Resident Care Procedures
Terminology
Admission
Anti-embolic stockings
Bandage
Binders
Clean catch
Closed bed
Defecate
Discharge
Terminology #2
Drawsheet
Edematous
Elastic bandage
Electric bed
Evacuation
Excoriated
Expectorate
Fan fold
Terminology #3
Fluid
Gastrostomy
Gatch
Hives
Intake
Integumentary system
Intravenous
Lesions
Terminology #4
Manual bed
Mitered corner
Mucus
Nasogastric
Non-prescription
Occupied bed
Ointment
Open Bed
Terminology #5
Output
Pruritus
Reverse Trendlenberg
Scaling
Semi-Fowler’s position
Side rails
Specimen
Terminology #6
Suppository
T.E.D. hose
Transfer
Trendlenberg
Unoccupied bed
Collecting sputum specimens
Reason for study sputum
Blood
Microorganisms
Abnormal cells
Collecting sputum specimens –
Role of NA
Usually coughed up in early AM
Allow resident to rinse mouth with
water
Do not use mouthwash
May be embarrassing to the resident
Specimen may be perceived as
unpleasant
Collecting urine specimens –
Methods of collection
Mid-stream
Clean catheter urine specimen
24-hour urine specimen
Fresh-fractional urine (second void)
Collecting urine specimens –
Role of NA
Wash hands before and after
Use Standard Precautions
Use correct and clean container
Label the container accurately
Collecting urine specimens –
Role of NA #2
Do not touch inside the container
Ask resident not to have a BM while
specimen is being collected
Take specimen and requisition slip to the
designated lab pick-up station
Document that specimen was obtained
Collecting stool specimens –
Purpose
Blood
Fat
Micro-organisms
Worms
Any abnormal contents
Collecting stool specimens –
Role of NA
Maintain privacy
Use Standard Precautions
Give clear instruction
Label container accurately
Clarify if specimen must be kept
warm or at room temperature
Take specimen and requisition slip to
the designated lab pick-up station
Bed making - Role of NA
Linen must be wrinkle-free
Keep call bell clipped to linen
Keep resident reality-oriented by use
of resident’s personal pillow, afghan,
etc.
Bed making - Role of NA #2
Wash hands before and after
Hold and carry linen away from
uniform
Do not shake linens
Keep linens off the floor or bedside
table
Soiled linen hampers kept covered
Hospital Bed – Functions and
structures
Manually operated beds
Electric beds
Side rails
Bed Positions
High positions
Low positions
Fowler’s position
Semi-Fowler’s position
Bed making – Body Mechanics
Know your limitations
Get close to sides of bed
Keep back straight and knees bent
Keep feet apart
Move feet to turn
Face in the direction you are working
Maintaining Environment –
Role of NA
Rooms should be comfortable
Rooms should be safe
Maintaining Environment –
Role of NA #2
Make sure resident can reach
bedside stand
Arrange personal belongings as per
resident’s preference
Keep call bell within reach
Make sure resident can reach equip.
Provide tissues and toilet paper
Enemas - Purpose
Stimulate a bowel movement
Cleanse bowel prior to surgery
Remove flatus (gas)
Enemas - Types
Cleansing enemas
Oil retention enemas
Commercial mixtures (i.e. Fleet’s)
Enemas – Role of NA
Temperature of solution
Amount of solution
Resident position
Height of enema bag
Depth of tube insertion
Enemas – Role of NA #2
Administer solution slowly
Hold enema tube in place
Make sure toilet facility is nearby and
available
Observe the results of the enema
Use Standard Precautions
Rectal Tube
Inserted into rectum to relieve
flatulence and intestinal distention
Equipment:
Tube and flatus bag or folded
waterproof pad
Method: See book
Suppository - Purpose
Stimulate one to empty the bowel
Lubricate the stool to ease
evacuation
Suppository – Role of NA
Identify the resident
Remove wrapper from suppository
Place suppository
Instruct resident to hold the
suppository in the rectum as long as
possible
Observe results
Report results
Gastrointestinal tubes
Nasogastric tubes ( inserted through
nose )
Gastrostomy tubes ( inserted
through abdominal wall )
Gastrointestinal tubes –
Nursing Care
Frequent oral hygiene
Securing tubing with clamp or tape
to clothing
Tubing free of kinks
Checking if suction machine
operating satisfactorily
Position head of bed elevated at all
times to prevent reflux
Gastrointestinal tubes –
Nursing Care #2
Keep environment clean
Answer call lights promptly
Give emotional support
Giving an extra back rub
Straightening or changing bed linen
Asking resident to express concerns
Encourage resident to be up, dress in
day clothes and join in activities
Intravenous (I.V.) Therapy
Provides the body with needed
elements that cannot be given
rapidly or efficiently by other means.
Blood, plasma
Nutritional – water, salt, sugar, etc.
Medications
Intravenous (I.V.) Therapy –
Role of NA
Keep tubing free of kinks
Observe tube and condition of
injection site for any infiltration
Wash gently around the area
Assist resident with ADLs
Assist resident to ambulate
Maintaining fluid body balance
Death can result from taking
inadequate fluids or loosing too much
fluids
Amount of fluid taken in and amount
lost must be equal
Edema
Dehydration
An adult needs 2000 ml of fluids/day
Force fluids
Resident drink an increased amount
of fluids
May order specific amount of fluid for
24-hour period
Maintains fluid balance
May be for general or specific
amount of fluid
Nurse assistant responsibility
Keep record of amount taken in
Provide variety of fluids
Place within resident’s reach
Offer fluids frequently to residents
who cannot feed themselves
Restrict fluids
Sign posted above bed
Water is offered in small amounts
Keep accurate intake and output
record
Provide resident with frequent oral
hygiene
Explain to resident and family the
reason for limiting fluid
Nothing by mouth (NPO)
Reasons-before and after surgery,
before certain lab tests and x-rays,
and in the treatment of some
illnesses
Nurse assistant responsibilities
NPO sign above bed
Remove water pitcher and glass
Offer frequent oral hygiene; no
swallowing of any fluid
“Intake and Output”
The doctor or nurse may want to
keep track of a resident’s fluid intake
and output
To evaluate fluid balance and kidney
function, or medical treatment
Measuring the amount of fluid
taken in by the resident
Measurement of resident’s intake is
done in milliliters (ml) or cubic
centimeters (cc)
Determine the fluid capacity
A conversion table is on the intake
and output record used to chart
intake
A graduated cylinder is used to
measure fluid
Measuring the amount of fluids
excreted by the resident
Measurement of resident’s output is
also done in ml or cc
Plastic urinals and emesis basins
may be calibrated
Use universal precautions when
measuring output
Recording intake and output
Document amounts when fluid is
taken or excreted
Amounts are totaled at end of shift
and entered in the patient’s record
Other special forms may be required
by facility
Report any unusual occurences
Reasons for using bandages and
binders
To apply pressure
To provide for immobilization
To hold dressings in place
To protect open wounds from
contaminants
To apply warmth
To provide support and aid in venous
circulation
Materials used for dressings and
bandages
Gauze
Bandages
Binders
Principles of bandaging
Apply bandage so pressure is evenly
distributed to area
Support joint in a comfortable
position with a slight flexion
Attach bandage securely to avoid
friction of underlying tissue
Observations that should be
reported
Swelling
Pain
Change in color
Decreased temperature
Use and method of applying
antiembolic hose (T.E.D. hose)
Anti-embolic hose/stockings are used
to increase circulation by improving
venous return from the legs to the
heart
Things to remember when applying
elastic stockings
Always apply before resident gets
out of bed
Check frequently for wrinkles
Check circulation in feet frequently
Check popliteal pulse
Integumentary System
Largest organ of the body
Forms water proof, protective
covering for the body
Helps regulate the body temperature
Anatomy of the skin
Epidermis
Dermis
Symptoms associated with skin
disease
Pruritus
Swelling (edema)
Scaling
Lesions
Hives
Applying non-prescription
ointments, lotions, or powders
Provide emotional support to the
resident
Do not apply ointments, lotions, or
powders to irritated skin surfaces or
open lesions
Skin conditions the nurse assistant
can care for
Foot care
Dandruff
Dry skin
Report the existing skin conditions
to a licensed nurse
Acne
Minor burn
Diaper rash or prickly heat
Eczema or psoriasis
Poison ivy or poison oak
Minor wounds
Insect bites or stings
General rules the nurse assistant
should follow
Prepare the resident
Position the resident
Cleanse the skin
Protect the surrounding skin
Applying ointments, lotions, or
powders
Chart and report observations
Admission Of A Resident To The
Facility-Role of NA
First impression of the facility is
important
The new resident may have many
feelings of loss
Welcome the resident
Collect baseline information
Report all questions and concerns
Admission of a resident to the
facility #2-Role of NA
Orient the resident and family to the
facility
Care for personal belongings
Transferring a resident from one
area to another in the facility
Tell resident in advance about the
transfer
Collect all the resident’s belongings
Introduce resident to new
roommates
Discharge of a resident-Role of NA
Collect all personal belongings
Assist the resident to his or her
vehicle