HPH NAT Certification 23 - Final Review Study

Types of Vital Signs & Normal Ranges

Temperature: 98.6 F (37 C)

Pulse: 60-100 beats per min

Respirations: 12-20 breaths per min

Blood Pressure: systolic 120 < & diastolic 80 <

O2 sat: 95-100%

What is Intake & Output (I&O)?

Give examples of both.

The measurement of fluid that enters the patient and leaves the patient.

Intake: Water, juice, ice, jello, (anything that melts @ room temp)

Output: urine, vomit, blood, diarrhea, wound drainage

oz → cc’s conversion. How to calculate. Vice versa.

30 ml = 1 oz

1 oz = 30 cc

oz(30) = cc

cc/30 = oz

Patient Positioning

Supine = flat face up

Prone = flat face down

Lateral = side laying

Fowlers = HOB 45-60*

Low-Fowlers = HOB 15-30 *

Semi-Fowlers = HOB 30-45*

High-Fowlers = HOB 90*

Trendelenburg = HOB pointed down, feet of bed facing up

Bed position & care for patients with tube feeding

Position: High Fowlers (45-90)

How to give hand & foot care.

• Put on gloves

• Fill basin w/ warm water, test temp.

• Hands: soak for at least 5 min, wash one hand at a time with soapy washcloth, then rinse.

• clean under nails with orangewood stick, and smooth nail edges using emery board.

• Foot: place absorbent pad and basin on the floor and let foot soak for 10 min. Clean foot and inbetween toes with soapy washcloth for each foot then rinse.

How to empty a drainage bag & perform foley care.

Empty drainage bag: Put on gloves, measure urine in drainage bag, place an absorbent pad and graduate on a flat surface, un-clamp tubing of the drainage bag and aim into the graduate, unlock tube and let all contents flow into graduate, once empty relock the tubing and clean drainage spout then carefully placing the clamp back into place making sure not to cross contaminate it.

Foley care: Put on gloves, preform perineal care, hold foley close of meatus and wipe away 4-6in until biofilm is gone.

How to assist patient ambulating with cane & walker.

Cane: cane is on patient stronger side then patient leads with weaker leg. (NA stands on pt weaker side)

walker: patient pushes walker and steps into walker (NA stands behind pt)

How long does it take for pressure sores to occur?

S/S of pressure sores.

How to treat pressure sores/prevent pressure sores.

1-2 hours

s/s: pain, itchiness, discoloration of skin (red, purple/blue)

tx: regular repositioning, dressings to heal ulcer, special mattresses.

S/S of abuse. What to do when observing s/s of abuse?

S/S: fear or afraid to be alone, poor self control, withdrawl or apathy, threaten others, alcohol or drug abuse, agitation or anxiety.

Report to the RN

Pros & Cons of using a heating pad.

Pros: pain relief, relieve/ reduce swelling

Cons: only for specific times, if used unproperly it can damage body tissues.

What is anti-embolic or the purpose of using stockings, to prevent what?

What are universal standard precautions?

precautions set to prevent the transmission of pathogens through exposure. (ex: hand hygiene, PPE (gloves, gown, mask, eyewear, face shield)

How to perform hand hygiene?

• wet hands & apply soap

• rub hands together for 20 seconds (wrist, palm, nails, fingers, etc)

• keep hands lower than elbows & fingertips

• use paper towel to properly dry

*dont touch sick or anything during, before, or after washing hands

What are the different areas of ROM (6)?

Shoulder, elbow, wrist, hip, knee, ankle

What are contractions & muscle atrophy?

What steps can the NA do to prevent this?

How to empty an ostomy bag.

• apply gloves

• place bed protector under pt

• expose ostomy site and remove bag & discard properly

• use gauze to absorb leakage

• wipe area of stoma with wipes

• using washcloth & warm water wash the area in one direction away from stoma

• Rinse & pat dry with a towel

What are two kinds of pans?

How do you position the bed pans for the patient to use?

Fracture pan and Bed pan

Under their butt, flat side on their back, bed position with the head lowered when placing the bed pan. Then high fowlers when the bed pan is being used.

How to communicate with hearing impaired or psych patients?

• get pts attention

• you & pt are face to face

• hearing aid is on pt

• reduce/remove background noises

When do you give patients thickened liquids?

Why are liquids thickened for patients?

Thickened liquids are given to pts who have difficulty swallowing.

They are given to help prevent aspiration.

What does it mean to aspirate?

How to prevent aspirations?

aspirate: food, liquid, or other material goes into the airway or lungs.

Prevention: eat slowly, avoid distractions, high fowlers, bite sized pieces.

What is ADL’s?

What do ADL’s consist of?

Activities of daily living

What are transmission based precautions?

What does it consist of?

If a patient c/o Chest Pain, what might that entail?

myocardio infarcation (heart attack)

Military time format.

How to communicate with patients who are non-verbal.

make eye-contact, make sure pt sees you, speak loudly/ clearly, body language/gestures.

How to give patients oxygen?

When giving CPR 30:2

But if not in face of an emergency, the NA shall NOT administer oxygen.

What is the purpose of filing a incident report?

When to use a transfer belt?

How to apply a transfer belt?

What is syncope?

loss of consciousness for a short period of time

What is dyspnea?

difficulty breathing

How to stop a bleed - Bleeding control.

apply pressure

What is patient confidentiality?

Define HIPAA & date of establishment.

Purpose of HIPAA?

Patient records and personal information is kept confidential to patient and care team only.

HIPAA: Health Insurance Portability & Accountability Act of 1996.

What is TB - Tuberculosis?

airborne & develops when a person with a weakened immune system is exposed.

s/s: fatigue, loss of appetite, nausea

How to care for patients with AIDS, what kind of disease is AIDS?

Difference between: Adult day service, hospitals, SNF -- LTC.

Patients limits - can and cannot do.

How to respond to aggressive/combative patient?

How to respond to comatose patients?

How to respond to a patient who is disoriented?

How to transport patient into car seat, car, & crib.

How do babies receive nutrients while in the womb?

Through the umbilical cord. Connection between baby and mother, the placenta.

Difference between prenatal & postpartum.

Why do women recieve episiotomies? - How to care for an episiotomy?

Prenatal: Before babies birth; pregnancy.

Postpartum: After baby is born; after birth.

Episiotomy: Surgical incision made under the vagina to prevent tear/rip in vagina from childbirth. Aides in birth.

Care for episiotomy: ice to reduce swelling at the vagina after delivery. Given sits bath to keep vaginal area clean, ease pain, & heal incision.

What are the different colors of discharge & stages?

Lochia: vaginal discharge after childbirth.

Lochia rubra: 1st stage, dark red in color ~4 days long.

Lochia Serosa: 2nd stage, pinkish color ~10 days long (Mostly WBC).

Lochia Alba: 3rd stage, whitish yellow color ~10 days ~14 days.

What is meconium?

Newborns first poop/stool.

Dark, thick, sticky stool.

Babies first poop within few hours after birth.

What is the purpose of the umbilical cord?

Connection between mother and baby during pregnancy.

Contains 3 arteries:

1: Carries food and oxygen from placenta to baby

2 & 3: Carries babies waste to placenta

Different age behaviors.

Infants/ Newborns: seperation anxiety due to absence of parent.

Toddlers: fear of strangers.

Preschoolers: body mutilation, fear of dark, being left alone.

School Age: fear of disability, death, injury, and pain.

Adolescents: fear of injury, pain, disability, seperation.

Caring for patients with different cultural beliefs.

What are six times to wash your hands: intervention

Before & after eating food/serving food, contact with bodily fluids: vomit, saliva/mucus, urine, stool, touching wound, contact with patient.

Different body mechanics & lifting patients.

When do you use and not use transfer belt.

Five incidents to report to nurse.

Four instances when to wear gloves.

Entering and accessing patient, contact with blood, contact with urine, giving a bath.

A.M. & H.S. Care

A.M. Care: assist w/ elimination, wash face and hands, assist w/ mouth care, assist w/ haircare, dressing, and shaving.

H.S. Care: assist w/ elimination, wash face and hands, assist w/ mouth care, back rub.

What is the APGAR score?

Test performed 1-5 mins after babies birth. Determine how baby is responding out of the womb.

Categories scored on a scale 0-2:

Breathing, heart rate, muscle tone, reflexes, & skin color.

Temperature Conversions:

F → C

C → F

F → C: 5/9 (F - 32)

C → F: 9/5 (C) + 32