Mosby's Nursing Assistant Skills

Basic Principles Roles and responsibilities (RN, LPN, NA), information about when an action can be performed & when it cannot Nursing process (5 steps of Nursing Process, including nursing diagnosis & written plan of care) Delegation, including 5 rights of delegation and content on what a "task" is Patient & resident rights brief examples of how to promote rights in daily care activities Communication (oral, written, non-verbal; reporting, charting, end-of-shift report, guidelines for how to communicate effectively) Medical asepsis (chain of infection, handwashing, examples of medical asepsis applied in daily care) Normal Elimination Assisting with a urinal Assisting with a bedpan, including standard & fracture bedpans Providing catheter care, also demonstrating application of condom catheter Administering a cleansing enema Measurements Height and weight Intake & output, how to measure oral fluids Vital signs Temperature: oral, axillary, & rectal, using mercury-in-glass & electronic thermometers Pulse: radial and apical; rate, rhythm and quality; how to locate apical pulse and point of maximal/maximum impulse Respiration: rate, rhythm, effort Blood pressure: one-step and two-step methods Bathing The complete bed bath, including gloving, how to place bath blanket & towels for privacy Back massage, including descriptions of techniques but not names Perineal care for the female & for the male including gloving, draping, washing from "clean to dirty" Bedmaking Making the occupied bed, including making a mitered corner & toe pleat Personal Hygiene and Grooming Oral hygiene, including oral care for unconscious person, cleaning dentures, precautions for person at risk of aspiration Hair care, including shampoo in bed & shaving the male patients facial hair Nail & foot care, including shaping toenails Dressing, changing into pullover shirt & shorts; measuring for & application of TED hose Body Mechanics and Exercise Principles of body mechanics & how to use Moving a person up in bed (with lift/draw sheet) Turning & positioning (to side-lying position) Dangling Transfer from bed to wheelchair, using transfer belt Passive range-of-motion exercises Ambulation, using gait belt, & heel/toe gait Orthostatic hypotension definition, signs/ symptoms, & precautions Safety and Restraints Preventing falls Using restraint alternatives, including proper use of side rails, bed & wheelchair locks Safe use of restraints, what can be delegated to assistive personnel, application of vest restraint, extremity restraint, & finger-control mitten Monitoring restraint use Nutrition and Fluids Preparing for meals, including creating a pleasant environment, attending to persons needs for elimination, hygiene, pain relief, socialization, meal plan; checking meal card against ID Serving meal trays, including use of "clock" technique for visually impaired person to help identify location of individual food items Feeding the dependent person, including positioning observations for person with dysphagia, signs of aspiration & difficulty swallowing, "pocketing" of food, help with washing hands and face, alternating liquids with solids Preventing and Treating Pressure Ulcers Assessing risk, causes, risks & signs of pressure ulcers Measures to prevent pressure ulcers, including skin inspection, skin care, positioning into 30-degree lateral position, position changes, pressure-relief devices, including air flotation mattress, elbow protector, foam foot stabilizer the "heel boot" Measures to treat pressure ulcers (covered briefly)