Basic Nursing + Personal Care
40%of exam
Vital SignsTransfersCatheter CareI&OBed BathDressing
Role, Safety & Infection Control
37%of exam
ISDH RulesINARFire RACE/PASSPPEHand HygieneFalls
Communication & Mental Health
18%of exam
ChartingHIPAASBARDementiaResident RightsGrief
Restorative Care & Aging
5%of exam
ROMAmbulationContracturesAging ChangesAssistive Devices
Quick Facts
- Exam
- Indiana CNA
- Written
- 100 questions
- Time
- 2 hours written
- Pass
- 80% written
- Skills
- 5 skills, 100%
- Fee
- $100 both tests
- Training
- 105 hours total
- Admin
- Ivy Tech / ISDH
- Registry
- INAR, 2-year renewal
Hot vs Cold Application
Heat
- New injury after 48h
- Promotes circulation
- Relieves stiffness
Cold
- First 48 hours
- Reduces swelling
- Numbs pain
Acute cold; chronic heat
Vital Sign Action
- BP 140/90+→Record, report nurse(Stage 2 HTN)
- Pulse below 60→Report to nurse
- Resp below 12→Report bradypnea
- Resp above 20→Report tachypnea
- Temp above 99.1→Report fever
- Output below 30/hr→Report low output
Vital Sign Ranges
- Temperature
- 97.8-99.1 F oral
- Pulse
- 60-100 bpm adult
- Respiration
- 12-20 breaths/min
- BP normal
- 90-140 systolic
- BP diastolic
- 60-90 mmHg
- BP report
- 140/90 or higher
- Pulse regular
- Count 15 sec x4
- Pulse irregular
- Count full 60 sec
Dress Weak vs Undress Strong
Dressing
- Weak side first
- Affected side first
- Reduces discomfort
Undressing
- Strong side first
- Easier removal
- Then weak side
Dress weak; undress strong
Vital Sign Technique
- Oral temp
- Sublingual pocket
- Axillary temp
- Hold 5 minutes
- BP position
- Same arm, same position
- BP cuff
- At heart level
- Resp count
- Count 1 full minute
- Radial pulse
- Thumb side wrist
Intake & Output
- I&O includes
- All liquids at room temp
- Soup counts
- Liquid at room temp
- Ice cream
- Counts as intake
- Gelatin
- Counts as intake
- 1 oz
- 30 mL
- Normal output
- 30 mL/hour minimum
- Report low
- 180 mL in 8 hrs
- Convert
- Ounces to mL
Transfers & Body Mechanics
- Lift
- Bend knees, not waist
- Transfer belt
- Gait belt for safety
- Weak side
- Dress affected first
- Undress
- Strong side first
- Stand pivot
- Pivot toward strong side
- Wheelchair
- Lock brakes first
- Elastic stocking
- Apply lying down
Personal Care Sequence
- Bed bath order
- Face to perineal last
- Perineal
- Cleanest to dirtiest
- Catheter clean
- Insertion site outward
- Oral unconscious
- Head turned to side
- Shaving
- Direction of hair growth
- Back rub
- Effleurage, upward strokes
- Bath water
- Change when cold/soapy
Fire Response
RACE: Rescue-Alarm-Confine-Extinguish
R: rescueA: alarmC: contain doorsE: extinguish
Handwashing vs Sanitizer
Soap + Water
- 20 seconds scrub
- C. diff required
- Visibly soiled hands
- After restroom
Alcohol Rub
- Routine clean hands
- Quick access
- Not for C. diff
- Not if soiled
Soap kills spores; gel doesn't
Precaution Type
- MRSA, C. diff→Contact precautions(Gown + gloves)
- Flu, meningitis→Droplet precautions(Surgical mask)
- Active TB→Airborne precautions(N95 mask)
- All body fluids→Standard precautions(Always)
- Visibly soiled hands→Soap and water(Not sanitizer)
- C. diff spores→Soap and water only(Sanitizer fails)
- Routine clean hands→Alcohol rub(20 seconds)
- Needlestick→Wash with soap(Report immediately)
ISDH & Indiana Regulations
- ISDH
- Regulatory authority
- Ivy Tech
- Exam administrator
- 410 IAC 16.2
- IN nurse aide code
- INAR
- IN Nurse Aide Registry
- Renewal
- 2 years, 8 paid hours
- Training
- 105 hrs: 75 clinical
- Test window
- Within 2 years
- Mandated reporter
- Report abuse to APS
PPE Sequence
Don: Gown-Mask-Goggles-Gloves
Don top to bottomDoff: gloves firstDoff: mask lastHandwash after
Contact vs Airborne
Contact
- MRSA, C. diff
- Gown + gloves
- Dedicated equipment
Airborne
- TB, measles
- N95 mask
- Negative pressure room
Surface vs airborne particles
Emergency Response
- Fire discovered→RACE sequence(Rescue first)
- Extinguisher needed→PASS technique
- Resident falls→Stay, assess, call nurse(Don't move alone)
- Seizure starts→Protect head, clear area(Nothing in mouth)
- Choking adult→Heimlich thrusts
- Unresponsive no breath→Start CPR(30 compressions)
- DNR order→No CPR, comfort only(Call nurse)
Infection Control
- Hand wash
- 20 seconds minimum
- C. diff
- Soap and water only
- Don PPE
- Gown-mask-goggles-gloves
- Doff PPE
- Gloves first, last mask
- Standard prec
- All body fluids
- Contact prec
- MRSA, C. diff
- Droplet prec
- Flu, meningitis
- Airborne prec
- TB, N95 mask
- Sharps
- No recap, sharps box
- Chain
- 6 links of infection
Chain of Infection
Agent-Reservoir-Exit-Transmission-Entry-Host
6 linksBreak any linkStop spreadHandwash breaks chain
Restraint vs Reposition
Restraint
- Last resort only
- Release q2h
- Doctor order needed
Reposition
- First choice
- Q2h turn schedule
- Prevents ulcers
Reposition first; restrain last
Safety & Emergency
- Fire
- RACE: rescue-alarm-confine
- Extinguisher
- PASS: pull-aim-sweep
- Fall found
- Stay, assess, call nurse
- Seizure
- Protect head, no mouth
- Choking
- Heimlich, call 911
- CPR adult
- 30 compressions, 2 breaths
- Restraint
- Release q2h, exercise
- Tornado
- Interior, lowest floor
SBAR Report
Situation-Background-Assessment-Recommendation
S: what nowB: historyA: your obsR: what needed
Charting vs Verbal Report
Charting
- Permanent record
- Objective data
- Single-line errors
Verbal Report
- Shift handoff
- SBAR format
- Continuity of care
Chart facts; report changes
Communication & Documentation
- SBAR
- Situation-Background-Assessment
- Charting error
- Single line, no erase
- HIPAA
- No PHI in hallways
- Hearing impaired
- Face-to-face, lip read
- Visual impaired
- Clock method for food
- Shift report
- Continuity of care
- Subjective data
- Resident states symptoms
- Objective data
- Measured, observed facts
Mental Health & Psychosocial
- Validation
- Acknowledge emotion
- Dementia wander
- Calm redirect to safe
- Sundowning
- Evening agitation
- Grief stages
- Denial-anger-bargaining
- Depression
- Report hopelessness signs
- Resident rights
- Refuse care allowed
- Dignity
- Knock before entering
- End-of-life
- Comfort, support family
Restorative Care & Aging
- ROM
- Never force past pain
- Contracture
- From prolonged immobility
- Ambulation
- Gait belt, lock wheelchair
- Cardiac aging
- Decreased reserve
- Dehydration
- Thirst less sensitive
- Parkinson freeze
- Visual cues help
- Oxygen therapy
- Monitor, never adjust
- Functional decline
- Report 3-month change
Common Traps
Dress weak vs undress strong
Dress affected first ≠ Undress strong first
C. diff: sanitizer does not work
Soap and water only ≠ Alcohol gel fails
Fall: don't move alone
Stay and assess first ≠ Call nurse before moving
DNR does not mean do not care
No CPR started ≠ Comfort and call nurse
Report not treat
CNAs observe and report ≠ Nurses assess and treat
Toenails: don't trim abnormal
Report to nurse ≠ Diabetic: never trim
Charting errors: no erase
Single line through ≠ Write 'error' + initial
Last Minute
- 1.BP: same arm, same position
- 2.Handwash: 20 seconds minimum
- 3.C. diff: soap and water only
- 4.Dress weak side; undress strong
- 5.Perineal care: cleanest to dirtiest
- 6.PPE don: gown-mask-goggles-gloves
- 7.Fire: RACE; extinguisher: PASS
- 8.Fall: stay, assess, call nurse
- 9.INAR: 2-year renewal, 8 paid hours
- 10.Seizure: protect head, no mouth
- 11.Chart objective facts only
- 12.Restraint: last resort, release q2h
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