Physical Care Skills
61%of exam
Psychosocial Care Skills
13%of exam
CommunicationEmotional NeedsDementia CareCulturalSpiritualLoss/Grief
Role of the Nurse Aide
26%of exam
Residents' RightsReportingLegal/EthicalScopeTeamCT Registry
Quick Facts
- Exam
- CT Nurse Aide
- Provider
- Prometric / DPH
- Written
- 60 questions
- Time
- 90 min written
- Pass written
- ~72%
- Skills
- 5 (Hand Hygiene + 4)
- Training
- 100 hours
- Renewal
- Every 2 years
Fire Response
RACE = Rescue, Alarm, Confine, Extinguish
R: rescueA: alarmC: confineE: extinguish
Soap vs Sanitizer
Soap + Water
- Visibly soiled
- C. diff / norovirus
- 20 seconds
Sanitizer
- Not soiled
- Faster routine
- Most pathogens
Soiled or spores = soap
Infection / PPE Picker
- Hands visibly soiled→Soap + water(Always)
- C. diff or norovirus→Soap + water(Spores resist gel)
- Hands not soiled→Hand sanitizer(Faster)
- MRSA / C. diff→Contact gown+gloves(Private room)
- Influenza→Droplet mask(Within 3 ft)
- Tuberculosis→N95 respirator(Airborne, negative pressure)
- Any resident→Standard precautions(Treat all)
ADLs
- Bathing
- Clean to dirty
- Grooming
- Hair, nails, shaving
- Dressing
- Weak arm first
- Undressing
- Strong arm first
- Toileting
- Privacy, dignity
- Feeding
- Sit upright 90°
- Oral care
- Turn head, side
- Perineal care
- Front to back
Extinguisher Use
PASS = Pull, Aim, Squeeze, Sweep
P: pull pinA: aim baseS: squeezeS: sweep
Active vs Passive ROM
Active ROM
- Resident moves
- Aide guides
- More function
Passive ROM
- Aide moves limb
- Resident cannot
- Prevent contractures
Who does the moving
Emergency Response
- Fire alarm→RACE(Rescue first)
- Use extinguisher→PASS(Aim at base)
- Resident choking→Abdominal thrusts(If conscious)
- Resident falling→Ease to floor(Protect head)
- After a fall→Stay, call nurse(Do not lift)
- Seizure→Clear area, time(Nothing in mouth)
- Bleeding→Direct pressure(Gloves on)
Vital Sign Norms
- Temp oral
- 97.6-99.6°F
- Pulse adult
- 60-100 bpm
- Respirations
- 12-20 / min
- BP normal
- <120/80 mmHg
- O2 sat
- 95-100%
- Apical pulse
- Full minute
- Radial pulse
- Wrist, thumb side
- Report changes
- Tell nurse
Dressing Side
Weak in first, strong out first
Dress: weak armUndress: strong armSupport jointsResident's pace
Infection Control
- Hand hygiene
- Best preventionMandatory
- Soap + water
- C. diff, norovirus
- Sanitizer
- If not soiled
- Standard precautions
- All residents
- Contact
- MRSA, gown/gloves
- Droplet
- Flu, mask
- Airborne
- TB, N95
- Don order
- Gown, mask, goggles, gloves
PPE + Handwashing
- Doff first
- Gloves off first
- Doff last
- Mask off last
- Wash time
- 20 seconds
- Fingertips down
- Below elbows
- Dry paper towel
- Turn off faucet
- No touch sink
- Keep apron dry
- Soiled gloves
- Change between tasks
- Cuts covered
- Bandage breaks
Safety + Emergency
- RACE
- Rescue, Alarm, Confine, Extinguish
- PASS
- Pull, Aim, Squeeze, Sweep
- Call light
- Within reach
- Bed low
- Lock wheels
- Choking
- Heimlich, abdominal thrusts
- Fall
- Ease to floor
- Seizure
- Protect head, time it
- Burn
- Cool water
Body Mechanics + Transfers
- Wide base
- Feet shoulder-width
- Bend knees
- Not the back
- Hold close
- Load near body
- Push not pull
- Use legs
- Gait belt
- Transfer safety
- Lock wheelchair
- Before transfer
- Strong side
- Lead transfer
- Two aides
- Dependent lift
Restorative + Positioning
- ROM
- Maintain joint motion
- Active ROM
- Resident moves self
- Passive ROM
- Aide moves limb
- Reposition
- Every 2 hours
- Fowler's
- Sitting upright
- Supine
- On back
- Lateral
- On side
- Prevent contractures
- Use ROM
Dementia vs Delirium
Dementia
- Gradual onset
- Permanent decline
- Chronic
Delirium
- Sudden onset
- Often reversible
- Report fast
Slow vs sudden
Knock + Privacy
Knock, identify, explain, privacy, dignity
Knock firstSay your nameExplain carePull curtain
Objective vs Subjective
Objective
- Measured facts
- Vitals, intake
- What you see
Subjective
- Resident says
- Pain, nausea
- Quote them
Seen vs reported
Reporting + Documentation
- Suspect abuse→Report to nurse now(Mandatory)
- Vital out of range→Tell nurse(Objective data)
- Resident refuses care→Report, document(Honor right)
- Charting→Facts only(No opinions)
- Made an error→Report honestly(Never hide)
- Asked to do nurse task→Decline politely(Out of scope)
Residents' Rights (OBRA)
- Dignity
- Respect always
- Privacy
- Knock, curtains
- Confidentiality
- HIPAA protected
- Self-determination
- Make choices
- Free from restraints
- Last resort only
- Free from abuse
- Report suspicion
- Refuse care
- Resident may decline
- Grievance
- Voice complaints
MOLST vs Living Will
MOLST
- Physician order
- Actionable now
- CT form
Living Will
- Patient wishes
- Legal document
- Future guide
Order vs directive
Legal/Ethical + CT Rules
- Mandatory reporter
- Report suspicion
- Report to nurse
- Immediately
- Facility to DPH
- Within 24 hours
- MOLST
- CT's POLST order
- Scope of practice
- No meds, no IVs
- Negligence
- Care below standard
- False imprisonment
- Improper restraint
- CT registry
- DPH lists CNAs
CT DPH vs Prometric
CT DPH
- Maintains registry
- Investigates abuse
- Approves training
Prometric
- Administers exam
- Written + skills
- Scoring
Regulator vs tester
Common Traps
Soap vs sanitizer
Soap kills spores ≠ Gel does not
Report vs decide
Aide reports changes ≠ Nurse interprets
Scope of practice
CNAs give care ≠ No meds or IVs
Dress vs undress
Dress weak first ≠ Undress strong first
Restraint use
Last resort only ≠ Needs MD order
Refuse care
Resident may refuse ≠ Report, do not force
Last Minute
- 1.Weights: ~61% / ~13% / ~26%
- 2.CT requires 100 training hours
- 3.Written: 60 questions, 90 minutes
- 4.Skills: Hand Hygiene + 4 random
- 5.Renew every 2 years; in-service yearly
- 6.Soap + water for C. diff, norovirus
- 7.TB = N95; MRSA = contact; flu = droplet
- 8.Dress weak first; undress strong first
- 9.Report suspected abuse to nurse immediately
- 10.CNAs never give meds or IVs
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