Certified Nurse Assistant Module 9: Patient Care Procedures

Section 1: Define Key Terminology

• Review terminology as listed
• Ensure accurate spelling
• Practice correct pronunciation
• Use terms in proper context

Section 2: Collecting Specimens

Sputum Specimens

• Purpose: Diagnose respiratory disorders by analyzing mucus (sputum) from lungs, bronchi, trachea.
• Procedure:
  • Best collected in early morning.
  • Rinse mouth with water, avoid mouthwash.
  • Maintain privacy and use standard precautions.
  • Label specimen accurately.
  • Document color, odor, consistency, presence of blood.

Urine Specimens

• Purpose: Diagnose medical conditions, evaluate treatment.
• Methods:
  • Midstream
  • Clean-catch
  • 24-hour collection
• Procedure:
  • Use clean containers, label accurately.
  • Do not contaminate specimen.
  • Document collection details and any difficulties.

Stool Specimens

• Purpose: Test for blood, fat, microorganisms, parasites.
• Procedure:
  • Maintain privacy and use clean containers.
  • Label correctly, follow storage instructions.
  • Document color, amount, consistency.

Section 3: Bed Making & Body Mechanics

• Importance: Comfort, prevents pressure sores, enhances mental well-being.
• Procedure:
  • Use clean, wrinkle-free linen.
  • Follow aseptic technique.
• Body Mechanics:
  • Keep back straight, use knees.
  • Work close to the bed.
  • Avoid twisting.

Section 4: Types of Beds and Positions

• Manual/Electric Beds: Use hand cranks or electric controls.
• Side Rails: Used as restraints, require consent.
• Positions:
  • Fowler’s, Semi-Fowler’s
  • Trendelenburg, Reverse Trendelenburg

Section 5: Maintaining Patient Environment

• Ensure comfort (temperature, noise, lighting).
• Maintain safety (furniture placement, call bell access).

Section 6: Administering an Enema

• Purpose: Stimulate bowel movement, cleanse bowel.
• Procedure:
  • Ensure appropriate training and conditions.
  • Use proper temperature and volume.
  • Position patient in left Sims’.

Section 7: Giving a Suppository

• Purpose: Stimulate bowel, ease evacuation.
• Procedure:
  • Use gloves, insert past anal sphincter.
  • Observe and report results.

Section 8: Gastrointestinal Tubes

• Types:
  • Nasogastric: Through nose to stomach/intestine.
  • Gastrostomy: Surgically inserted into stomach.

Section 9: Care for Patients with Feeding Tubes

• Oral hygiene, secure tubing.
• Positioning: Elevate head of bed.
• Monitor for complications (kinks, infection).

Section 10: Intravenous (IV) Therapy

• Purpose: Provide fluids, nutrition, medication.
• Procedure:
  • Monitor flow, tubing, injection site.
  • Assist with physical comfort and mobility.

Section 11: Fluid Balance

• Importance: Equilibrium in fluid intake/output.
• Conditions:
  • Edema: Excess fluid.
  • Dehydration: Fluid deficit.
• Nursing Role:
  • Encourage or restrict fluids as per orders.
  • Monitor intake/output.

Section 12: Measuring Fluid Intake and Output

• Purpose: Evaluate fluid balance.
• Procedure:
  • Record intake in milliliters.
  • Use standard measures (graduated cylinder).

Section 13: Use of Bandages and Dressings

• Purpose: Apply pressure, immobilization, protect wounds.
• Materials: Gauze, hypoallergenic tape.
• Procedure:
  • Apply evenly, support joints.
• Observation: Report swelling, pain, color changes.

Section 14: Anti-Embolic Hose/Elastic Stockings

• Purpose: Improve venous return.
• Procedure:
  • Apply before rising, remove every 8 hours.

Section 15: Skin Conditions and Non-Prescription Treatments

• Nurse Assistant Role:
  • Apply OTC ointments to intact skin.
  • Report significant skin issues to nurse.

Section 16: Admission to Facility

• Process:
  • Welcome, orientation, baseline information collection.
  • Explanation of facilities and routines.

Section 17: Transfer within Facility

• Procedure:
  • Inform patient/resident, transfer belongings.
  • Orientation to new surroundings.

Section 18: Discharge from Facility

• Procedure:
  • Collect and verify belongings, measure vital signs.
  • Assist with transportation arrangements.