November, 2009
Manual Skills
Hidden Skill Steps made visable by "Selecting" with mouse. * marks Key Skill Step
4 In's
Hidden answers made visable by "Selecting" with mouse.
1. Knock and wait for reply.
2. Identify resident, yourself, and why you are there.
3. Wash hand before touching anything.
4. Provide privacy by closing door, privacy curtain, and window blinds when resident may be exposed.
4 Safety's
Hidden answers made visable by "Selecting" with mouse.
1. Lock bed.
2. Lower bed to lowest position.
3. Put on no-skid footwear.
4. Lock wheel chair.
4 Out's
Hidden answers made visable by "Selecting" with mouse.
1. Neaten bed and area.
2. Remove privacy by opening door, privacy curtain, and window blinds.
3. Provide a call light.
4. Wash hand just before leaving.
Are You Ready?
To Take the Skills Portion of the
State Test AND Pass it
Hidden answers made visable by "Selecting" with mouse.
1. In full detail, what does it mean when the KEY STEP for Handwashing says, "do not re-contaminate"?
Do not dirty hands by touching sink, faucet, self, trash can, paper towel dispenser, or anything other than a clean paper towel.
2. What 4 "moving" skills share the same 2 KEY STEPS?
Skill 03 - Ambulation using a Gait Belt
Skill 04 - Ambulation with Walker
Skill 21 - Transfer from Bed to Wheelchair using a Gait Belt
Skill 22 - Transfer from Wheelchair to Bed using a Gait Belt
3. What are the 2 KEY STEPS for those 4 "moving" skills?
Lock bed brakes to ensure resident's safety.
Lock wheelchair brakes to ensure resident's safety.
4. What 5 "measurement" skills?
Skill 06 - Bedpan/Fracture Pan and Output
Skill 09 - Emptying a Urinary Drainage Bag
Skill 10 - Feeding the Dependent Resident
Skill 24 - Vital Signs - Temperature, Pulse and Respiration
Skill 25 - Weighing an Ambulatory Resident
5. Name the KEY STEP for those 5 "measurement" skills.
Candidate's mesurement reading is within... of RN Evaluator's reading.
Skill 06 - Bedpan/Fracture Pan and Output - 25 cc
Skill 09 - Emptying a Urinary Drainage Bag - 25 cc
Skill 10 - Feeding the Dependent Resident - 25% of solid food and 60 cc of fluid
Skill 24 - Vital Signs - Temperature, Pulse and Respiration - 0.1 degreee of temperature, 4 pulse beats, 2 breaths, write it all right and sign for example "98.5 degrees, 70 beats, 12 breaths"
Skill 25 - Weighing an Ambulatory Resident - 2 lbs.
6. One "measurement" skill shares another KEY STEP with the "moving" skills.
Which skill? Skill 25 - Weighing an Ambulatory Resident
And what is the KEY STEP? Insures the residents safety. Locks wheelchair brakes.
7. Another one of the "measurement" skills, Emptying a Urinary Bag, has a second key step.
What is it? Wipes the drain with antiseptic wipe.
8. What 3 skills do not have KEY STEPS?
Skill 07 - Denture Care
Skill 11 - Hair Care
Skill 16 - Partial Bed Bath - Face, Arm, Hand and Underarm
9. What step do students often forget when doing Hair Care?
Place towel on shoulders.
10. What is the purpose of lining the sink with a wash cloth or paper towel when doing Denture Care?
To prevent damage to dentures if they are dropped into sink during brushing.
11. What is the purpose of a bath blanket?
Keep exposed resident covered for privacy and warmth and to keep bed sheets dry.
12. Why do you think you do not use soap on a person's face?
To prevent eye irritation and any allergic reaction.
13. Can you ever use soap on a person's face? AND if yes, when?
Yes. When a person has a personal preference for soap.
14. Explain the proper way to wash an eye.
Wipe from inner aspect to outer aspect using a new wash cloth surface for each wipe.
15. What is the KEY STEP for applying an Antiembolic Stocking?
Leaves resident with stockings that are smooth and wrinkle free.
16. When Dressing a resident the 2 KEY STEPS are:
A. Dress the top half starting from the weak side.
B. Dress the bottom half starting from the weak side.
... Explain why it is best to dress starting on the weak side.
By dressing the weak side first one has the maximum clothing slack and the resident is able to help more.
17. When making an Occupied Bed the first KEY STEP is to raise the side rail opposite your working side. What is the purpose of this KEY STEP?
To prevent the resident from rolling out of bed.
18. What is the second KEY STEP for making an Occupied Bed?
Raise the second side rail.
19. The KEY STEP for making an Unoccupied Bed is an infection control issue and you should always practice it no matter where you work, what is it?
Place removed dirty linen in hamper and never on floor.
20. The KEY STEP when doing Mouth Care is to make sure you brush all surfaces. Name the SIX surfaces.
A. Upper Outer
B. Upper Inner
C. Upper Chewing
D. Lower Outer
E. Lower Inner
F. Lower Chewing
21. What is the KEY STEP in Nail Care?
Cleans gently under nails with orange stick.
22. What is another name for the Abdominal Thrust Skill?
Heimlich Maneuver.
23. When do you know it is time to start abdominal thrusts?
When a person can no longer cough or breath.
24. What are the 2 KEY STEPS when doing Peri Care?
A. Cleans one side of labia from top to bottom using a clean portion of a wet soapy wash cloth with each stroke.
B. Cleans area from vagina to rectum using a clean portion of a wet soapy wash cloth with each stroke.
25. Which 2 skills do you leave the side rail(s) up at the end of the skill?
A. Skill 18 - Position Resident on Left Side
B. Skill 23 - Vest Restraint in Bed
... One of these skills, leaving the side rail(s) up is the KEY STEP, which one?
Skill 18 - Position Resident on Left Side
26. What is the KEY STEP for Positioning on Left Side?
Place pillows to maintain correct body alignment with pillow behind back and protect bony prominences of the head, right arm, and between knees. No skin on skin or bone on bone.
27. Even though leaving the side rails up at the end of Vest Restraint is not a KEY STEP, there are 3 KEY STEPS for this skill, what are they?
A. Obtain proper size restraint.
B. Secure to moveable part of the bed.
C. Use secure knot that can be released with one pull.
28. There are 5 skills you need to wear gloves for during the State Test, which ones are they?
A. (upper) Skill 07 - Denture Care
B. (upper) Skill 14 - Mouth Care
C. (lower) Skill 06 - Bedpan/Fracture Pan and Output
D. (lower) Skill 09 - Emptying Urinary Drainage
E. (lower) Skill 17 - Perineal Care for a Female
29. The Range of Motion skills (both upper and lower extremities) share the same KEY STEP, what is it?
Does not cause discomfort or pain and does not force any joint beyond the point of free movement.
30. How will you know if you are doing the KEY STEP right during Range of Motion?
By asking the resident about pain during each motion. By listening and watching the resident's reaction to the motion.
31. What does aphasic mean? Inability to speak Loss of the ability to articulate ideas or comprehend spoken or written language
32. When a person is aphasic, how would you know if you are hurting them when doing ROM exercises?
Facial expression and body language. Person could give some prearranged signal if encountering pain.
33. Explain the difference betweem the following terms:
AROM - Active Range of Motion - Resident performs
PROM - Passive Range of Motion - STNA performs
34. There are 12 skills requiring the privacy curtain during the State Test, which ones are they?
A. Skill 05 - Applying Antiembolic Stocking to One Leg
B. Skill 06 - Bedpan/Fracture Pan and Output
C. Skill 08 - Dressing Resident
D. Skill 09 - Emptying Urinary Drainage
E. Skill 12 - Making an Occupied Bed
F. Skill 14 - Mouth Care
G. Skill 16 - Partial Bed Bath - Face, Arm, Hand and Underarm
H. Skill 17 - Perineal Care for a Female
I. Skill 18 - Position Resident on Left Side
J. Skill 19 - Range of Motion Hip & Knee
K. Skill 20 - Range of Motion One Shoulder
L. Skill 23 - Vest Restraint in Bed
M. Skill 24 - Vital Signs - Temperature, Pulse and Respiration
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Manual Skills' Steps
Need Nothing
Remember to take wedding ring off and push wrist watch up above wrist.
01.Introduces self to the resident.
02.Turns on water.
03.Wets hands.
04.Applies liquid soap to hands.
05.Rubs hands together using friction.
06.Interlaces fingers pointing downward.
07.Washes all surfaces of hands and wrist with liquid soap.
08.Rinses hands thoroughly under running water with fingers pointed downward.
09.Dries hands on clean paper towel(s).
10.Turns off faucet with a SECOND (last) clean dry paper towel.
11.Discards paper towels to trash container as used.
12.*Does not re-contaminate hands at any point during the procedure.
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Need Nothing
01.Identifies symptoms of choking.
02.Asks actor, "Are you choking?"
03.Brings actor to a standing position while calling for help.
04.Stands behind resident.
05.Wraps arms around resident above the waist.
06.Candidate makes a fist with one hand.
07.Places the thumb side of the fist against resident’s abdomen.
08.Positions fist slightly above navel and below bottom of sternum.
09.Grasps fist with other hand.
10.Verbalizes that he/she will press fist and hand into the resident’s abdomen with an inward, upward thrust.
11.Verbalizes that he/she will thrust at least three times.
12.*Stops, asks actor, "Are you still choking?" Actor will say, "No." (Tester will ask what would you have done if the resident would have indicated that they were still choking)
13.Candidate states, "I would repeat this procedure until it is successful or the resident lost consciousness.
14.Resident would then be placed in a supine or recovery position (Must be physically performed)
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Need Gait Belt
01.Identifies that hands should be washed.
02.Explains procedure to be performed and obtains gait belt.
03.*Locks bed brakes to ensure resident’s safety.
04.Lowers bed to a position so the resident’s feet will rest comfortably flat on the floor when sitting on the bed.
05.Brings resident to sitting position with feet flat on the floor and places gait belt around waist to stabilize trunk. Tightens gait belt. Checks gait belt for tightness by slipping fingers between gait belt and resident.
06.Assists resident to put on non-skid slippers.
09.*Locks wheelchair brakes to ensure resident’s safety.
07.Brings resident to standing position, using proper body mechanics.
08.With one hand grasping gait belt and the other stabilizing resident by holding forearm, shoulder, or using other appropriate method to stabilize, ambulates resident at least 10 steps.
10.Assists resident to pivot and sit in a controlled manner that ensures safety. Removes gait belt.
11.Maintains respectful, courteous interpersonal interactions at all times.
12.Leaves call light or signaling device within easy reach of the resident.
13.Identifies that hands should be washed.
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Need Walker
01.Identifies that hands should be washed.
02.Explains procedure to resident.
03.*Locks bed wheels to ensure resident’s safety.
...Lowers bed to a position so the resident’s feet will rest comfortably flat on the floor when sitting on the bed.
05.Brings resident to sitting position.
06.Assists resident in putting on non-skid slippers.
04.*Locks wheelchair brakes to ensure resident’s safety.
07.Positions walker correctly.
08.Assists resident to stand, stabilizes walker and insures resident has stabilized walker.
09.Positions self behind and slightly to side of resident.
10.Safely ambulates resident at least 10 steps.
11.Assists resident to pivot and sit, using correct body mechanics.
12.Maintains respectful, courteous interpersonal interactions at all times.
13.Leaves call light or signaling device within easy reach of the resident.
14.Identifies that hands should be washed.
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Need Antiembolic Stocking
01.Identifies that hands should be washed.
02.Explains procedure to resident.
03.Provides for resident's privacy by only exposing one leg and pulling privacy curtain.
04.Rolls, gathers, or turns stocking down inside out to the heel.
05.Places stocking over the toes, foot, and heel and rolls OR pulls up the leg.
06.Checks toes for possible pressure from stocking and adjusts as needed.
07.*Leaves resident with stockings that are smooth and wrinkle free.
08.Maintains respectful, courteous interpersonal interactions at all times.
...Leave bed neat.
09.Leaves call light or signaling device within easy reach of the resident.
10.Identifies that hands should be washed.
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Need Gloves, bed pan, toilet paper, wash cloth, towel, bag or hamper, recording sheet, pen
Remember to wash resident's hands after putting equipment away.
01.Identifies that hands should be washed.
02.Explains the procedure to resident.
03.Provides privacy for resident pulls curtain.
04.Candidate puts on gloves.
05.Positions resident on bedpan/fracture pan correctly using correct body mechanics.
06.Positions resident on bedpan/fracture pan with pan in correct orientation.
07.Raises head of bed to comfortable level.
08.Leaves tissue within reach of resident and candidate steps away from the resident until RN Evaluator identifies resident is finished.
09.Candidate returns and gently removes bedpan/fracture pan and holds while Evaluator adds a known quantity of fluid.
10.Candidate measures output.
11.Empties graduate, rinses and dries bedpan/fracture pan and graduate. Flushes toilet if used.
12.Washes/assists resident to wash and dry hands with wet wash cloth and towel.
13.Turns gloves inside out as they are removed and disposes of gloves in an appropriate container.
14.Records the output in cc/ml on signed recording sheet.
15.*Candidate's measurement reading is within 25cc/mL of RN Evaluator’s reading.
16.Maintains respectful, courteous interpersonal interactions at all times.
...Leave bed neat.
17.Leaves call light or signaling device within easy reach of the resident.
18.Identifies that hands should be washed.
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Need Wash cloth or paper towel, gloves, toothpaste, toothbrush, bag or hamper
01.Identifies that hands should be washed.
02.Explains procedure to resident.
03.Lines sink with a protective lining that would help prevent damage to the dentures. (Towel, paper towel or washcloth)
04.Puts on gloves and removes dentures from cup.
05.Handles dentures carefully to avoid damage.
06.Applies toothpaste and thoroughly brushes dentures including the inner, outer, and chewing surfaces of upper and/or lower dentures. Toothettes may be utilized instead of a toothbrush as long as all of the surfaces listed above are cleaned.
07.Rinses dentures using clean cool water.
08.Places dentures in rinsed cup.
09.Adds cool clean water to denture cup.
10.Cleans and dries equipment and returns to storage.
11.Discards protective lining in an appropriate container.
12.Turns gloves inside out as they are removed and disposes of gloves in an appropriate container.
13.Maintains respectful, courteous interpersonal interactions at all times.
14.Leaves call light or signaling device within easy reach of the resident.
15.Identifies that hands should be washed.
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Need Shirt, pants, socks, shoes
01.Identifies that hands should be washed.
02.Explains the procedure to the resident.
03.Provides privacy for resident. (Pulls curtain.)
04.Keeps resident covered while removing gown.
05.Removes gown from unaffected side first.
06.Places used gown in laundry hamper.
07.*When dressing the resident in a shirt or blouse, the Candidate inserts his/her hand through the sleeve of the shirt orblouse and grasps the hand of the resident, dressing from the weak side first.
08.*When dressing the resident in pants, the Candidate assists the resident to raise buttocks or turns resident from side to side and draws the pants over the buttocks and up to the resident’s waist, always dressing from the weak side first.
09.When putting on the resident’s socks, the Candidate draws the socks up the resident’s foot until they are smooth.
10.When putting on the resident’s shoes, the Candidate slips each shoe on and securely fastens the shoe with Velcro tabs or ties.
11.Leaves the resident comfortably and properly dressed.
12.Maintains respectful, courteous interpersonal interactions at all times.
...Leave bed neat.
13.Leaves call light or signaling device within easy reach of the resident.
14.Identifies that hands should be washed.
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Need Graduate pitcher, paper towel barrier, antiseptic wipe, gloves, recording sheet, pen
01.Identifies that hands should be washed. (Knock on door removed 6/2009)
02.Explains procedure to resident.
03.Provides for privacy pulls privacy curtain.
04.Puts on gloves.
05.Places a barrier on the floor under the drainage bag.
06.Places the graduate on the previous placed barrier. Opens the drain to allow the urine to flow into the graduate.
07.Avoids touching the graduate with the tip of the tubing. Closes the drain.
08.*Wipes the drain with antiseptic wipe.
09.Replaces drain in holder. With graduate at eye level, measures output.
10.Empties graduate into toilet. Cleans and dries equipment. Returns equipment to storage.
11.Turns gloves inside out as they are removed. Disposes of gloves in the appropriate container.
12.Leaving resident in a position of safety and comfort.
13.Records the output in cc/ml on signed recording sheet.
14.*Candidate’s measurement is within 25cc of Observer’s measurement.
15.Places call light within reach of resident.
16.Maintains respectful, courteous interpersonal interactions.
17.Identifies that hands should be washed.
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Need Wash cloth, towel, clothing protector or towel, bag or hamper, recording sheet, pen
Remember to wash resident's hands after putting on clothing protector and before feeding.
01.Identifies that hands should be washed.
02.Explains procedure to the resident.
03.Identify resident’s name against the diet card and verbalizing that the resident has received the correct tray.
04.Positions the resident in an upright position. At least 45 degrees.
05.Protects clothing from soiling by using napkin, clothing protector or towel.
06.Washes and dries resident's hands and face before feeding.
07.Discards soiled linen appropriately.
08.Candidate positions self at eye level sitting down and facing the resident while feeding resident.
09.Describes the foods being offered to the resident.
10.Alternately offers EACH fluid frequently. (Two fluids will be offered)
11.Offers food in small amounts at a reasonable rate, allowing resident to chew and swallow.
12.Wipes resident's hands and face during meal frequently.
13.Leaves resident clean and in a position of comfort.
14.Records intake in percentage of total solid food eaten on signed recording sheet.
15.Records the sum of the intakes of fluid in cc on signed recording sheet for each.
16.*Candidate is within 25% of the solids and within 60cc/mL of the fluids consumed.
17.Maintains respectful, courteous interpersonal interactions at all times.
18.Leaves call light or signaling device within easy reach of the resident.
19.Identifies that hands should be washed.
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Need Towel, comb or brush, bag or hamper
01.Identifies that hands should be washed.
02.Explains procedure to the resident.
03.Places towel on shoulders.
04.Asks resident how they would like their hair combed.
05.Combs/brushes hair gently and completely.
06.Discards linen in appropriate container.
07.Leaves hair neatly brushed, combed or styled.
08.Maintains respectful, courteous interpersonal interactions at all times.
09.Leaves call light or signaling device within easy reach of the resident.
10.Identifies that hands should be washed.
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Need Pillow case, blanket, flat sheet, fitted sheet, bag or hamper
01.Identifies that hands should be washed.
02.Gathers linen and transports correctly.
03.Places clean linen on top of bedside stand, on over-bed table, over back of chair or drapes over foot of bed. (6/2009)
04.Explains procedure to resident.
05.Provides privacy pulls privacy curtain.
06.*Raises side rail opposite working side of the bed or asks test observer to stand on the opposite side of the bed.
07.Raises bed to working height.
08.Resident is to remain covered at all times.
09.Assists resident to roll onto side toward raised side rail or test observer. Side rail remains up or test observer is directed to remain on side opposite candidate at all times during the task.
10.Rolls or fan folds soiled linen, soiled side inside, to the center of the bed.
11.Places clean bottom sheet along the center of the bed and rolls or fan folds linen against resident's back and unfolds remaining half.
12.Secures two fitted corners.
13.*Raises second side rail or asks test observer to stand opposite working side of the bed and assists the resident to roll over the bottom linen, preventing trauma and avoidable pain to resident.
14.Removes soiled linen without shaking, and places in hamper.
15.Avoids touching linen to uniform.
16.Pulls through and smoothes out the clean bottom linen.
17.Secures other two fitted corners.
18.Places clean top linen and blanket or bedspread over covered resident. Removes used linen making sure the resident is unexposed at all times.
19.Tucks in top linen and blanket or bedspread at foot of the bed.
20.Makes mitered corners at the foot of the bed.
21.Applies clean pillowcase, with zippers and/or tags to inside.
22.Gently lifts resident's head when replacing the pillow.
23.Lowers bed if it was raised.
24.Returns side rails to lowered position if side rails were used.
25.Maintains respectful, courteous interpersonal interactions at all times.
26.Leaves call light or signaling device within easy reach of the resident.
27.Identifies that hands should be washed.
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Need Pillow case, flat sheet, blanket, fitted sheet, bag or hamper
01.Identifies that hands should be washed.
02.Gathers linen and transports correctly.
03.Places clean linen top of bedside stand, on over-bed table, over back of chair or drapes over foot of bed.
04.Elevates bed to appropriate working height.
05.Removes soiled linen from bed without shaking or contaminating uniform.
06.*Places removed linen in linen hamper.
07.Applies bottom fitted sheet, keeping it straight and centered.
08.Makes bottom linen smooth and/or tight, free of wrinkles.
09.Places clean top linen and blanket or bed spread on the bed.
10.Tucks in top linen and blanket or bedspread at the foot of the bed.
11.Makes mitered corners at the foot of the bed.
12.Applies clean pillowcase with zippers and/or tags to inside of pillow case.
13.Leaves bed completely and neatly made.
14.Returns bed to lowest position if it was raised.
15.Identifies that hands should be washed.
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Need 2 towels, gloves, toothbrush, toothpase, emesis basin, bag or hamper
Remember Clean tongue.
01.Identifies that hands should be washed.
02.Explains procedure to the resident.
03.Provides for resident's privacy pulls privacy curtain.
04.Drapes the chest with towel (Paper or cloth) to prevent soiling.
05.Candidate puts on gloves.
06.Applies toothpaste to toothbrush.
07.*Brushes resident's teeth, including the inner, outer, and chewing surfaces of all upper and lower teeth. If available, toothettes may be utilized instead of the toothbrush as long as all of the surfaces listed above are cleaned.
08.Cleans tongue.
09.Assists resident in rinsing mouth.
10.Wipes resident's mouth, removes soiled towel and places in appropriate container.
11.Empties and cleans emesis basin. Rinses toothbrush. Returns emesis basin and toothbrush to storage.
12.Turns gloves inside out as they are removed. Disposes of gloves in the appropriate container.
13.Leaves resident in position of comfort.
14.Leaves call light or signaling device within easy reach of the resident.
15.Maintains respectful, courteous interpersonal interactions at all times.
16.Identifies that hands should be washed.
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Need Towel, wash cloth, orange stick, emesis basin, nail file, bag or hamper
01.Identifies that hands should be washed.
02.Explains procedure to the resident.
03.Immerses nails in comfortably warm water and soaks for at least five (5) minutes. (The five minutes may be verbalized.)
04.Dries hand thoroughly, being careful to dry between fingers.
05.*Gently cleans under nails with orange stick.
06.Gently pushes cuticle back with wash cloth.
07.Files each fingernail.
08.Cleans equipment and returns to storage. Discards linen in linen hamper.
09.Identifies that hands should be washed.
10.Maintains respectful, courteous interpersonal interactions at all times.
11.Leaves call light or signaling device within easy reach of the resident.
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Need Bath blanket, 2 wash cloths, 2 towels, soap, wash basin, clean gown, bag or hamper
01.Identifies that hands should be washed.
02.Explains procedure to the resident.
03.Pulls privacy curtain.
04.Raises bed to appropriate working level.
05.Covers resident with a bath blanket.
06.Fanfolds bed linens at least down to waist or moves linens to opposite side.
07.Removes resident's gown without exposing resident.
08.Fills basin with comfortably warm water.
09.Washes and dries face WITHOUT SOAP.
10.Places towel under arm, exposing one arm.
11.Washes arm, hand and underarm using soap and water.
12.Rinses arm, hand, underarm, and dries entire area.
13.Assists resident to put on a clean gown.
14.Properly cleans, dries and stores all equipment used.
15.Disposes of soiled linen in appropriate container.
...Leave bed neat.
16.Lowers bed if it was raised.
17.Maintains respectful, courteous interpersonal interactions at all times.
18.Leaves call light or signaling device within reach of the resident.
19.Identifies that hands should be washed.
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Need Waterproof pad, bath blanket, 2 towels, 4 wash cloths, soap, wash basin, bag or hamper
Remember apply the waterproof pad before washing.
01.Identifies that hands should be washed.
02.Explains procedure to the resident. (Mannequin)
03.Pulls curtain; provides privacy.
05.Fills basin with comfortably warm water.
04.Raises the bed to the appropriate height.
06.Raises side rail opposite working side of bed or asks test observer to stand on the opposite side of the bed.
07.Turns resident to side and places waterproof pad under resident’s buttocks then returns resident to his/her back OR raises hips and places waterproof pad under buttocks.
08.Puts on gloves.
09.Exposes perineum only.
10.Verbalizes separating and pushing back the labia. (6/2009)
11.*Using water and soapy washcloth, cleans one side of labia from top to bottom using a clean portion of a washcloth with each stroke.
12.Cleans other side of labia from top to bottom using a clean portion of a washcloth with each stroke.
13.Rinses and dries the area from top to bottom. (6/2009)
14.Covers the exposed area with the bath blanket.
15.Assists resident (mannequin) to turn onto side away from the Candidate.
16.With a new washcloth, cleans the rectal area.
17.*Using water, washcloth and soap cleans area from vagina to rectal area with single strokes.
18.Rinses and dries area from vagina to rectal area. (6/2009)
19.Removes waterproof pad from under buttocks.
20.Position resident (mannequin) on their back.
21.Disposes of soiled linen and bath blanket in an appropriate container.
22.Cleans and replaces equipment.
23.Turns gloves inside out as they are removed. Disposes of gloves in the appropriate container.
24.Lowers bed if it was raised.
25.Lowers side rail if side rail was used. (6/2009)
...Leave bed neat.
26.Places call light or signaling device within reach of resident.
27.Identifies that hands should be washed.
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Need 4 pillows (including head pillow)
Remember to check residents body alignment before covering up.
01.Identifies that hands should be washed.
02.Explains what is to be done and how the resident may help.
03.Pulls curtain, provides privacy.
04.Positions bed flat
05.*Raises side rail on left side of the bed or asks test observer to stand on the left side of the bed.
...Move left arm next to head.
06.From the right side - moves upper body toward self.
07.Moves hips toward self.
08.Moves legs toward self.
09.Assists/turns resident to left side and insures that the resident’s face never becomes obstructed by the pillow. (Candidate must physically checks and verbalize checking).
10.Checks to be sure resident is not laying on his/her left arm.
11.*Places support devices such as pillows, wedges, blankets, etc., to maintain correct body alignment and protect bony prominences, under head, right arm, behind back and between knees.
...Leave left side rail up.
...Leave bed neat.
12.Maintains respectful, courteous interpersonal interactions at all times.
13.Leaves call light or signaling device within easy reach of the resident.
14.Identifies that hands should be washed.
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Need Nothing
Remember to check resident's body alignment before starting.
01.Identifies that hands should be washed.
02.Explains procedure to the resident.
03.Pulls curtain; provides for resident's privacy.
04.Positions resident supine and in good body alignment.
05.Correctly supports joints at all times by placing one hand under the knee and the other hand under the ankle.
06.Moves the entire leg away from the body. (abduction) Check for pain each time.
07.Moves the entire leg back toward the body. (adduction)
08.Completes abduction and adduction of the hip three times.
09.Continue to correctly support joints and bend the resident’s knee and hip toward the resident’s trunk. (flexion of the hip and knee at the same time) Check for pain each time.
10.Straighten the knee and hip. (extension of knee and hip at the same time)
11.Complete flexion and extension of knee and hip three times.
12.*Does not cause discomfort or pain and does not force any joint beyond the point of free movement. Candidate must ask if they are causing any pain or discomfort.
13.Leaves resident in a comfortable position.
14.Maintains respectful, courteous interpersonal interactions at all times.
...Leave bed neat.
15.Leaves call light or signaling device within easy reach of the resident.
16.Identifies that hands should be washed.
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Need Nothing
Remember to check resident's body alignment before starting.
01.Identifies that hands should be washed.
02.Explains procedure to the resident.
03.Pulls curtain; provides for resident's privacy.
04.Positions resident supine and in good body alignment.
05.Correctly supports the resident’s joint by placing one hand under their elbow and the other hand under the resident’s wrist.
06.Raises resident’s arm up and over the resident’s head. (flexion) Check for pain each time.
07.Brings the resident’s arm back down to the resident’s side. (extension) Check for pain each time.
08.Completes full range of motion for shoulder through flexion and extension three times.
09.Continue supporting joints correctly and move the resident’s entire arm out away from the body. (abduction)
10.Return the resident’s arm to the side of the resident’s body. (adduction)
11.Completes full range of motion for shoulder through abduction and adduction three times.
12.*Does not cause discomfort or pain and does not force any joint beyond the point of free movement. Candidate must ask if they are causing any pain or discomfort.
13.Maintains respectful, courteous interpersonal interactions at all times.
14.Leaves call light or signaling device within easy reach of the resident.
15.Identifies that hands should be washed.
return
Need Gait belt
Remember to get resident's robe and slippers.
01.Identifies that hands should be washed.
02.Explains the procedure to be performed to the resident and obtains a gait belt.
03.Positions wheelchair at the foot or head of bed.
04.*Locks wheelchair brakes to ensure residents safety.
05.*Locks bed brakes to ensure residents safety.
06.Lowers bed to lowest position so resident’s feet will be flat on floor and assist resident to a sitting (dangling) position.
07.Assist resident to put on robe and non-skid slippers.
08.Places gait belt around waist to stabilize trunk.
09.Tightens gait belt. Checks gait belt for tightness by slipping fingers between gait belt and resident.
10.While facing resident grasps gait belt with both hands and brings resident to standing position, using proper body mechanics.
11.With both hands grasping gait belt, transfers resident from bed to wheelchair.
12.Assist resident to pivots and assists them to sit in the wheelchair, in a controlled manner that ensures resident’s safety.
13.Maintains respectful, courteous interpersonal interactions at all times.
14.Leaves call light or signaling device within easy reach of the resident.
15.Identifies that hands should be washed.
return
Need Gait belt
01.Identifies that hands should be washed.
02.Explains the procedure to be performed to the resident and obtains a gait belt.
03.Positions wheelchair at the foot or head of the bed.
04.*Locks wheelchair brakes to ensure resident’s safety.
05.*Locks bed brakes to ensure resident’s safety.
06.Lowers bed to a position so the resident’s feet will be flat on the floor when the resident is transferred to the bed.
07.Places gait belt around waist to stabilize trunk. Tightens gait belt. Checks gait belt for tightness by slipping fingers between gait belt and resident.
08.While facing resident grasps gait belt with both hands and brings resident to standing position, using proper body mechanics.
09.Assists resident to pivot in a controlled manner that ensures safety and sits the resident on the bed. Raise resident's robe. Resident's bottom should be about where upper bed breaks.
10.Assists resident in removing non-skid slippers, robe and gait belt.
11.Assists resident to move to center of bed and lie down, supporting extremities as necessary.
12.Makes sure resident is comfortable (offers blanket etc.) and is in good body alignment.
13.Maintains respectful, courteous interpersonal interactions at all times.
14.Leaves call light or signaling device within easy reach of the resident.
15.Identifies that hands should be washed.
return
Needs proper size restraint
01.Identifies that hands should be washed.
02.Provides for privacy - pulls privacy curtain.
03.*Obtains proper size restraint.
04.Must verbalize checking straps for tears or frays. (6/2009)
05.Explains procedure to resident.
06.Applies restraint crossed in front.
07.*Secures restraint to moveable part of bed frame on both sides at waist level so the device will not tighten or loosen when any section of the bed is raised or lowered.
08.*Uses a secure knot that maintains proper tightness and can be released with ONE pull.
09.Checks tightness of restraint by placing fingers between restraint and resident.
10.Leaves both side rails up.
11.Maintains respectful, courteous interpersonal interactions at all times.
12.Leaves call light or signal calling device within easy reach of the resident.
13.Identifies that hands should be washed.
return
Need thermometer, clock with secound hand, recording sheet, pen
01.Identifies that hands should be washed.
02.Explains procedure to resident.
03.Provides for resident's privacy pulls curtain.
04.Correctly turns on digital oral thermometer.
05.Gently inserts bulb end of thermometer in mouth under tongue.
06.Holds thermometer in place for appropriate length of time.
07.Removes thermometer and Candidate reads and records the temperature reading on signed recording sheet. (Completing one task at a time and recording in-between temperature, pulse and respirations)
08.*Candidate's recorded temperature varies no more than .1 degree from Test Evaluator’s.
09.Candidate wipes thermometer clean with alcohol pad or discards sheath.
10.Locates the radial pulse by placing tips of fingers on thumb side of the resident’s wrist.
11.Counts pulse for 60 seconds, or 30x2. Then records on signed recording sheet.
12.*Candidate's recorded pulse rate is within 4 beats of Test Evaluator’s recorded rate.
13.Candidate counts respirations for 60 sec or 30X2 and records results on signed recording sheet.
14.*The Candidate's recorded respiratory rate is within 2 breaths of the Test Evaluator’s recorded rate.
15.Maintains respectful, courteous interpersonal interactions at all times.
16.Leaves call light or signaling device within easy reach of the resident.
17.Identifies that hands should be washed.
return
Need Pen, scale
01.Identifies that hands should be washed.
02.Explains procedure to resident.
03.Checks balance of scale before weighing resident and balances or zeros if necessary. A digital scale is not allowed.
04.*Insures resident's safety. Locks wheelchair brakes.
05.Assists resident to stand and walks them to the scale.
06.Assists resident to step on scale.
07.Checks that resident is balanced and centered on scale with arms at side and not holding on to anything that would alter reading of the weight.
08.Appropriately adjusts weights until scale is in balance or observes analog scale.
09.Reads weight.
10.Returns resident to wheelchair and assists to sitting position.
11.Records weight on signed recording sheet provided.
12.*Candidate's recorded weight varies no more than 2 lb. from Test Evaluator’s reading.
13.Maintains respectful, courteous interpersonal interactions at all times.
14.Leaves call light or signaling device within easy reach of the resident.
15.Identifies that hands should be washed.
return
abandonment
abdominal thrust
abduction pillow
abuse - Purposely causing physical, mental, or emotional pain or injury to someone
acceptance
accidents
activities
adaptive devices
adduction - Moving a body part toward the body
ADL - Activities of Daily Living - Bathing, dressing, caring for teeth and hair, toileting, eating and drinking, moving from place to place
admission
admitting resident
affected side - The side of the body affected by paralysis The weaker side
aging process
alternating pressure mattress
Alzheimer's
ambulation - Walking or mobility
amputees
anger
antiembolic stockings
anxiety
aphasia - Partial or total loss of the ability to articulate ideas or comprehend spoken or written language, resulting from brain damage due to injury or disease
apical - Forming a highpoint An "apical" pulse is taken directly from the heart through the chest with a stethoscope.
appropriate response
arteries
arthritis - Inflammation or swelling of the joints Common form in elderly is Osteo Rhumatoid occurs in all ages
aseptic - Free from the living germs of disease, fermentation, or putrefaction
aspiration - The act of breathing. The act of inhaling fluid or a foreign body into the bronchi and lungs, often after vomiting. The act of removing a fluid, as pus or serum, from a cavity of the body, by a hollow needle or trocar connected with a suction syringe.
assistive device
atrophy - The wasting away, decreasing is size, and weakening of muscles
attitudes
axillary temperature - Temperature taken from deep within the armpit
back strain
bacteria - Ubiquitous (existing or being everywhere) one-celled organisms, spherical, spiral, or rod-shaped and appearing singly or in chains, comprising the Schizomycota, a phylum of the kingdom Monera (in some classification systems the plant class Schizomycetes), various species of which are involved in fermentation, putrefaction, infectious diseases, or nitrogen fixation.
bargaining
basic needs
basic skin care
bathing
bathing resident
bed cradle
bed height
bed position
bed rest
bedpan
behavioral care plan
biohazard
bladder training
blindness
blood pressure - Normal blood pressure is under 120/80 - 117/78.
blood pressure reading
bodily fluids
body alignment
body fluids
body language
body mechanics
body temperature
bone loss
bowel program
bradycardia - Pulse below 60
break time
breathing - Breaths per minute or respiration is the process of breathing air into the lungs, inspiration, and exhaling air out of the lungs, expiration. Normal adult respiration is 12 - 20.
burnout
burns
call light
cancer - Abnormally growing cells
cane
cardiac arrest
cardiovascular system - The circulatory system consisting of the heart, blood vessels, and blood
care impaired
care plan - Resident care problems and strengths to be addressed by the healthcare team and approaches to aid the resident are identified in care plan. Care plans are communicated to all three shifts and to all involved in resident care to ensure consistancy.
cast
cataracts
catheter care
cc's in an ounce - 30 cc's or ml's = 1 oz. An 8 ounce glass contains 240 cc's.
central nervous system
cerebral vascular accident - See CVA.
charge nurse
chest pain
choking
chronic - Chronic care is long lasting even for life.
circulation
clarification
cleaning up of spills
clear liquid diet
clergy
cold compress
combative resident
comfort care
communicable
communication
compensation
competency evaluation program
confidentiality
confused resident
congestive heart failure - CHF is characterized by the backing up of the blood into the heart instead of circulating
constipation
constrict
contact isolation
contaminated hands
contamination
contracture
converting measures
COPD - Chronic Obstructive Pulmonary Disease is a serious lung disease which makes it hard to breathe. Also known as emphysema or chronic bronchitis, COPD is now the 4th leading cause of death in the United States and also causes long-term disability.
coping mechanisms
cueing
CVA - Cerebral Vascular Accident is a sudden interruption in the blood supply of the brain. Most strokes are ischemic or caused by a blockage. A hemorrhagic stroke is caused by bleeding.
CVA resident
cyanotic - Has blue coloration of the skin and mucous membranes due to the presence of excess deoxygenated hemoglobin in blood vessels near the skin surface. The resident is not getting enough oxygen.
death and dying
decubitus ulcer - Pressure or Bed sores are caused by staying in one position for too long. Stage 1 - Persistant redness, Stage 2 - Ulceration, Stage 3 - Cratering, Stage 4 - Deeper muscle, tendons, bones, or blood damage
dehiscence - Wound separation
dehydration - Lacking sufficient water
demanding resident
dementia
denial
dentures
dependability
depression
developmental process
diabetes - The body either does not produce enough, or does not properly respond to, insulin, a hormone produced in the pancreas. Insulin enables cells to absorb glucose in order to turn it into energy. In diabetes, the body either fails to properly respond to its own insulin, does not make enough insulin, or both. This causes glucose to accumulate in the blood, often leading to various complications.
diabetic
dialysis - The process of removing uric acid and urea from circulating blood by means of a external separator replacing failing kidney function.
diastolic - Blood pressure when heart is at rest
diet
dietitian
digestion
discharging resident
disinfection - Process of destroying as many disease producing micro organisms as possible. It may destroy most or slow the growth.
disoriented
disoriented resident
disposing of contaminated materials
dizziness
DNR - Do Not Resuscitate - An advanced directive used in hospitals and other healthcare facilities to indicate to the staff the decision of a patient's doctors and family, or of the patient by a living will, to avoid extraordinary means of prolonging life.
documentation - If it is not written down it did not happen
dressing
droplets
drowsy
dry skin
dying
dysphagia - Difficulty in swallowing
dyspnea - Difficulty in breathing, often associated with lung or heart disease and resulting in shortness of breath
dysuria - Painful or difficult urination
edema - Swelling caused by excess fluid in body tissues
elastic stockings
elevate head
elimination
emergency procedures
emesis basin
emotional needs
emotional support
empathy - Entering into the feelings of others - Feeling their pain
emphysema
ethics
extremity
eye glasses
facility policy
falls
fatigue
faulty equipment
fecal impaction
feeding
fingernail care
fire
fire safety
flatus
flexed
fluid intake
Foley catheter
foot board
foot care
foot drop
Fowler's position - Sitting position
fracture pan
fractures
fraud
free from disease
frequent urination
gait belt
gastrostomy tube
geriatrics
germ transmission
gerontology
gestures
gloves
grieving process
group settings
hair care
hallucination
hand tremors
hand washing
health-care team
hearing aid
hearing impaired
hearing loss
heart
heart muscle
height
Heimlich maneuver - Abdominal thrusts to clear airway
hemiplegia - Weakness, loss of movement or paralysis of one side of body as from a stroke
hospice care
hydration
hypertension
ice bag
ileostomy
immobility
immune system - Protects the body from disease and infection.
impairment
incontinence
indwelling catheter
infection
infection control
initial observations
input and output
in-service programs
insulin
intake and output
integumentary system - Skin
interpersonal skills
isolation
jaundice
job description
job responsibilities
laxatives
life support
lift/draw sheet
linen
liquid diet
listening
low sodium diet
making occupied bed
mask
Maslow
measuring height
measuring temperature
mechanical soft diet
medical asepsis
medical record
medications
memory loss
mentally impaired
microorganisms - Organisms seen under a microscope. Exist all through the environment. Include pathogens.
minerals
mistakes
mistreatment
mobility
money
morning care
mouth care
moving
Multiple Sclerosis
muscle spasms
musculoskeletal system
NA role
nail care
nasal cannula
neglect - Harming the person in your care physically, mentally, or emotionally by failing to give needed care.
non-contagious disease
nonverbal communication
NPO
nursing assistant's role
nutrition
objective
occupied bed
official records
ombudsman - Legal advocate for residents
oral care
oral hygiene
oral temperature
orientation
oriented
osteoporosis
overbed table
oxygen
pain
paralysis
paranoia
Parkinson's
partial assistance
partial bath
passive
pathogens - Organisms that produce disease
patience
perineal care
personal belongings
personal care
personal hygiene
personal items
personal protective equipment
personal stress
phone etiquette
physical needs
physical therapist
physician's authority
plaque
policy book
positioning resident
positive attitude
post mortem care
postural supports
pressure ulcers
preventing falls
preventing injury
privacy
progressive
projection
prostate gland
prosthesis
protective equipment - PPE - Personal Protective Equipment - Goggles, mask, gowns, gloves
providing privacy
psychological needs
pulse - Heart beats per minute Should be regular and equal strength Normal adult pulse ranges from 60 - 100.
quadriplegia
radial
radial pulse
ramps
range of motion
rationalization
rectal
reddened/discolored area
rehabilitation
religious service
reminiscing
reporting
reposition resident
resident abuse
resident belongings
resident identification
resident independence
resident rights
resident unit
residents
resident's bill of rights
resident's chart
resident's environment
respectful treatment
respirations
respiratory symptoms
respiratory system
responding to resident behavior
restorative care
restraints
resuscitation
right to equal care
rights
saliva
scabies
scale
secretions
security
seizure
self-esteem
sensory system
sexual activity
sexual expression
sexual harassment
sexual needs
sharps container
shaving
shearing of skin
simple fracture
skin integrity
slander
smoking
social needs
soiled linen
specimen
spilled food
spills
spiritual needs
stages of grief
standard precautions
state survey
stereotypes
sterilization - Process of killing all pathogens.
stethoscope
stomach
stress
stroke - See CVA.
subjective
suicide
sundowning
supine
supplemental feedings
suspected abuse
swelling
systolic - Blood pressure when heart is at work
tachycardia - Pulse above 100
tachypea - Respiration above 20
TED hose
telephone etiquette
temperature -
Balance between heat created and heat lost Report any reading over 100
Normal adult temperature:
097.5 - 099.5 - Oral
098.5 - 100.5 - Rectal most accurate
096.6 - 098.6 - Axillary (Armpit)
096.4 - 100.0 - Tympanic (Ear) least accurate
tendons
terminal illness
threatening resident
tips
toenails
toileting schedule
transfers
treating residents with respect
tub bath
tube feeding
tubing
twice daily - bid
tympanic temperatures - Taken in the ear and the least accurate
unaffected - Parts of the body not weakened and to be dressed last and undressed first
unconscious
unethical behavior
uniform
unopened mail
unsteady
urethral
urinary catheter bag
urinary problems
urinary system
urine
urine specimen
vaginal drainage
vision change
vital signs
vitamins
vomitus
walker
wandering resident
water faucets
water intake
weakness
weighing
weight
wheelchair safety
white blood cells
withdrawal
The Ohio Department of Health requires a State Tested Nurse Aide (STNA)
complete a Training and Competency Evaluation Program before taking the Ohio State Tested Nurse Aide Exam.
This involves 59 hours of classroom training and testing, and 16 hours of clinical training.
A STNA is responsible for providing competent basic nursing care within a limited scope of practice -
only performing client care allowed by an STNA and
for which adequate training has been received from a licensed nurse or licensed physician.
An STNA is generally not allowed to give medications, insert or remove tubes,
change sterile dressings, give feeding tubes, or start or remove oxygen administration.
STNA's should have a job description from their employer
to fully understand their nursing care responsibilities.
The job description should not conflict with the Ohio State Department of Health's
guidelines for a STNA.
A STNA is to be employed under the supervision and delegation of a licensed nurse or
licensed physician.
A STNA must perform at least 8 hours of nursing related services for pay
under the supervision of a licensed nurse or licensed physician
during each 24 month certification period in order to qualify for re-certification.
Such employment is to be reported on a annual basis to the Ohio Department of Health on Form HEA 7713
which includes the name of either the licensed physician or licensed nurse supervisor.
A STNA may contact the Ohio Department of Health with questions and concerns.