3. always respect residents' privacy when communicating with other care team members
4. be careful with communication do not share info about diagnoses and condition changed
5. when in doubt about what you can or should communicate, ask the nurse
6. use the chain of command to voice complaints - 74Rootpart of a word that contains its basic meaning or definition
- 75prefixthe word part that precedes the root to help form a new word
- 76sufficthe word part added to the end of a root that helps form a new word
- 77all of the following occurrences should be reported immediately1/falls
2. chest pain
3. severe headache
4. difficulty breathing
5. abnormal pulse, respiration, or blood pressure
6. change in mental status
7. sudden weakness or loss of mobility
8. fever
9. loss of or change in consciousness
10. bleeding
11. change in condition
12. bruises, abrasions, or other signs of abuse - 78an NA should document the following about an oral reportwhen
why
about
what
to whom - 79SBAR whats forsituation (patient detail), background (resident's medication, treatments, and history, assessment (concerns, early warning score), recommendations (make suggestions, confirm actions to be taken)
- 80a medical chart is a legal record of a resident's care. it includes the following information (9)admission sheet.
resident's medical history.
doctor's orders,
progress notes,
lab/test results,
graphic sheet,
nurse's notes,
flow sheet/ADL - 81why is documentation is very important (4)1. Guarantees clear and complete communication
2. provides legal record of treatment
3. protects NA and employer
4. Provides up to date record of resident's status - 82NAs should always follow these guidelines for documentation1. document care immediately after is it given
2. think before writing,. brief and clear
3. use facts
4. write neatly with black ink
5. correct errors properly
6. sign full name and title
7. document per care plan - 83True or false if something is not documented, legally speaking it was not donetrue
- 84midnight may be written as (military time)0000 or 2400
- 8512 pm to1200
- 86incidentan accident, problem, or unexpected event during the course of care that is not part of the normal routine in a healthcare facility
- 87sentinel eventan unexpected occurrence that results in grave physical or psychological injury or death
- 88the following 7 events are considered incisdentsfalls, NA or resident breaks or damages something , mistakes in care, requests outside scope of practice, sexual advances or remarks, unsafe or uncomfortable situations, NA is injured on the job, blood or body fluids exposure
- 89NAs must follow these 5 guidelines for incident reporting1. tell what happened
2, described the person's reaction to the incident
3. state facts only
4. do not write about anything in the incident report on the medical record
5. describe action taken to give care - 90effective telephone communication involves the following stepswhen calling to some
1. identify yourself politely before asking to speak to someone
2. ask for the person with whom you need to speak
3. state the reason for your call
4.leave a brief message if the person you are calling is not available
5. thank the person who takes the Message for you - 91steps are important when answering the telephoneidentify the facility's name, your name \ and your position
2. place caller on hold if necessary
3. write down messages. Ask for correct spelling of names, get a number
4, say thank and goodbye - 92true or false NAs should never give out information about staff or residents over the phonetrue
- 93remember 4 thing to remember about call lights1. NA must always answer the call lights, no matter what
2. call lights must be left within residents' reach and answered promptly every time the resident pushes the button
3. if the resident has a stronger hand, the light should be in reach of that hand specifically
4. it is also important to be sure the resident understands how to use the call light - 94impairmenta loss of function or ability
- 95farsightednessthe ability to see objects in the distance better than objects nearby; also called hyperopia
- 96nearsightednessthe ability to see things near bu not far; also called myopia
- 97cerebrovascular accidentcondition that occurs
- 98hemiplegiaparalysis on one side of the body
- 99hemiparesisweakness on one side of the body
- 100expressive aphasiadifficulty communicating thoughts through speech or writing
- 101receptive aphasiadifficulty understanding spoken or written words
- 102emotional labilityinappropriate or unprovoked emotional responses, including laughing, crying, and anger
- 103dysphagiadifficulty swallowing
- 104combativeviolent or hostile
- 10511 guidelines are important when communicating with residents with hearing impairmentmake sure hearing aid is on and working. Clean hearing aid as instructed and everyday
2. reduce or remove background noise
3. get residents' attention before speaking
4. speak, clearly, slowly, and in good lighting
5. do not shout or mouth words in an exaggerated way.
6. lower pitch of voice
7. do not chew gum or eat while speaking, and keep hands away from face.
8. speak and stand on side with better hearing
9. use short sentences and simple words
10. repeat what was said using different words if necessary
11. use pictures cards or notepads - 10610 guidelines are important when communicating with residents with vision impairment1. encourage use of eyeglasses or contact lenses if worn
2. make sure eyeglasses or lenses are clean and in good condition. If resident is able, leave contact lens care to him
3. identify self when entering room
4. make sure there is proper lighting. Face resident when speaking
5. orient residents to new areas
6. tell resident what you are doing
7. use imaginary clock as a guide
8. do not move items.
9. tell resident where call light is
10.give assistance with cutting food and opening containers as needed
11. use large clocks or clocks that chime
12. offer large-print books, audio books, digital books
13. do not play with guide dogs
14. encourage use of other senses - 1078 guidelines when communicating with residents who have experienced CVA/stroke1.keep questions and directions simple
2. phrase questions that can be answered with a yes or no
3. agree on signals
4. give residents plenty of time to respond
5. use a pencil and paper if possible
6. use the term weaker or involved to refer to affected side
7. use both verbal and nonverbal
8. use communication boards or special cards - 1089 guidelines with residents who are demonstrating combative behavior1. block blows or step out of way
2. allow the resident time to calm down before the next interaction
3. ensure resident is safe and give him space
4. remain calm. lower tone of voice
5. be flexible and patient
6. stay neutral. do not respond to verbal attacks or argue
7. be reassuring and supportive
8. consider what provoked the resident
7. - 1096 guidelines with resident who are angry1. stay calm
2. empathize
3. try to find out cause
4. be respectful. Explain what you are going to do
5. answer call lights promptly
6. stay at a safe distance - 110different between assertive and aggressive behaviorassertive: expresses thoughts , feelings, and beliefs in honest way. Respect his own needs
aggressive: expresses thoughts, feelings, and beliefs in ways that humiliate, disgrace, or overpower the other person.
shows little or no respect for the needs or feelings of others - 111True or false NA should not report aggressive behavior from residentsfalse
- 112situations to solve when communicating with resident who are demonstrating inappropriate behavior (resident giving gifts or asking for NA's personal life, tip)1. try a light approach, like "im sorry, but im not allowed to do that"
2. address behavior directly, with "That makes me uncomfortable." If resident persists, call nurse
3. respond to personal question by saying, " I cant talk about my personal life on the job"
4.firmly refuse the gifts
5. be professional
6. try distraction, or take resident to private area
7. always report inappropriate behavior to the nurse. - 113True or False NA must never hit a resident, no matter how the resident behaves.true
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- Flashcards on Chapter 3 and 4 , created by Alice Sonic on 14/09/2020.
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