Skin & Pressure Injuries
A resident who cannot change positions independently has an increased risk for developing this.
Pressure injury
This body area should normally be washed every day.
Perineal area
A resident has right-sided weakness after a stroke. When dressing the resident, this arm goes into the shirt first.
the right/affected arm
A resident lying flat on the back is in this position.
Supine
A transfer belt should be placed here on the resident.
around the waist over the resident’s clothing
Demonstrate how you would correctly place a gait belt on a resident.
Belt over clothing, around the waist, snug but not too tight, with room for flat fingers underneath.
A resident spends most of the day in bed and needs help changing positions. What makes this resident more likely to develop a pressure injury?
Restricted mobility.
When providing female perineal care, the CNA should clean in this direction.
Front to back
When undressing a resident with one-sided weakness, clothing should be removed from this side first.
the stronger/unaffected side
A resident lying on the stomach is in this position.
Prone
When transferring a resident with one weak side from the bed into a wheelchair, the wheelchair is generally placed on this side.
the stronger side
Demonstrate how you would position a resident in Fowler’s position using the bed and pillows.
Head and shoulders elevated, resident aligned and supported, comfort checked.
This stage of pressure injury involves intact skin with persistent redness or discoloration.
Stage 1
Before helping a resident into a bath or shower, the CNA should make sure this is comfortable and safe.
water temperature
A resident cannot easily raise the hips to use a regular bedpan. The CNA should use this instead.
a fracture pan
A resident lying on either side is in this position.
Lateral
Before standing, a resident sits on the side of the bed with the legs hanging over the edge. This procedure is called what?
dangling
Demonstrate how you would dress a resident who has weakness on the right side.
Dress the weak/right side first and encourage the resident to participate.
A CNA notices persistent redness over a resident’s sacrum during morning care. What should the CNA do?
relieve the pressure/reposition the resident and report the skin change to the nurse?
Why should the CNA make sure the room is warm before beginning a resident’s bath?
to prevent chilling and maintain the resident’s comfort
Dentures should never be cleaned using this temperature of water because it can damage their shape.
hot water
The resident’s head and shoulders are elevated approximately 45–60 degrees. Name the position.
Fowler's
A resident must be moved while keeping the head, shoulders, hips, and legs aligned as one unit. What technique should the CNA use?
logrolling
Show how you would prepare a resident to dangle before a transfer. Explain what you are watching for while they sit at the bedside.
Resident sits safely on edge of bed with feet/legs supported appropriately; CNA watches for dizziness, weakness, pallor, or loss of balance.
A resident is frequently incontinent, cannot reposition independently, and has poor nutrition. Explain why this resident has such a high risk for pressure injury.
multiple risk factors—moisture, immobility, and poor nutrition—that contribute to skin breakdown?
During a bath, the CNA discovers a new reddened area over the resident’s hip. The resident says, “It doesn't hurt, so don't worry about it.” What should the CNA do?
report the skin change to the nurse and relieve pressure from the area
A resident with dementia insists on wearing a sweater that does not match the CNA’s choice of clothing. The clothing is safe and appropriate for the weather. What should the CNA do?
respect the resident’s choice and allow them to wear the sweater
The resident is side-lying with the upper knee flexed toward the chest. Name the position.
Sims
A resident begins to fall while being transferred with a gait belt. Instead of trying to hold the resident upright, what should the CNA do?
widen the stance, bring the resident close, and lower/guide the resident safely to the floor
Your resident begins to fall during a transfer. Demonstrate, using a partner or mannequin, what you would do.
Widen stance, bring resident close, bend knees, control the descent, and guide them safely down rather than trying to hold them upright.
A resident’s skin is intact, but the CNA notices a dark red area over the coccyx that feels warmer than the surrounding skin. What should the CNA do?
relieve pressure from the area and report the skin change to the nurse
A resident can wash their face and upper body independently but needs help with the lower body. What is the best way for the CNA to provide care?
allow the resident to do the parts they can safely do and assist only where needed
Why is oral care especially dangerous for an unconscious resident?
how do you rinse an unconscious resident's teeth
risk of aspiration
Mouth swab dipped in water.
A resident must remain on one side with pillows supporting the back and legs to maintain alignment and reduce pressure. What general position is this?
Lateral
A resident who normally transfers with one-person assistance suddenly cannot bear weight when standing. What should the CNA do?
stop the transfer, return the resident to a safe position, get help, and follow the care plan for the appropriate transfer method?
show me how you put a hoyer sling under a resident
handle on the outside, aligned with shoulders, tucked evenly under the patient.