BRIEF CONTENTS
CHAPTER 1 The Health Care System 2
CHAPTER 2 Your Role as a Nursing Assistant 14
CHAPTER 3 Communication Skills 34
CHAPTER 4 Patients, Residents, and Clients 64
CHAPTER 5 Infection Control 79
CHAPTER 6 Safety 112
CHAPTER 7 Body Mechanics: Positioning, Moving, and Transporting Patients 142
CHAPTER 8 Admitting, Transferring, and Discharging a Patient 174
CHAPTER 9 The Patient's Environment 192
CHAPTER 10 Bedmaking 204
CHAPTER 11 Home Health Care 220
CHAPTER 12 Personal Care of the Patient 242
CHAPTER 13 Emergency Care 278
CHAPTER 14 The Human Body 300
CHAPTER 15 Growth and Development 314
CHAPTER 16 The Musculoskeletal System and Related Care 326
CHAPTER 17 The Integumentary System and Related Care 344
CHAPTER 18 The Circulatory and Respiratory System and Related Care 364
CHAPTER 19 Measuring Vital Signs 382
CHAPTER 20 The Gastrointestinal System and Related Care 410
CHAPTER 21 Nutrition for the Patient 438
CHAPTER 22 The Urinary System and Related Care 454
CHAPTER 23 Specimen Collection 478
CHAPTER 24 The Endocrine System and Related Care of Diabetics 494
CHAPTER 25 The Reproductive System and Related Care 508
CHAPTER 26 The Nervous System and Related Care 524
CHAPTER 27 Warm and Cold Applications 544
CHAPTER 28 Care of the Surgical Patient 566
CHAPTER 29 Special Procedures 584
CHAPTER 30 Other Patients with Special Needs 594
CHAPTER 31 Neonatal and Pediatric Care 608
CHAPTER 32 The Older Adult Patient and Long-Term Care 628
CHAPTER 33 Rehabilitation and Return to Self-Care 648
CHAPTER 34 The Terminally Ill Patient and Postmortem Care 672
CHAPTER 35 Beginning Your Career as a Nursing Assistant 684
APPENDIX Medical Terms, Abbreviations, and Specialties 707
Glossary 715
Index 731
DETAILED CONTENTS
Procedures xxii
Guidelines xxv
Acknowledgments xxvii
Introduction xxxiv
CHAPTER 1 The Health Care System 2
The Health Care Environment 4
Health Care Delivery Sites 6
The Patient/Health Care Team 7
The Nursing Assistant: Part of the Team 10
CHAPTER 2 Your Role as a Nursing Assistant 14
The Nursing Assistant: An Important Caregiver 16
Personal Qualities 18
Organizing Your Work 19
· GUIDELINES: Ways to Reduce Stress 21
Ethical Behavior 21
· GUIDELINES: Code of Ethics 21
· GUIDELINES: Work Rules and Instructions 24
Legal Aspects of Patient Care 25
CHAPTER 3 Communication Skills 34
Communication Skills 36
Communication and Relating to People 37
· GUIDELINES: Communicating with Patients 42
· GUIDELINES: Communicating with Visitors 45
Observing the Patient 49
Methods of Observation 50
Reporting and Recording Observations 52
CHAPTER 4 Patients, Residents, and Clients 64
Understanding and Relating to Patients, Residents, and Clients 66
Customer-Focused Care 66
Cultural Differences and Diversity 67
· GUIDELINES: Appreciating Cultural Diversity 68
Basic Human Needs 71
Dealing With Difficult Behavior 74
Physical Crisis Management 74
· GUIDELINES: Dealing with the Disruptive Individual 75
· GUIDELINES: General Techniques to Try 75
CHAPTER 5 Infection Control 78
History of Infection Control 80
Nature of Microorganisms 80
Preventing the Spread of Infection 83
Isolation Precautions 86
· GUIDELINES: Handwashing 96
· PROCEDURE: Handwashing 96
· PROCEDURE: Putting on Disposable Gloves 97
· PROCEDURE: Removing Gloves 98
· PROCEDURE: Putting on a Mask 99
· GUIDELINES: Using Masks to Prevent Cross Infection 99
· GUIDELINES: Care and Cleaning of Noncritical Items 100
· PROCEDURE: Application of a Gown 100
· PROCEDURE: Removing a Gown 101
OSHA Standards for Occupational Exposure to Bloodborne Pathogens 103
Asepsis and Sterile Technique 104
· GUIDELINES: Maintaining a Sterile Field 105
· PROCEDURE: Putting on Sterile Gloves 106
· PROCEDURE: Opening a Sterile Package 107
· THE NURSING ASSISTANT IN ACTION: Patient Withholds Information 109
CHAPTER 6 Safety 112
General Safety Measures 114
· GUIDELINES: Safety Measures 114
· GUIDELINES: Safety Measures for Young Children 115
Oxygen Safety 116
· GUIDELINES: Oxygen Safety 117
Fire Safety and Prevention 118
Patient Safety 123
· PROCEDURE: Applying a Waist Restraint 124
· PROCEDURE: Applying a Vest Restraint 125
Patient Restraint Policy Example 125
· PROCEDURE: Application and Care of the Patient in Leather Restraints 130
· GUIDELINES: Patient Ambulation Safety 138
· THE NURSING ASSISTANT IN ACTION: Restraint Alternatives 139
CHAPTER 7 Body Mechanics: Positioning, Moving,
and Transporting Patients 142
Proper/Protective Body Mechanics 144
· GUIDELINES: Proper/Protective Body Mechanics 144
Positioning and Draping the Patient 145
Moving and Lifting Patients 150
· GUIDELINES: Moving and Lifting Patients 150
· PROCEDURE: Moving the Helpless Patient Up in Bed 151
· PROCEDURE: Moving a Patient Up in Bed with the Patient's Help 152
· PROCEDURE: Moving the Mattress to the Head of the Bed with the Patient's Help 153
· PROCEDURE: Moving a Helpless Patient to One Side of the Bed on
the Patient's Back 154
· PROCEDURE: Rolling the Patient Like a Log (Log Rolling) 156
· PROCEDURE: Turning a Patient onto the Patient's Side Toward You 157
· PROCEDURE: Turning a Patient onto the Patient's Side Away from You 158
· PROCEDURE: Repositioning a Patient in a Chair or Wheelchair 159
Transporting a Patient by Wheelchair 159
· PROCEDURE: Moving the Nonambulatory Patient into a Wheelchair
or Arm Chair from the Bed 161
· PROCEDURE: Helping a Nonambulatory Patient Back into Bed from a
Wheelchair or Arm Chair 162
· PROCEDURE: Helping an Ambulatory Patient Who Can Stand, Back
into Bed from a Chair or a Wheelchair 163
· PROCEDURE: Using a Portable Mechanical Patient Lift to Move the
Helpless Patient 164
Using a Stretcher 166
· PROCEDURE: Moving a Patient from the Bed to a Stretcher 167
· PROCEDURE: Moving a Patient from a Stretcher to the Bed 168
Assisting the Patient to Ambulate 169
Assisting a Falling Patient 170
· GUIDELINES: Assisting a Falling Patient 170
· THE NURSING ASSISTANT IN ACTION: Should a Policy Be a Guideline for You 171
CHAPTER 8 Admitting, Transferring, and Discharging a Patient 174
Admitting the Patient 176
· PROCEDURE: Admitting the Patient 178
· PROCEDURE: Weighing and Measuring the Height of a Patient Who
is Able to Stand 181
Transferring the Patient 182
· PROCEDURE: Transferring the Patient 183
Discharging the Patient 184
· PROCEDURE: Discharging the Patient 187
· THE NURSING ASSISTANT IN ACTION: Patient Plans to Leave Without
Medical Approval 189
CHAPTER 9 The Patient's Environment 192
The Patient's Unit 194
Creating a Comfortable Environment 198
Caring for a Patient in a Home Setting 198
· THE NURSING ASSISTANT IN ACTION: Patient Lives in Clutter 201
CHAPTER 10 Bedmaking 204
Bedmaking 206
Four Basic Beds 206
· GUIDELINES: Bedmaking 206
· PROCEDURE: Making the Closed, Empty Bed 207
· PROCEDURE: Making the Open, Fanfolded, or Empty Bed 211
· PROCEDURE: Making the Postoperative or Surgical Bed 211
· PROCEDURE: Making the Occupied Bed 213
· THE NURSING ASSISTANT IN ACTION: Covering up the Evidence 217
CHAPTER 11 Home Health Care 220
Working in the Home Health Care Field 222
Helpful Personal Qualities of the Home Health Aide 223
The Family Unit 224
Duties of the Home Health Aide 226
Safety in the Home 229
Reporting an Accident or Emergency by Telephone 231
Care of the Infant in the Home 232
· GUIDELINES: Storing Formula 232
· PROCEDURE: Sterilizing Tap Water 233
· PROCEDURE: Sterilizing Bottles 234
Housekeeping Responsibilities in the Home 234
Reporting and Recording 236
· THE NURSING ASSISTANT IN ACTION: Patient Wants More Help than You Can Give 239
CHAPTER 12 Personal Care of the Patient 242
Daily Care of the Patient 244
Oral Hygiene 245
· PROCEDURE: Oral Hygiene 250
· PROCEDURE: Cleaning Dentures (False Teeth) 250
· PROCEDURE: Oral Hygiene for the Unconscious Patient (Special Mouth Care) 251
Helping the Patient to Bathe 252
· GUIDELINES: Bathing the Patient 253
· PROCEDURE: The Complete Bed Bath 254
· PROCEDURE: The Partial Bed Bath (Partial Self-Care) 257
· PROCEDURE: The Tub Bath 258
· PROCEDURE: Helping the Patient Take a Shower 260
Perineal Care 260
· PROCEDURE: Perineal Care for the Male Patient 261
· PROCEDURE: Perineal Care for the Female Patient 262
Care of Nails and Feet 263
The Back Rub 263
· PROCEDURE: Giving the Patient a Back Rub 264
Changing the Patient's Gown 265
· PROCEDURE: Changing the Patient's Gown 265
Hair Care 266
· PROCEDURE: Shampooing the Patient's Hair 267
· PROCEDURE: Combing the Patient's Hair 268
Shaving the Patient's Beard 269
· PROCEDURE: Shaving the Patient's Beard 270
Elimination Needs 270
· PROCEDURE: Offering the Bedpan 271
· PROCEDURE: Offering the Urinal 272
· PROCEDURE: Offering the Portable/Bedside Commode 273
The Incontinent Patient 274
· THE NURSING ASSISTANT IN ACTION: Doctors Overheard Discussing Patient 275
CHAPTER 13 Emergency Care 278
What to Do in an Emergency 280
· GUIDELINES: Assisting a Person in an Emergency 281
Shock 282
· GUIDELINES: Assisting the Patient in Shock 283
Heart Attack, Chest Pain, and Cardiac Arrest 284
· GUIDELINES: Assisting the Person Having a Heart Attack, Chest Pain,
or Myocardial Infarction 285
Cardiopulmonary Resuscitation (CPR) 285
Choking 288
· GUIDELINES: Performing the Heimlich Maneuver 289
Stroke or Cerebrovascular Accident 289
· GUIDELINES: Assisting a Person Who Is Suspected of Having a Stroke 290
Seizures 290
· GUIDELINES: Assisting a Person Who Is Having a Seizure 290
Hemorrhage 291
· GUIDELINES: Assisting the Person Who Is Hemorrhaging 292
Burns 292
· GUIDELINES: Assisting the Person Who Has Been Burned 293
Poisoning 293
· GUIDELINES: Assisting the Person Who Has Been Poisoned 295
· THE NURSING ASSISTANT IN ACTION: Responding in an Emergency 297
CHAPTER 14 The Human Body 300
Anatomy and Physiology 302
Cells, Tissues, and Organs 302
Body Systems 307
Anatomical Position 307
· THE NURSING ASSISTANT IN ACTION: Are Abnormal Cells Always Cancer Cells? 311
CHAPTER 15 Growth and Development 314
Growth and Development 316
Chronological-Age Considerations 320
· THE NURSING ASSISTANT IN ACTION: Baby Talk 323
CHAPTER 16 The Musculoskeletal System and Related Care 326
The Muscular System 328
The Skeletal System 330
The Musculoskeletal System and the Normal Aging Process 332
Common Diseases and Disorders of the Musculoskeletal System 333
Care of the Orthopedic Patient 334
Total Hip Replacement (THR) 338
· GUIDELINES: Caring for Patients with THR 339
Total Knee Replacement 339
· THE NURSING ASSISTANT IN ACTION: Itching Inside the Cast 341
CHAPTER 17 The Integumentary System and Related Care 344
The Skin (Integumentary System) 346
Care of the Patient with Potential Skin Problems 349
· GUIDELINES: Preventing Pressure Ulcers 352
· GUIDELINES: Foot Care 353
Equipment and Devices that Reduce Pressure on the Skin 354
· PROCEDURE: Safe Skin Cleansing for the Incontinent Patient 359
· THE NURSING ASSISTANT IN ACTION: Patient Incontinent at Shift Change 361
CHAPTER 18 The Circulatory and Respiratory
Systems and Related Care 364
The Circulatory System: Anatomy and Physiology 366
The Circulatory System and the Normal Aging Process 371
Common Diseases and Disorders of the Circulatory System 371
· GUIDELINES: Providing Care for Patients with Peripheral Vascular Disease 372
· GUIDELINES: Providing Care for Patients with Hypertensive Disease 372
The Respiratory System: Anatomy and Physiology 372
The Respiratory System and the Normal Aging Process 374
Common Diseases and Disorders of the Respiratory System 375
· THE NURSING ASSISTANT IN ACTION: Heart Patient Wants to Smoke 379
CHAPTER 19 Measuring Vital Signs 382
Body Temperature 384
· GUIDELINES: Care of Glass Thermometers 385
· PROCEDURE: Shaking Down the Glass Thermometer 386
· PROCEDURE: Reading a Fahrenheit Thermometer 386
· PROCEDURE: Reading a Centigrade (Celsius) Thermometer 387
· PROCEDURE: Measuring an Oral Temperature 389
· PROCEDURE: Using a Battery-Operated Electronic Oral Thermometer 390
· PROCEDURE: Using a Battery-Operated Electronic Tympanic or
Aural (Ear) Thermometer 391
· PROCEDURE: Measuring Rectal Temperature Using a Glass Thermometer 392
· PROCEDURE: Using a Battery-Operated Electronic Rectal Thermometer 393
· PROCEDURE: Measuring Axillary Temperature Using a Glass Thermometer 394
· PROCEDURE: Using a Battery-Operated Electronic Oral Thermometer to
Measure Axillary Temperature 394
Pulse 395
· PROCEDURE: Measuring the Radial Pulse 397
· PROCEDURE: Measuring the Apical Pulse 399
· PROCEDURE: Measuring the Apical Pulse Deficit 399
Respirations 400
· PROCEDURE: Measuring Respiration 401
Blood Pressure 402
· GUIDELINES: Noninvasive Blood Pressure Monitoring (NIBP) 405
· PROCEDURE: Measuring Blood Pressure Using a Sphygmomanometer 405
CHAPTER 20 The Gastrointestinal System and Related Care 410
The Gastrointestinal System (Digestive System) 412
Tube Feedings 415
· GUIDELINES: Caring for the Patient with a Nasogastric Tube (NG) 417
· GUIDELINES: Gastrostomy Tube (GT, PEG, or PEG-J) Daily Care 419
· GUIDELINES: Tube Feedings 419
Diarrhea and Constipation 420
Rectal Treatments 421
· PROCEDURE: The Cleansing Enema 422
· PROCEDURE: Giving the Ready-to-Use Cleansing Enema 424
· PROCEDURE: Giving the Ready-to-Use Oil Retention Enema 426
· PROCEDURE: Giving the Harris Flush (Return-Flow Enema) 427
· PROCEDURE: Using the Disposable Rectal Tube with Connected Flatus Bag 429
The Ostomy 430
· PROCEDURE: Emptying the Ostomy Pouch 433
· PROCEDURE: Changing the Ostomy Appliance 434
CHAPTER 21 Nutrition for the Patient 438
A Well-Balanced Diet 440
What are Nutrients? 441
Regular and Special Diets 442
Assisting Patients With Foods 444
· PROCEDURE: Preparing the Patient for a Meal 444
· PROCEDURE: Serving the Food 445
· GUIDELINES: Feeding a Patient with Dysphasia 447
· PROCEDURE: Feeding the Physically Challenged Patient or the Patient
Who Is Unable to Feed Himself 447
Between-Meal Nourishment 448
· PROCEDURE: Serving Between-Meal Nourishment 449
Passing Drinking Water 449
· PROCEDURE: Passing Drinking Water 450
· THE NURSING ASSISTANT IN ACTION: Patient Requests Fast Food-Case 1 451
CHAPTER 22 The Urinary System and Related Care 454
Anatomy and Physiology of the Urinary System 456
Diseases and Disorders of the Urinary System 458
Homeostasis 458
Fluid Balance and Fluid Imbalance 459
Unit of Measurement 462
Measuring and Recording Fluid Intake 464
· PROCEDURE: Measuring the Capacity of Serving Containers 465
· PROCEDURE: Determining the Amounts Consumed 465
Force Fluids, Restrict Fluids, and NPO 466
· GUIDELINES: Force Fluids 467
· GUIDELINES: Restrict Fluids 467
· GUIDELINES: Nothing by Mouth (NPO) 468
Measuring and Recording Fluid Output 468
· PROCEDURE: Measuring Urinary Output 469
· GUIDELINES: Indwelling Urinary Catheter 470
· GUIDELINES: Checking Catheters and Containers 471
· PROCEDURE: Emptying Urine from an Indwelling Catheter Container 471
· PROCEDURE: Giving Daily Indwelling Catheter Care 472
· GUIDELINES: Discontinuing an Indwelling Catheter 473
· THE NURSING ASSISTANT IN ACTION: Patient is Unable to Urinate 475
CHAPTER 23 Specimen Collection 478
Specimen Collection 480
· GUIDELINES: Specimen Collection Accuracy 481
Urine Specimens 482
· PROCEDURE: Collecting a Routine Urine Specimen 482
· PROCEDURE: Collecting a Routine Urine Specimen from an Infant 483
· PROCEDURE: Collecting a Midstream Clean-Catch Urine Specimen 484
· PROCEDURE: Collecting a 24-Hour Urine Specimen 486
· PROCEDURE: Straining the Urine 487
Sputum Specimen 488
· PROCEDURE: Collecting a Sputum Specimen 488
Stool Specimen 489
· PROCEDURE: Collecting a Stool Specimen 489
· PROCEDURE: Preparing a Hemoccult Slide 490
CHAPTER 24 The Endocrine System and Related Care of Diabetics 494
Anatomy and Physiology of the Endocrine System 496
The Endocrine System and the Normal Aging Process 497
Common Diseases and Disorders of the Endocrine System 498
Diabetes Mellitus 498
· GUIDELINES: Care of the Feet and Skin for Diabetics 501
· PROCEDURE: Testing for Glucose Using the One-Touch
Profile Diabetes Tracking System 502
· THE NURSING ASSISTANT IN ACTION: Family Brings Sugary Foods to a Diabetic 505
CHAPTER 25 The Reproductive System and Related Care 508
The Reproductive System 510
Sexuality 513
The Reproductive System and the Normal Aging Process 513
Common Diseases and Disorders of the Reproductive System 514
Care of the Gynecological Patient 517
· PROCEDURE: Preparing the Patient for a Pelvic Exam 517
· PROCEDURE: Nonsterile Vaginal Irrigation (Douche) 519
Postpartum Care 520
· PROCEDURE: Postpartum Perineal Care 520
CHAPTER 26 The Nervous System and Related Care 524
Anatomy and Physiology of the Nervous System 526
Care of the Artificial Eye 531
· PROCEDURE: Caring for the Artificial Eye 532
Care of Eyeglasses 533
· PROCEDURE: Caring for Eyeglasses 533
Hearing Aids 533
The Nervous System and the Normal Aging Process 535
Care of the Seizure Patient 537
The Cerebrovascular Accident (Stroke) Patient 538
· GUIDELINES: Caring for a Cerebrovascular Accident Patient 539
Patients with Aphasia 540
· THE NURSING ASSISTANT IN ACTION: Aphasic Patient Confuses Family 541
CHAPTER 27 Warm and Cold Applications 544
Principles for Warm and Cold Applications 546
· PROCEDURE: Applying the Warm Compress (Moist Heat Applications) 549
· PROCEDURE: Applying the Warm Soak (Moist Warm Application) 550
· PROCEDURE: Applying the Warm-Water Bottle (Dry Heat Application) 551
· PROCEDURE: Applying the Commercial Unit Heat Pack (Moist Warm Application) 553
· PROCEDURE: Applying a Heat Lamp (Dry Warm Application) 553
· PROCEDURE: Applying the Aquamatic Hydro-Thermal (K-Pad, Dry
Heat Application) 554
· PROCEDURE: Using the Disposable Sitz Bath (Moist Warm Application) 555
· PROCEDURE: Using the Portable Chair-Type or Built-In Sitz Bath
(Moist Warm Application) 556
· PROCEDURE: Applying the Cold Compress (Moist Cold Application) 557
· PROCEDURE: Applying the Cold Soak (Moist Cold Application) 558
· PROCEDURE: Applying the Ice Bag, Ice Cap, or Ice Collar (Dry Cold Application) 559
· PROCEDURE: Applying the Commercial Unit Cold Pack (Dry Cold Application) 560
· GUIDELINES: Giving the Cooling (Tepid) Sponge Bath 561
· PROCEDURE: Giving the Cooling (Tepid) Sponge Bath 561
· THE NURSING ASSISTANT IN ACTION: Cold Pack in Place for an Unknown
Length of Time 563
CHAPTER 28 Care of the Surgical Patient 566
Preoperative Care 568
Skin Preparation 571
· PROCEDURE: Shaving a Patient in Preparation for Surgery 572
The Morning of Surgery 575
Postoperative Nursing Care 576
· PROCEDURE: Assisting the Patient with Deep-Breathing Exercises 580
CHAPTER 29 Special Procedures 584
Intravenous Infusion (IV) Equipment 586
Caring for the Patient with an Intravenous Infusion 587
· PROCEDURE: Changing a Patient's Gown 587
Binders 588
· GUIDELINES: Binders 588
Elastic Stockings and Elastic Bandages 589
· PROCEDURE: Applying Elastic Bandages 591
CHAPTER 30 Other Patients with Special Needs 594
Cancer and Benign Tumors 596
Immunosuppression 598
Mental Health and Mental Illness 600
· GUIDELINES: Preventing Depression 602
Substance Abuse 602
· GUIDELINES: Identifying the Signs and Symptoms of a Drinking Problem 605
CHAPTER 31 Neonatal and Pediatric Care 608
Neonatal Care 610
· GUIDELINES: Helping the Mother with Breast-Feeding 611
· PROCEDURE: Diapering the Baby 614
· GUIDELINES: Care of the Umbilical Cord 615
· PROCEDURE: Giving the Infant a Tub Bath 616
Pediatric Care 619
· GUIDELINES: Safety When Caring for the Child 620
· PROCEDURE: Measuring the Child's Pulse Rate (Heartbeat) 621
· PROCEDURE: Measuring the Child's Respiratory Rate 622
· PROCEDURE: Measuring the Child's Blood Pressure 622
· GUIDELINES: Communicating With Pediatric Patients 624
· THE NURSING ASSISTANT IN ACTION: Observing Bruises on a Toddler 625
CHAPTER 32 The Older Adult Patient and Long-Term Care 628
Physical Changes of the Geriatric Patient 630
Psychosocial and Psychological Aspects of Aging 631
· GUIDELINES: Meeting the Older Adult Person's Psychosocial Needs 635
Reality Orientation for the Confused Patient 636
Validation Therapy 637
Safety for the Older Adult Patient 639
Nursing Care for the Older Adult Patient 642
Maintaining Dignity and Quality of Life 644
CHAPTER 33 Rehabilitation and Return to Self-Care 648
The Holistic Approach to Rehabilitation 650
OBRA Requirements 651
The Professional Rehabilitation Team 651
Psychological Aspects of Rehabilitative Care 655
Psychosocial Aspects of Rehabilitative Care 656
Personal Care of the Disabled Patient 657
· GUIDELINES: Bathing the Disabled Patient 657
· GUIDELINES: Dressing and Grooming 658
· GUIDELINES: Assisting with Feeding 659
· PROCEDURE: Assisting with Feeding 659
· PROCEDURE: Bowel and Bladder Rehabilitation and Training 661
· PROCEDURE: Inserting a Rectal Suppository 662
· GUIDELINES: Range of Motion Exercises 663
· PROCEDURE: Range of Motion Exercises 663
Pediatric Rehabilitation 666
Subacute Care 667
· THE NURSING ASSISTANT IN ACTION: Patient Wants to Give Up on Rehab 669
CHAPTER 34 The Terminally Ill Patient and Postmortem Care 672
Psychological/Psychosocial Aspects of Caring for a Terminally Ill Patient 674
The Patient's Family or Significant Other 675
Hospice Care 677
Making the Patient Comfortable 678
Signs of Approaching Death 679
Postmortem Care (PMC) 680
· PROCEDURE: Postmortem Care 681
CHAPTER 35 Beginning Your Career as a Nursing Assistant 684
Preparing for the Competency Evaluation Exam 686
Pursuing Employment Opportunities 692
Positioning Yourself for Promotion 701
· GUIDELINES: Keeping a Job 702
· THE NURSING ASSISTANT IN ACTION: Lying on an Application 703
APPENDIX Medical Terms, Abbreviations, and Specialties 707
Abbreviations and Their Meanings 707
Word Elements: Roots, Prefixes, and Suffixes 711
Medical Specialties 713
Glossary 715
Index 731
PROCEDURES
Infection Control
· Handwashing, 96
· Putting on Disposable Gloves, 97
· Removing Gloves, 98
· Putting on a Mask, 99
· Application of a Gown, 100
· Removing a Gown, 101
Putting on Sterile Gloves, 106
Opening a Sterile Package, 107
Safety
· Applying a Waist Restraint, 124
· Applying a Vest Restraint, 125
· Application and Care of the Patient in Leather Restraints, 130
Moving and Transporting Patients
· Moving the Helpless Patient Up in Bed, 151
· Moving a Patient Up in Bed with the Patient's Help, 152
· Moving the Mattress to the Head of the Bed with the Patient's Help, 153
· Moving a Helpless Patient to One Side of the Bed on the Patient's Back, 154
· Rolling the Patient Like a Log (Log Rolling), 156
· Turning a Patient onto the Patient's Side Toward You, 157
· Turning a Patient onto the Patient's Side Away from You, 158
· Repositioning a Patient in a Chair or Wheelchair, 159
· Moving the Nonambulatory Patient into a Wheelchair or Arm Chair from the Bed, 161
· Helping a Nonambulatory Patient Back into Bed from a Wheelchair or Arm Chair, 162
· Helping an Ambulatory Patient Who Can Stand, Back into Bed from a Chair or a Wheelchair, 163
· Using a Portable Mechanical Patient Lift to Move the Helpless Patient, 164
· Moving a Patient from the Bed to a Stretcher, 167
· Moving a Patient from a Stretcher to the Bed, 168
Admitting, Transferring, and Discharging
· Admitting the Patient, 178
· Weighing and Measuring the Height of a Patient Who is able to Stand, 181
· Transferring the Patient, 183
· Discharging the Patient, 187
Bedmaking
· Making the Closed, Empty Bed, 207
· Making the Open, Fanfolded, or Empty Bed, 211
· Making the Postoperative or Surgical Bed, 211
· Making the Occupied Bed, 213
Infant Home Care
Sterilizing Tap Water, 233
Sterilizing Bottles, 234
Personal Care
· Oral Hygiene, 250
· Cleaning Dentures (False Teeth), 250
· Oral Hygiene for the Unconscious Patient (Special Mouth Care), 251
· The Complete Bed Bath, 254
· The Partial Bed Bath (Partial Self-Care), 257
· The Tub Bath, 258
· Helping the Patient Take a Shower, 260
· Perineal Care for the Male Patient, 261
· Perineal Care for the Female Patient, 262
· Giving the Patient a Back Rub, 264
· Changing the Patient's Gown, 265
· Shampooing the Patient's Hair, 267
· Combing the Patient's Hair, 268
· Shaving the Patient's Beard, 270
· Offering the Bedpan, 271
· Offering the Urinal, 272
· Offering the Portable/Bedside Commode, 273
Skin Care
· Safe Skin Cleansing for the Incontinent Patient, 359
Measuring Vital Signs
· Shaking Down the Glass Thermometer, 386
· Reading a Fahrenheit Thermometer, 386
· Reading a Centigrade (Celsius) Thermometer, 387
· Measuring an Oral Temperature, 389
· Using a Battery-Operated Electronic Oral Thermometer, 390
· Using a Battery-Operated Electronic Tympanic or Aural (Ear) Thermometer, 391
· Measuring Rectal Temperature Using a Glass Thermometer, 392
· Using a Battery-Operated Electronic Rectal Thermometer, 393
· Measuring Axillary Temperature Using a Glass Thermometer, 394
· Using a Battery-Operated Electronic Oral Thermometer to Measure Axillary Temperature, 394
· Measuring the Radial Pulse, 397
· Measuring the Apical Pulse, 399
Measuring the Apical Pulse Deficit, 399
· Measuring Respiration, 401
· Measuring Blood Pressure Using a Sphygmomanometer, 405
Rectal Treatments
· The Cleansing Enema, 422
· Giving the Ready-to-Use Cleansing Enema, 424
· Giving the Ready-to-Use Oil Retention Enema, 426
· Giving the Harris Flush (Return-Flow Enema), 427
Using the Disposable Rectal Tube With Connected Flatus Bag, 429
· Emptying the Ostomy Pouch, 433
· Changing the Ostomy Appliance, 434
Nutrition
· Preparing the Patient for a Meal, 444
· Serving the Food, 445
· Feeding the Physically Challenged Patient or the Patient Who is Unable to Feed Himself, 447
Serving Between-Meal Nourishment, 449
Passing Drinking Water, 450
Measuring and Recording Fluid Intake
· Measuring the Capacity of Serving Containers, 465
· Determining the Amounts Consumed, 465
Measuring and Recording Fluid Output
· Measuring Urinary Output, 469
· Emptying Urine from an Indwelling Catheter
Container, 471
· Giving Daily Indwelling Catheter Care, 472
Specimen Collection
· Collecting a Routine Urine Specimen, 482
Collecting a Routine Urine Specimen from an Infant, 483
· Collecting a Midstream Clean-Catch Urine
Specimen, 484
· Collecting a 24-Hour Urine Specimen, 486
· Straining the Urine, 487
· Collecting a Sputum Specimen, 488
· Collecting a Stool Specimen, 489
Preparing a Hemoccult Slide, 490
Testing of Blood Glucose
Testing for Glucose Using the One-Touch Profile Diabetes Tracking System 502
Care of the Gynecological Patient
Preparing the Patient for a Pelvic Exam, 517
Nonsterile Vaginal Irritation (Douche), 519
Postpartum Care
Postpartum Perineal Care, 520
The Eye
Caring for the Artificial Eye, 532
Caring for Eyeglasses, 533
Warm and Cold Applications
· Applying the Warm Compress (Moist Heat
Applications), 549
· Applying the Warm Soak (Moist Warm Application), 550
· Applying the Warm-Water Bottle (Dry Heat
Application), 551
Applying the Commercial Unit Heat Pack (Moist Warm Application), 553
· Applying a Heat Lamp (Dry Warm Application), 553
· Applying the Aquamatic Hydro-Thermal (K-Pad, Dry Heat Application), 554
· Using the Disposable Sitz Bath (Moist Warm Application), 555
Using the Portable Chair-Type or Built-In Sitz Bath (Moist Warm Application), 556
· Applying the Cold Compress (Moist Cold Application), 557
· Applying the Cold Soak (Moist Cold Application), 558
· Applying the Ice Bag, Ice Cap, or Ice Collar (Dry Cold Application), 559
· Applying the Commercial Unit Cold Pack (Dry Cold Application), 560
Giving the Cooling (Tepid) Sponge Bath, 561
Care of the Surgical Patient
Shaving a Patient in Preparation for Surgery, 572
· Assisting the Patient with Deep-Breathing Exercises, 580
Special Procedures
· Changing a Patient's (with IV) Gown, 587
· Applying Elastic Bandages, 591
Neonatal and Pediatric Care
Diapering the Baby, 614
Giving the Infant a Tub Bath, 616
Measuring the Child's Pulse Rate (Heartbeat), 621
Measuring the Child's Respiratory Rate, 622
Measuring the Child's Blood Pressure, 622
Rehabilitation and Return to Self-Care
· Assisting with Feeding, 659
Bowel and Bladder Rehabilitation and Training, 661
Inserting a Rectal Suppository, 662
· Range of Motion Exercises, 663
Postmortem Care
· Postmortem Care, 681
· Indicates mandatory OBRA content. The page number follows the procedure title.
GUIDELINES
· Indicates mandatory OBRA content. The page number follows the guideline title.
Your Role as a Nursing Assistant
Ways to Reduce Stress, 21
· Code of Ethics, 21
· Work Rules and Instructions, 24
Communication Skills
· Communicating with Patients, 42
· Communicating with Visitors, 45
Customer Focused Care
Appreciating Cultural Diversity, 68
· Dealing with the Disruptive Individual, 75
General Techniques to Try, 75
Infection Control
· Handwashing, 96
· Using Masks to Prevent Cross Infection, 99
Care and Cleaning of Noncritical Items, 100
Maintaining a Sterile Field, 105
Safety
· Safety Measures, 114
Safety Measures for Young Children, 115
· Oxygen Safety, 117
· Patient Ambulation Safety, 138
Positioning and Moving
· Proper/Protective Body Mechanics, 144
· Moving and Lifting Patients, 150
· Assisting a Falling Patient, 170
Bedmaking
· Bedmaking, 206
Home Care
Storing Formula, 232
Helping Patient Bathe
· Bathing the Patient, 253
Emergency Care
· Assisting a Person in an Emergency, 281
Assisting the Person in Shock, 283
· Assisting the Person Having a Heart Attack, Chest Pain, or Myocardial Infarction, 285
Performing the Heimlich Maneuver, 289
Assisting a Person Who is Suspected of Having a Stroke, 290
Assisting a Person who is Having a Seizure, 290
Assisting the Person Who is Hemorrhaging, 292
Assisting the Person Who Has Been Burned, 293
Assisting the Person Who Has Been Poisoned, 295
Total Hip Replacement (THR)
Caring for Patients with THR, 339
Skin Care
· Preventing Pressure Ulcers, 352
· Foot Care, 353
Disorders of the Circulatory System
· Providing Care for Patients with Peripheral Vascular Disease, 372
Providing Care for Patients with Hypertensive Disease, 372
Measuring Vital Signs
· Care of Glass Thermometers, 385
Noninvasive Blood Pressure Monitoring (NIBP), 405
Tube Feedings
Caring for the Patient with a Nasogastric Tube (NG), 417
Gastrostomy Tube (GT, PEG, or PEG-J) Daily Care, 419
Tube Feeding, 419
Nutrition and Fluids
Feeding a Patient with Dysphasia, 447
Force Fluids, 467
Restrict Fluids, 467
· Nothing by Mouth (NPO), 468
Urinary Catheters
· Indwelling Urinary Catheter, 470
· Checking Catheters and Containers, 471
Discontinuing an Indwelling Catheter, 473
Specimen Collection
· Specimen Collection Accuracy, 481
Diabetes Mellitus
· Care of the Feet and Skin for Diabetics, 501
The Stroke Patient
· Caring for a Cerebrovascular Accident Patient, 539
Cold Applications
Giving the Cooling (Tepid) Sponge Bath, 561
Use of Binders
Binders, 588
Special Needs
Preventing Depression, 602
Substance Abuse
Identifying the Signs and Symptoms of a Drinking Problem, 605
Neonatal and Pediatric Care
Helping the Mother with Breast-feeding, 611
Care of the Umbilical Cord, 615
Safety When Caring for the Child, 620
Communicating With Pediatric Patients, 624
The Older Adult
· Meeting the Older Adult Person's Psychosocial
Needs, 635
· Bathing the Disabled Patient, 657
· Dressing and Grooming, 658
· Assisting with Feeding, 659
· Range of Motion Exercises, 663
Your Career
Keeping a Job, 702



Library of Congress Subject Headings for this publication: Nurses' aides, Nurses' Aides, Nursing Care methods