CNA Final Exam
Quick Review
Vital Signs
Pulse: 60 to 100 bpm (beats per minute)
Respirations: 14 to 20 breaths/min
Blood Pressure: 90-140/60-90 (average normal is 120/80)
Oxygen Saturation (O2sat): >95%
Temperature: (ranges from one degree below normal to one degree above normal)
r - Rectal: 99.6
o - Oral: 98.6
t - Temporal (forehead): 97.6
ty - Tympanic (ear- most accurate): 97.6
ax - Axillary (armpit): 97.6
Wait 15 minutes before checking vital signs after:
Exercise or exertion
Bathing
Eating or drinking
WNL: Within Normal Limits
HTN: HyperTensioN - High blood pressure (NOT HBP)
Chronic Illnesses
Review Unit 15! These are very important to understand.
COPD: Chronic Obstructive Pulmonary Disease - Lung disease most often caused by long term smoking
CHF: Congestive Heart Failure - causes swollen legs/feet and fluid in the lungs so they have breathing problems too
MI: Miocardial Infarction - Heart attack - caused by clot in a coronary artery
CVA: Cerebral Vascular Accident - Stroke - caused by either a clot in the brain or a brain bleed
Parkinson’s: Brain loses communication with muscles leading to shuffled gait, tremors, and "mask-like" face
Osteoporosis: “porous bones” - Caused by lack of weight bearing so the body steals the calcium if you’re not using them. Makes bones very fragile and easily broken.
Osteoarthritis: Inflammation in the joints. Caused by normal wear and tear. Pain management and ROM help to relieve discomfort and keep them moving.
Contractures: Stiffened joints. Caused from not fully extending their joints very often so the muscle shrinks and will no longer extend. This can be avoided with regular ROM exercises.
Dementia: Brain failure. The brain slowly deteriorates from the frontal lobe (personality/judgement) and works its way back (to basic functions), often deteriorating the left hemisphere of the brain more than the right. Right=Rhythm. Left=Language. Causes short term memory loss, lack of good judgement, inability to control emotions, and inability to learn or retain. As it is progressive, the patient will slowly regress to infancy and eventually, death.
Diabetes
Review the instructor video in Unit 10 regarding diabetes. It is important to understand diabetes since many of your residents suffer from it.
Hyperglycemia: High blood sugar - Not enough insulin to move glucose (blood sugar) out of the bloodstream and into the cells. Too much glucose will wreck tiny blood vessels in the eyes and kidneys and will clog capillaries where there is poor circulation (feet) leading to blindness, renal failure/dialysis, and amputations of the lower extremities. In addition, they are highly prone to infections and slow healing times.
Hypoglycemia: Too much insulin - Not enough glucose to feed the brain. The brain needs glucose almost as much as it does oxygen. If they are not given sugar quickly enough they will slip into a coma and die within hours! CNA’s are usually the first staff to see residents who might be in a hypoglycemic state so YOU MUST KNOW THE SIGNS to know what to do. They will be pale, sweaty, confused, and uncoordinated. They may even be unconscious.
“Cold and Clammy gettem’ candy! Hot and dry- Sugar High.”
Body Mechanics
Feet should be shoulder-width apart
Keep back straight
Bend your knees and lift with the big muscles in your thighs
NEVER twist
Always raise the bed to waist height when helping with bed mobility or changing sheets so you aren’t bent over
Intake & Output - I & O
1ml=1cc 1oz=30 ml 1cup=240ml
A resident drinks 10oz of juice, a cup of coffee, and 360ml of his room water. What is his intake?
Steps in figuring I & O:
Convert oz to ml by multiplying the ounces times 30 10 oz x 30= 300 ml juice
Convert cups to mls by multiplying cups times 240 1 cup x 240= 240 ml coffee
Once all figures have been converted to mls add them all together + 360 ml room water
900 ml total intake
Other Major Concepts to Understand
Handwashing is the number one way to prevent the spread of infection
Always promote independence- it is better to have them participate than to do it for them
Resident’s rights are paramount! Always consider how you would feel in that situation. They have the same rights as you do and can make their own decisions.
You are not expected to know what to do in every situation but you are expected to know when something is wrong and know when to report it to the nurse (which is most situations that are outside of the norm).
That being said, there are always times that you should act first before reporting it to the nurse, such as in an emergency where the resident is in danger: during a seizure, a major fall, a fire, or if the resident is in an abusive situation. These situations require that you rescue before reporting.
Test Taking Strategies for the Class Final Exam
You can mark the question if you aren't sure about it. If you want to look it up but afraid you won't have time, ANSWER the question so it isn't accidently left blank, FLAG it by clicking the flag next to it, and when you are done, if you have time you can go back and look it up.
Read through ALL of your options- there are A LOT of "All of the above" type questions
Read each question carefully- watching for words like "EXCEPT"
Have your VS norms, your terminology/abbreviations, I&O conversions nearby and easy to find quickly