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Texas CNA Skills
Required Nursing Assistant Skills
34
Medical
12th Grade
11/22/2007
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Cards

Term
SKILL 1
Handwashing
 Definition
  1. Turns on water.
  2. Wets hands.
  3. Applies skin cleanser or soap to hands.
  4. RUBS HANDS TOGETHER FOR AT LEAST 10 SECONDS.
  5. WASHES ALL SURFACES OF THE HANDS AT LEAST UP TO THE WRIST.
  6. Rinses hands thoroughly under running water.
  7. Dries hands on clean towel/warm air dryer.
  8. Turns off faucet with towel and/or avoids contact with sink or other dirty surfaces during rinsing and drying of the hands.
  9. Discards wet towel appropriately.
Term
SKILL 2
How to Start Conversation and Send Messages
 Definition
  1. Greets resident by preferred name.
  2. Identifies self to resident.
  3. Focuses on the appropriate topic to be presented.
  4. Faces the resident to speak and avoids talking off into space.
  5. TALKS WITH RESIDENT WHILE GIVING CARE.
  6. LISTENS AND RESPONDS APPROPRIATELY WHEN RESIDENT SPEAKS.
  7. Uses social reinforcers such as praise and smiles.
  8. Encourages resident to interact with nurse aide and others.
  9. USES COURTESY WHEN COMMUNICATING.
  10. Informs resident before leaving room.
Term
SKILL 3
Communicating with Residents Who Have Vision Loss
 Definition
  1. TO AVOID STARTLING THE RESIDENT, KNOCKS ON DOOR BEFORE ENTERING AND IDENTIFIES SELF UPON ENTERING THE ROOM.
  2. Positions self in good light and faces resident when speaking.
  3. Greets resident by preferred name using touch such as pat on the arm or holding hand as appropriate.
  4. TALKS WITH RESIDENT WHILE GIVING CARE, GIVING STEP-BY-STEP EXPLANATION AS APPROPRIATE.
  5. Explains what the resident is to do.
  6. LISTENS ATTENTIVELY AND CLARIFIES RESIDENT'S UNDERSTANDING AS APPROPRIATE.
  7. INFORMS RESIDENT BEFORE LEAVING THE ROOM.
  8. USES COURTESY WHEN COMMUNICATING.
Term
SKILL 4
Communicating with Residents Who Have Hearing Loss
 Definition
  1. Alerts resident to presence by approaching from the front or side.
  2. Positions self in good light and faces resident while speaking.
  3. Greets resident by preferred name.
  4. Identifies self to resident.
  5. TALKS WITH RESIDENT WHILE GIVING CARE.
  6. SPEAKS IN A LOWER PITCHED VOICE AT A NORMAL OR ONLY SLIGHTLY INCREASED LOUDNESS-AVOIDS SHOUTING AS APPROPRIATE.
  7. LISTENS ATTENTIVELY AND CLARIFIES RESIDENTS UNDERSTANDING AS APPROPRIATE.
  8. USES COURTESY WHEN COMMUNICATING.
  9. Informs resident before leaving room.
Term
SKILL 5
Communicating With Residents Who Have Problems With Speech
 Definition
  1. Greets resident by preferred name.
  2. Identifies self to resident.
  3. TALKS WITH RESIDENT WHILE GIVING CARE.
  4. GIVES RESIDENT ADEQUATE TIME TO RESPOND, LISTENING ATTENTIVELY.
  5. Encourages and assists resident with the use of assistive devices for communication, such as picture board and word boards, if necessary.
  6. Clarifies resident's understanding as appropriate.
  7. USES COURTESY WHEN COMMUNICATING.
  8. Informs resident before leaving the room.
Term
SKILL 6
Assisting Residents Who Have Memory Loss, Confusion or Understand Problems
 Definition
  1. Greets resident by preferred name.
  2. Identifies self to resident.
  3. TALKS WITH RESIDENT WHILE GIVING CARE, GIVING SIMPLE STEP-BY-STEP INSTRUCTION AS APPROPRIATE.
  4. PRONOUNCES WORDS CLEARLY AND SLOWLY.
  5. Promotes resident's independence.
  6. LISTENS AND RESPONDS APPROPRIATELY WHEN RESIDENT SPEAKS.
  7. Provides some orientation to resident with mild memory loss as appropriate.
  8. Continues to call resident by name during conversation.
  9. USES COURTESY WHEN COMMUNICATING.
  10. Informs resident before leaving room.
Term
SKILL 7

Assisting Resident Who Is Demanding or Angry
 Definition
  1. Greets resident by preferred name.
  2. Identifies self to resident.
  3. TALKS WITH RESIDENT WHILE GIVING CARE AS APPROPRIATE.
  4. REMAINS CALM.
  5. Encourages resident to talk about concerns as appropriate.
  6. LISTENS ATTENTIVELY AS RESIDENT SPEAKS.
  7. USES COURTESY WHEN COMMUNICATING.
  8. Informs resident before leaving room.
Term

SKILL 8

Moving the Helpless Resident to the Head of the Bed with One Assistant

(Using Draw Sheet or Incontinent Pad)

 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Provides for resident's privacy as appropriate.
  4. INSURES RESIDENT'S SAFETY.
  5. Lowers the head of the bed as flat as possible if tolerated by resident.
  6. Places pillow against headboard before moving resident, to protect resident's head.
  7. Exhibits proper body mechanics.
  8. Gives directions and coordinates moves with assistant.
  9. USING DRAW SHEET OR INCONTINENT PAD MOVES THE RESIDENT TO THE HEAD OF THE BED, PREVENTING TRAUMA AND AVOIDABLE PAIN.
  10. Leaves resident in a position of comfort, replacing pillow under head, if appropriate.
Term
SKILL 9

Assisting Resident to Sit Up On Side of Bed
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Provides for resident's privacy as appropriate.
  4. INSURES RESIDENT'S SAFETY.
  5. Rolls head of bed to upright position.
  6. Exhibits proper body mechanics.
  7. SAFELY SUPPORTS AND TURNS THE RESIDENT, ALLOWING THE LEGS TO GO OVER THE SIDE OF THE BED AS THE TRUNK BECOMES UPRIGHT.
  8. PREVENTS TRAUMA AND AVOIDABLE PAIN TO THE RESIDENT DURING MOVE.
  9. REMAINS WITH RESIDENT WHILE HE/SHE SITS ON SIDE OF BED AS APPROPRIATE.
  10. Leaves resident in a position of comfort.
Term
SKILL 10
Assisting the Resident to Transfer from Chair to Bed or Bed to Chair
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Assembles appropriate equipment before procedure.
  3. Explains procedure to resident and encourages resident to participate as appropriate.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Obtains assistance if needed and exhibits proper body mechanics.
  7. Places chair or wheelchair near the bed if appropriate.
  8. LOCKS WHEELS IF POSSIBLE OR STABILIZES BOTH BED AND WHEELCHAIR.
  9. Assists resident into sitting position and allow resident to rest in sitting position before standing, if indicated.
  10. SAFELY TRANSFERS RESIDENT, SUPPORTING RESIDENT DURING PROCEDURE.
  11. PREVENTS TRAUMA AND AVOIDABLE PAIN TO RESIDENT DURING PROCEDURE.
  12. Leaves resident in a position of comfort.
Term
SKILL 11
Assisting the Resident With Ambulation
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. ASSEMBLES APPROPRIATE EQUIPMENT BEFORE PROCEDURE INCLUDING AMBULATION AIDS SUCH AS CANE, WALKER OR GAIT BELT IF USED BY RESIDENT.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Obtains assistance if needed and exhibits proper body mechanics.
  7. SAFELY ASSISTS RESIDENT TO STANDING POSITION.
  8. Walks slightly behind and to one side of ambulating resident.
  9. SUPPORTS RESIDENT AS NEEDED DURING AMBULATION TO AVOID FALLS AND TRAUMA.
  10. Leaves resident in a position of comfort.
Term
SKILL 12
Making the Unoccupied Bed
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Assembles appropriate equipment and places it in the appropriate place.
  3. Begins with bed in flat position and elevated to appropriate height if possible. Lowers bed when completed.
  4. REMOVES SOILED LINEN AND PLACES IT IN APPROPRIATE PLACE.
  5. Avoids shaking and touching linen to uniform as much as possible.
  6. Applies bottom sheet to clean mattress, keeping it straight and centered.
  7. MAKES ALL CLEAN BOTTOM LINEN TIGHT AND FREE OF WRINKLES (UNLESS WATER BED, EGG CRATE OR AIR MATTRESS.)
  8. APPLIES TOP LINEN.
  9. Applies clean pillowcase to the pillow, keeping zippers and/or tags on the pillow to the inside of the pillowcase.
  10. Leaves bed completely and neatly made according to facility policy.
Term
SKILL 13
Making the Occupied Bed
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure and places it in appropriate place.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Begins with the bed in flat position, if tolerated by resident and elevated appropriate height if possible.
  7. RAISES SIDE RAIL AND ASSISTS RESIDENT TO ROLL ON SIDE FACING SIDE RAIL.
  8. Rolls or fan folds soiled linen, soiled side inside, to the center of the bed.
  9. Places clean bottom sheet along the center of the bed and rolls or fanfolds linen against resident's back and unfolds remaining half.
  10. RAISES THE OPPOSITE SIDE RAIL AND ASSISTS THE RESIDENT TO ROLL OVER THE BOTTOM LINEN, PREVENTING TRAUMA AND AVOIDABLE PAIN TO RESIDENT.
  11. REMOVES SOILED LINEN AND PLACES IN APPROPRIATE PLACE.
  12. Avoids shaking and touching linen to uniform as much as possible.
  13. MAKES ALL CLEAN BOTTOM LINEN TIGHT AND FREE OF WRINKLES (UNLESS WATER BED, EGG CRATE OR AIR MATTRESS.)
  14. APPLIES UNSOILED TOP LINEN.
  15. Applies clean pillowcase with zippers and/or tags to inside, gently lifting resident's head to replace pillow.
  16. Leaves resident in position of comfort in a neatly made bed.
Term
SKILL 14

Tub or Shower Bath with Shampooing the Hair
 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT SAFETY.
  6. Assists resident to undress as needed.
  7. REGULATES TEMPERATURE AND FLOW OF WATER PRIOR TO AND DURING SHOWER OR BATH AND SHAMPOO.
  8. Positions resident to shampoo hair, offering washcloth to protect the eyes.
  9. Directs warm water close to scalp and away from face.
  10. Applies appropriate shampoo, works up lather, and massages into scalp using tips of fingers/not fingernails.
  11. Rinses hair thoroughly and towel dries.
  12. WASHES, RINSES AND DRIES BODY FROM CLEAN TO DIRTY AREAS, LEAVING RESIDENT CLEAN AND DRY.
  13. Reports any deviations from the norm. (Nurse Examiner asks aide for report)
  14. Leaves resident in position of comfort.
Term

SKILL 15

Perineal Care/Incontinent Care—

Female With or Without Catheter

 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. If indwelling catheter present, holds and supports catheter tubing to one side to avoid traction or unnecessary movement during procedure.
  7. If indwelling catheter present, when cleaning urethral area, gently washes, rinses, and dries the catheter tubing from urethra outward for about three inches of tubing.
  8. If indwelling catheter present, keeps drainage bag below level of bladder.
  9. First separates labia and gently washes, rinses, and dries, as appropriate, the urethral area, wiping from front to back and avoiding the rectum.
  10. Then washes, rinses and dries, as appropriate, the remaining perineal area, wiping from front to back and working outward to thighs.
  11. Turns resident on side and appropriately and gently washes, rinses and dries the remaining area including the rectum and buttocks without returning to the urethral area.
  12. APPROPRIATELY AND GENTLY WASHES, RINSES AND DRIES FROM CLEAN TO DIRTY AREA LEAVING ENTIRE AREA CLEAN AND DRY.
  13. Removes soiled linen and places in an appropriate place.
  14. Leaves resident in position of comfort.
Term

SKILL 16

 

Perineal Care/Incontinent Care—

Male With or Without Catheter

 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. If uncircumcised male, retracts foreskin before and replaces foreskin after procedure.
  7. If indwelling catheter present, holds and supports catheter tubing to one side to avoid traction or unnecessary movement during procedure.
  8. If indwelling catheter present, when cleaning urethral area, appropriately and gently washes, rinses and dries the catheter tubing from urethra outward for about 3 inches of tubing.
  9. If indwelling catheter present, keeps drainage bag below level of bladder.
  10. Appropriately and gently washes, rinses and dries the tip of the penis, starting at urethra first and working outward in a circular motion.
  11. Then washes, rinses and dries the entire perineal area including the penis, scrotum and outward to thighs.
  12. Turns resident on side and appropriately and gently washes, rinses and dries the remaining area including the rectum and buttocks without returning to the urethral area.
  13. APPROPRIATELY AND GENTLY WASHES, RINSES, AND DRIES FROM CLEAN TO DIRTY AREA LEAVING ENTIRE AREA CLEAN AND DRY.
  14. Removes soiled linen and places in an appropriate place.
  15. Leaves resident in position of comfort.
Term
SKILL 18
Brushing the Teeth
 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. POSITIONS RESIDENT UPRIGHT OR ON SIDE WITH HEAD TURNED WELL TO ONE SIDE AS APPROPRIATE TO AVOID CHOKING OR ASPIRATION.
  7. Drapes the chest as needed to prevent soiling.
  8. Applies or assists/supervises resident in applying toothpaste to toothbrush.
  9. GENTLY AND THOROUGHLY BRUSHES OR ASSISTS/SUPERVISES RESIDENT IN BRUSHING TEETH, INCLUDING THE INNER, OUTER AND CHEWING SURFACES OF ALL UPPER AND LOWER TEETH.
  10. Cleans tongue if appropriate.
  11. Assists or supervises resident in rinsing mouth.
  12. Leaves resident in position of comfort.
  13. Reports all deviations from the norm. (Nurse Examiner asks nurse aide for report.)
Term
SKILL 19
Denture Care
 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Positions resident upright or on side with head turned well to one side as appropriate to avoid choking or aspiration.
  7. Removes or assists/supervises resident in removing dentures from mouth or storage container.
  8. Handles dentures carefully to avoid damage.
  9. THOROUGHLY BRUSHES DENTURES, INCLUDING THE INNER, OUTER AND CHEWING SURFACES OF UPPER AND LOWER DENTURES.
  10. RINSES DENTURES USING CLEAN WATER. (DOES NOT USE HOT WATER.)
  11. Assists or supervises resident in cleaning or rinsing mouth.
  12. Replaces or assists/supervises in replacing dentures in resident's mouth or into clean denture cup.
  13. Leaves resident in position of comfort.
  14. Reports all deviations from the norm. (Nurse Examiner asks nurse aide for report.)
Term
SKILL 20
Mouth Care of Dependent Resident
 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. POSITIONS RESIDENT UPRIGHT OR ON SIDE WITH HEAD TURNED WELL TO ONE SIDE AS APPROPRIATE TO AVOID CHOKING OR ASPIRATION.
  7. Drapes chest/bed as needed to prevent from soiling.
  8. Uses applicators or soft toothbrush and cleaning solutions according to facility policy.
  9. GENTLY AND THOROUGHLY CLEANS INSIDE OF MOUTH INCLUDING THE GUMS, TONGUE, AND THE INNER, OUTER AND CHEWING SURFACES OF ALL UPPER AND LOWER TEETH.
  10. Leaves resident in position of comfort.
  11. Reports all deviations from the norm. (Nurse examiner asks nurse aide for report.)
Term

SKILL 21

Shaving the Male Resident—

Safety or Disposable Razor

 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Provides adequate lighting.
  7. Drapes chest appropriately to prevent soiling.
  8. Wets face with warm water then appropriately applies shaving soap or cream to bearded areas.
  9. ENCOURAGES RESIDENT TO MAKE SKIN TAUT, OR PULLS SKIN TAUT WITH FREE HAND TO AVOID CUTTING FACE.
  10. USES SHORT AND EVEN STROKES UNTIL SHAVED.
  11. Removes excess shaving cream or soap as appropriate.
  12. Leaves resident shaved and in a position of comfort.
Term

SKILL 22

Shaving the Male Resident—

Electric Razor

 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Provides adequate lighting.
  7. Encourages resident to make skin taut or pulls skin taut with free hand.
  8. SHAVES WHISKERS USING UP AND DOWN OR CIRCULAR MOTIONS UNTIL SHAVED.
  9. Leaves resident shaved and in a position of comfort.
Term
SKILL 23
Hand and Fingernail Care
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Provides adequate lighting.
  7. Immerses nails in comfortable warm water and soaks for at least five (5) minutes. (If resident just completed shower or tub bath no additional soaking is necessary.)
  8. Gently cleans under nails with file, orange stick or nailbrush. (Nails may be cleaned as they soak.)
  9. Dries hands thoroughly, being careful to dry between fingers.
  10. Gently pushes cuticle back with towel or orange stick.
  11. CUTS FINGERNAILS STRAIGHT ACROSS OR SLIGHTLY OVAL AND EVEN WITH OR SLIGHTLY ABOVE END OF FINGERS, WITHOUT CAUSING TRAUMA OR AVOIDABLE PAIN.
  12. Smooth rough edges of nails with nail file or emery board, shaping as appropriate.
  13. Leaves resident in position of comfort with fingernails smooth and clean.
Term
SKILL 26
Oral Temperature/Pulse/ Respirations
 Definition
Oral Temperature:
  1. Cleans hands appropriately before procedure.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. PREPARES THERMOMETER FOR USE APPROPRIATELY (IF GLASS THERMOMETER, SHAKES DOWN MERCURY TO 96 DEGREES OR BELOW) AND PLACES CORRECT END OF THERMOMETER INTO RESIDENT'S MOUTH, UNDER TONGUE.
  7. LEAVES THERMOMETER IN PLACE FOR APPROPRIATE LENGTH OF TIME WITH LIPS CLOSED, (IF MERCURY THERMOMETER, THREE MINUTES.)
  8. Records the temperature reading. (Examiner should ask nurse aide to do this step.) (Instructions to Nurse Examiner: Read thermometer AFTER nurse aide does and record both readings on the Nurse Aide Skills Examination Performance Summary Sheet.)
  9. NURSE AIDE'S RECORDED TEMPERATURE VARIES NO MORE THAN 0.2 DEGREES FROM EXAMINER'S RECORDED TEMPERATURE.
    10. Radial Pulse:
  10. LOCATES THE RADIAL PULSE BY PLACING TIPS OF FINGERS ON THUMB SIDE OF THE RESIDENT'S WRIST.
  11. COUNTS PULSE FOR 30 SECONDS TIMES 2 OR FOR 60 SECONDS, USING A TIMEPIECE. (NURSE EXAMINER SHOULD ASK NURSE AIDE LENGTH OF TIME SHE/HE COUNTED.)
  12. Records pulse rate. (Nurse Examiner: Check resident's pulse rate, using same wrist, AFTER nurse aide does and record both rates on the Nurse Aide Skills Examination Performance Summary Sheet.)
  13. NURSE AIDE'S RECORDED PULSE RATE IS WITHIN 10% OF NURSE EXAMINER'S RECORDED RATE.
    14. Respirations:
  14. COUNTS AND RECORDS RESIDENT'S RESPIRATIONS FOR 30 SECONDS TIMES 2 OR FOR 60 SECONDS, USING A TIMEPIECE. (NURSE EXAMINER SHOULD ASK NURSE AIDE FOR LENGTH OF TIME SHE/HE WILL COUNT AND CHECK RESIDENT'S RESPIRATIONS WHILE NURSE AIDE DOES, RECORDING BOTH RATES ON THE NURSE AIDE EXAMINATION PERFORMANCE SUMMARY SHEET.)
  15. NURSE AIDE'S RECORDED RESPIRATORY RATE IS WITHIN 20% OF NURSE EXAMINER'S RECORDED RATE.
  16. Leaves resident in position of comfort.
Term
SKILL 27
Axillary Temperature/Pulse/ Respirations
 Definition
Axillary Temperature:
  1. Cleans hands appropriately before procedure.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. PREPARES THERMOMETER FOR USE APPROPRIATELY (IF GLASS THERMOMETER, SHAKES DOWN MERCURY TO 96 DEGREES OR BELOW) AND PLACES CORRECT END OF THERMOMETER IN THE HOLLOW OF THE ARMPIT.
  7. HOLDS THERMOMETER IN PLACE FOR APPROPRIATE LENGTH OF TIME, TEN (10) MINUTES IF MERCURY THERMOMETER, HOLDING RESIDENT'S ARM CLOSE TO HIS/HER BODY.
  8. Records the temperature reading, placing an “Ax” to indicate Axillary temperature. (Nurse Examiner should ask nurse aide to record the reading.) (Instructions to Nurse Examiner: Read thermometer after nurse aide does and record both readings on the Nurse Aide Skills Examination Performance Summary Sheet.)
  9. NURSE AIDE'S RECORDED TEMPERATURE VARIES NO MORE THAN 0.2 DEGREES FROM EXAMINER'S RECORDED TEMPERATURE.
    10. Radial Pulse:
  10. LOCATES THE RADIAL PULSE BY PLACING TIPS OF FINGERS ON THUMB SIDE OF THE RESIDENT'S WRIST.
  11. COUNTS PULSE FOR 30 SECONDS TIMES 2 OR FOR 60 SECONDS, USING A TIMEPIECE. (NURSE EXAMINER SHOULD ASK NURSE AIDE FOR LENGTH OF TIME SHE/HE COUNTED.)
  12. Records pulse rate. (Nurse Examiner: Check resident's pulse rate, using same wrist, AFTER nurse aide does and record both rates on the Nurse Aide Skills Examination Performance Summary Sheet.)
  13. NURSE AIDE'S RECORDED PULSE RATE IS WITHIN 10% OF NURSE EXAMINER'S RECORDED RATE.
    14. Respirations:
  14. COUNTS AND RECORDS RESIDENT'S RESPIRATIONS FOR 30 SECONDS TIMES 2 OR FOR 60 SECONDS, USING A TIMEPIECE. (NURSE EXAMINER SHOULD ASK NURSE AIDE FOR LENGTH OF TIME SHE/HE WILL COUNT AND CHECK RESIDENT'S RESPIRATIONS WHILE NURSE AIDE DOES, RECORDING BOTH RATES ON THE NURSE AIDE SKILLS EXAMINATION PERFORMANCE SUMMARY SHEET.)
  15. NURSE AIDE'S RECORDED RESPIRATORY RATE IS WITHIN 20% OF NURSE EXAMINER'S RECORDED RATE.
  16. Leaves resident in position of comfort.
Term
SKILL 28
Rectal Temperature/Pulse/ Respirations
 Definition
Gloves Required
Rectal Temperature:
  1. Cleans hands appropriately before procedure.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. PREPARES THERMOMETER FOR USE APPROPRIATELY (IF GLASS THERMOMETER, SHAKES DOWN MERCURY TO 96 DEGREES OR BELOW.) APPLIES SMALL AMOUNT OF LUBRICANT ON BULB OF RECTAL THERMOMETER IF NOT PRELUBRICATED AND GENTLY INSERTS CORRECT END OF THERMOMETER INTO RECTUM APPROXIMATELY ONE INCH.
  7. HOLDS THERMOMETER IN PLACE FOR APPROPRIATE LENGTH OF TIME, (THREE (3) MINUTES IF MERCURY THERMOMETER.)
  8. Records the temperature reading, placing an “R” to indicate rectal temperature. (Nurse Examiner should ask nurse aide to record reading.) (Instructions to Nurse Examiner: Read thermometer AFTER nurse aide does and record both readings on the Nurse Aide Skills Examination Performance Summary Sheet.)
  9. NURSE AIDE'S RECORDED TEMPERATURE VARIES NO MORE THAN 0.2 DEGREES FROM EXAMINER'S RECORDED TEMPERATURE.
    10. Radial Pulse:
  10. LOCATES THE RADIAL PULSE BY PLACING TIPS OF FINGERS ON THUMB SIDE OF THE RESIDENT'S WRIST.
  11. COUNTS PULSE FOR 30 SECONDS TIMES 2 OR FOR 60 SECONDS, USING A TIMEPIECE. (NURSE EXAMINER SHOULD ASK NURSE AIDE FOR LENGTH OF TIME SHE/HE COUNTED.)
  12. Records pulse rate. (Nurse Examiner: Check resident's pulse rate, using same wrist, AFTER nurse aide does and record both rates on the Nurse Aide Skills Examination Performance Summary Sheet.)
  13. NURSE AIDE'S RECORDED PULSE RATE IS WITHIN 10% OF NURSE EXAMINER'S RECORDED RATE.
    14. Respirations:
  14. COUNTS AND RECORDS RESIDENT'S RESPIRATIONS FOR 30 SECONDS TIMES 2 OR FOR 60 SECONDS, USING A TIMEPIECE. (NURSE EXAMINER SHOULD ASK NURSE AIDE FOR LENGTH OF TIME HE/SHE WILL COUNT AND CHECK RESIDENT'S RESPIRATIONS WHILE NURSE AIDE DOES. RECORDING BOTH RATES ON THE NURSE AIDE SKILLS EXAMINATION PERFORMANCE SUMMARY SHEET.)
  15. NURSE AIDE'S RECORDED RESPIRATORY RATE IS WITHIN 20% OF NURSE EXAMINER'S RECORDED RATE.
  16. Leaves resident in position of comfort.
Term
SKILL 29
Blood Pressure
 Definition
  1. Properly cleans hands appropriately before procedure.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure such as correct sized cuff.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Provides adequate lighting.
  7. Assists resident into a comfortable sitting or recumbent position with forearm relaxed and supported in a palm-up position, approximately at the level of the heart.
  8. Rolls resident's sleeve up about 5 inches above the elbow and applies the cuff around the upper arm just above the elbow.
  9. Cleans earpieces of stethoscope appropriately and places in ears.
  10. LOCATES BRACHIAL ARTERY, PLACES STETHOSCOPE OVER BRACHIAL ARTERY AND HOLDS SNUGLY IN PLACE WITHOUT TOUCHING CUFF, OR FEELS BRACHIAL PULSE WITH FINGERS WHILE INFLATING CUFF.
  11. Tightens valve attached to air bulb.
  12. Quickly pumps air into cuff to about 20 mm to 30 mm above the point where pulse ceased to be detected. (Places stethoscope over brachial artery now, if not done at step #10.)
  13. Opens valve on air bulb, letting air escape slowly and evenly, while watching gauge and listening for pulse sounds. Notes the systolic pressure (when the first regular sound is heard) and the diastolic pressure (when the pulse changes from a loud beat to a faint murmur, or if no change is heard, until the sound disappears.)
  14. Records the systolic and diastolic blood pressure. (Instructions to Examiner: Ask nurse aide to record blood pressure, then the Nurse Examiner checks blood pressure in same arm and records results on the Nurse Aide Skills Examination Performance Summary Sheet. Use teaching stethoscope if available.)
  15. NURSE AIDES RECORDED BLOOD PRESSURE READING (BOTH SYSTOLIC AND DIASTOLIC) VARIES NO MORE THAN 10 MM HG FROM NURSE EXAMINER'S BLOOD PRESSURE MEASUREMENT.
  16. Removes blood pressure cuff and leaves resident in a position of comfort.
Term
SKILL 30
Weight of Ambulatory Resident
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. ASSURES THAT SCALE IS IN BALANCE BEFORE WEIGHING RESIDENT.
  7. CHECKS THAT RESIDENT IS BALANCED AND CENTERED ON SCALE WITH ARMS AT SIDES AND NOT HOLDING ON TO ANYTHING THAT COULD ALTER READING OF THE WEIGHT.
  8. Properly adjusts weights until scale is in balance.
  9. Reads weight and reports it to the Nurse Examiner.
    10. (Nurse Examiner: Read weight of resident WHILE the nurse aide does and record both weights on the Nurse Aide Skills Examination Performance Summary Sheet.)
  10. NURSE AIDE'S RECORDED WEIGHT VARIES NO MORE THAN 2 LBS. FROM NURSE EXAMINER'S READING.
  11. Leaves resident in position of comfort.
Term
SKILL 31
Range of Motion (ROM)— Exercise for Right or Left Upper Extremity
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Provides for resident's privacy as appropriate.
  4. INSURES RESIDENT'S SAFETY, SUCH AS BY STOPPING EXERCISE IMMEDIATELY IF ANY PAIN OR DISCOMFORT OCCURS AND NOTIFYING CHARGE NURSE IF PAIN IS SHARP OR UNEXPECTED.
  5. Positions resident supine and in good body alignment.
  6. MOVES JOINTS GENTLY, SMOOTHLY AND SLOWLY THROUGH THE RANGE OF MOTION TO THE POINT OF RESISTANCE AS TOLERATED.
  7. GENTLY SUPPORTS ARM AT ELBOW AND WRIST.
  8. Beginning with arm straight at side, flexes elbow and brings arm over head as far as possible, then returns arm to side of body x3.
  9. Beginning with arm straight at side, moves straight arm out at a right angle to body, then returns straight arm to side x3.
  10. (Optional step) With resident standing or sitting, moves arm slightly behind body, then returns arm to side x3. (If this step is not performed by nurse aide, score NA.)
  11. Beginning with arm at side, flexes elbow and moves hand toward shoulder then straightens arm x3.
  12. With arm flat on bed, turns hand so palm is up, then turns hand so palm is down x3.
  13. GENTLY SUPPORTS WRIST AND HAND.
  14. With palm up, flexes wrist toward shoulder then extends wrist x3.
  15. Moves hand side to side at wrist toward thumb then toward little finger x3.
  16. Places fingers over resident's fingers and curls resident's fingers to form fist, then straightens resident's fingers out x3.
  17. Touches resident's thumb to each finger x3.
  18. Moves each finger and thumb away from middle finger, then moves each finger and thumb toward middle finger x3.
  19. Leaves resident in a position of comfort.
Term
SKILL 32
Range of Motion (ROM)— Exercise for Right or Left Lower Extremity
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Provides for resident's privacy as appropriate.
  4. INSURES RESIDENT'S SAFETY, SUCH AS STOPPING EXERCISE IMMEDIATELY IF ANY PAIN OR DISCOMFORT OCCURS AND NOTIFYING CHARGE NURSE IF PAIN IS SHARP OR UNEXPECTED.
  5. Positions resident supine and in good body alignment.
  6. MOVES JOINTS GENTLY, SMOOTHLY AND SLOWLY THROUGH THE RANGE OF MOTION TO THE POINT OF RESISTANCE AS TOLERATED.
  7. GENTLY SUPPORTS LEG AT KNEE AND ANKLE.
  8. Beginning with leg straight, flexes the knee and slowly raises the leg, then straightens the knee and lowers the leg x3.
  9. Beginning with leg straight, moves straight leg away from center of body then moves straight leg back toward center x3.
  10. With leg straight, turns leg inward, then turns leg outward x3.
  11. GENTLY SUPPORTS ANKLE AND FOOT.
  12. Moves forefoot in clockwise circles, and counter clockwise circles x3.
  13. Places fingers over resident's toes and curls toes down, then straightens toes x3.
  14. Moves each toe away from the middle toe, then moves each toe toward middle toe x3.
  15. Leaves resident in position of comfort.
Term
SKILL 33
Assisting the Totally Dependent Resident With Dressing, Hair Combing, and Application of Prosthetic Devices
 Definition
Note to Nurse Examiner: Prosthetic devices shall include eyeglasses, hearing aid and dental devices.
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Encourages resident to select his/her own clothing as appropriate.
  7. GENTLY AND NATURALLY MOVES BODY PARTS, TO AVOID FORCING OR OVEREXTENDING LIMBS, JOINTS OR TO PREVENT TRAUMA AND AVOIDABLE PAIN.
  8. Dresses resident in an organized manner to prevent undue exertion.
  9. Combs resident's hair including back of head, and arranges it according to resident's preference.
  10. Assist resident to put on desired prosthetic device(s) as needed, i.e., eyeglasses, hearing aid, and dental devices.
  11. Leaves resident in a position of comfort.
Term
SKILL 34
Complete Bed Bath
 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure and places it in appropriate place.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. Checks water for comfortable temperature.
  7. Wets washcloth, applies soap (if resident desires) and supervises/assists resident in washing, rinsing (if soap is used) and drying face, ears and neck.
  8. Supervises/assists resident in washing, rinsing, and drying arms and hands, thoroughly drying between fingers.
  9. Supervises/assists resident in washing, rinsing, and drying chest and abdomen.
  10. Supervises/assists resident in washing, rinsing, and drying legs and feet, thoroughly drying between toes.
  11. Changes bath water in basin at least prior to washing the back and as needed during bath to keep water reasonable warm, clean and free of excess soap.
  12. Washes, rinses, and dries back of neck, back and buttocks.
  13. Supervises/assists resident with properly washing, rinsing and drying perineal area or provides privacy if resident is able to wash perineum without assistance.
  14. WASHES, RINSES, AND DRIES FROM CLEAN TO DIRTY AREAS.
  15. Reports all deviations from the norm (Nurse Examiner asks nurse aide for report.)
  16. Leaves resident clean and in a position of comfort.
Term
SKILL 35
Feeding the Dependent Resident (Offering Food and Fluids)
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Assembles appropriate equipment before procedure.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. POSITIONS RESIDENT UPRIGHT AT LEAST 45 DEGREES OR ON SIDE TO AVOID CHOKING OR ASPIRATION.
  7. Protects clothing from soiling such as by using napkin or bib.
  8. Washes resident's hands and face before feeding as needed.
  9. Describes the foods being offered.
  10. Assures the safe temperature of food to avoid burns.
  11. Allows resident to feed self as much as possible to increase independence.
  12. Offers fluid after every third or fourth bite.
  13. OFFERS FOOD IN SMALL AMOUNTS AT A REASONABLE RATE, ALLOWING RESIDENT TO CHEW AND SWALLOW.
  14. Wipes resident's hands and face during meal as needed.
  15. Leaves resident clean and in position of comfort.
Term
SKILL 36

Turning the Resident On His Side Toward You
 Definition
  1. Properly cleans hands before procedure as appropriate.
  2. Explains procedure to resident and encourages resident to participate as appropriate.
  3. Provides for resident's privacy as appropriate.
  4. INSURES RESIDENT'S SAFETY.
  5. Exhibits proper body mechanics.
  6. Positions resident to assist in turning.
  7. GENTLY ROLLS RESIDENT ON TO SIDE TOWARD YOU WITHOUT TRAUMA OR AVOIDABLE PAIN.
  8. Leaves resident in position of comfort and in good body alignment, using supports as needed to maintain the side-lying position.
Term
SKILL 37
Assisting Resident With Use of Bedpan
 Definition
Gloves Required
  1. Properly cleans hands before procedure as appropriate.
  2. Assembles appropriate equipment.
  3. Explains procedure to resident and encourages resident to participate as appropriate.
  4. Provides for resident's privacy as appropriate.
  5. INSURES RESIDENT'S SAFETY.
  6. ADJUSTS CLOTHING AS NECESSARY AND PLACES/ASSISTS RESIDENT ONTO BEDPAN WITHOUT TRAUMA OR AVOIDABLE PAIN.
  7. Elevates head of bed, as appropriate.
  8. Places call signal and tissue in easy reach of resident.
  9. Instructs resident to call when finished or if help is needed.
  10. Washes hands and if appropriate leaves room.
  11. Returns when needed and lowers head of bed if appropriate.
  12. ASSISTS RESIDENT TO WIPE PERINEUM IF NEEDED, WIPING FROM FRONT OF BACK, OR PROVIDES PERINEAL CARE IF NEEDED.
  13. REMOVES BEDPAN WITHOUT TRAUMA OR AVOIDABLE PAIN.
  14. Empties, cleans, and replaces bedpan following facility policy.
  15. Leaves resident in a position of comfort.
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