Mosby's Textbook for Long-Term Care Assistants

* Basic Principles * Roles and responsibilities (RN, LPN, NA), information about when an action can be performed and when it cannot * Nursing process (5 steps of Nursing Process, including nursing diagnosis and written plan of care) * Delegation, including 5 rights of delegation and content on what a "task" is * Patient and 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 and fracture bedpans * Providing catheter care, also demonstrating application of condom catheter * Administering a cleansing enema * Measurements * Height and weight * Intake and output, how to measure oral fluids * Vital signs * Temperature: oral, axillary, and rectal, using mercury-in-glass and 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 and towels for privacy * Back massage, including descriptions of techniques but not names * Perineal care for the female and for the male including gloving, draping, washing from "clean to dirty" * Bedmaking * Making the occupied bed, including making a mitered corner and 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 and shaving the male patient's facial hair * Nail and foot care, including shaping toenails * Dressing, changing into pullover shirt and shorts; measuring for and application of TED hose * Body Mechanics and Exercise * Principles of body mechanics and how to use * Moving a person up in bed (with lift/draw sheet) * Turning and positioning (to side-lying position) * Dangling * Transfer from bed to wheelchair, using transfer belt * Passive range-of-motion exercises * Ambulation, using gait belt, and heel/toe gait * Orthostatic hypotension definition, signs/ symptoms, and precautions * Safety and Restraints * Preventing falls * Using restraint alternatives, including proper use of side rails, bed and wheelchair locks * Safe use of restraints, what can be delegated to assistive personnel, application of vest restraint, extremity restraint, and finger-control mitten * Monitoring restraint use * Nutrition and Fluids * Preparing for meals, including creating a pleasant environment, attending to person's 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 and difficulty swallowing, "pocketing" of food, help with washing hands and face, alternating liquids with solids * Preventing and Treating Pressure Ulcers * Assessing risk, causes, risks and 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)