Sudden onset, short duration (e.g., flu, appendicitis).
Acute illness
Assist with activities of daily living (ADLs): bathing, dressing, eating, toileting, mobility.
• Observe and report changes.
• Provide emotional support.
• Not allowed: Giving meds (unless trained/authorized), inserting tubes, performing sterile procedures.
• Refusing a task: Allowed if it is unsafe, illegal, or beyond training.
Role of nursing assistant
Use clear, simple words.
• Active listening.
• Observe nonverbal cues.
• With comatose residents: Speak normally, explain care, they may still hear.
Communication
• Steps:
1. Assessment (data collection – objective & subjective).
2. Diagnosis (nurse responsibility).
3. Planning (care plan with goals).
4. Implementation (nursing assistant helps carry out care).
5. Evaluation (check progress).
Nursing process
Reporting: Verbally tell the nurse important changes.
• Recording: Document accurately, objectively, in ink/electronically.
• Legal document → must be factual, not opinion.
Resident’s Medical Record
Observable, measurable (vital signs, skin color).
Objective data
Long-term, often lifelong, managed not cured (e.g., diabetes, arthritis).
Chronic illness
Cooperate with staff.
• Share information clearly.
• Support coworkers and residents.
Teamwork
Right to privacy, dignity, respect, informed consent, personal choice.
• Right to voice complaints without fear.
• Right to quality care and freedom from abuse/neglect.
• Right to access personal records.
Resident rights
Professional Appearance & Conduct
Clean uniform, good hygiene, no excessive jewelry/perfume.
• Be punctual, respectful, and maintain confidentiality (HIPAA).
• Stay within scope of practice.
Reported by patient (pain, nausea).
Subjective data:
Addressing Residents
Use respectful titles (Mr., Mrs., Miss, or preferred name).
• Never use nicknames unless resident asks.
• Be polite and kind.
No cure, leads to death (e.g., advanced cancer).
Terminal illness
Physical: food, water, oxygen, shelter.
2. Safety & Security: protection, stability.
3. Love & Belonging: relationships, social needs.
4. Self-Esteem: respect, independence, confidence.
5. Self-Actualization: reaching full potential.
Maslow’s Hierarchy of Needs
Types: Physical, emotional, sexual, financial, neglect.
• Reporting: Immediately to nurse/supervisor ; legally required.
Abuse and reporting
• Residents may have beliefs about healthcare, diet, or rituals.
• Respect and accommodate whenever possible.
Religion & Culture
Physical: weaker muscles, slower movement, fragile skin, vision/hearing loss.
• Mental: slower recall, not always memory loss (dementia is not normal aging).
• Emotional: coping with loss, loneliness, possible depression.
Aging Process
paralysis of lower body (legs).
Paraplegia
Includes: doctors, nurses, nursing assistants, therapists, dietitians, social workers, clergy, etc.
• Goal: Provide coordinated, patient-centered care.
• Function: Share information, set care goals, evaluate progress.
Interdisciplinary team
paralysis of one side of the body (common after stroke).
Hemiplegia
paralysis of all four limbs
Quadriplegia
Federal law to improve care in nursing homes.
• Requirements for nurse aide training:
• At least 75 hours of training.
• Competency exam (written + skills).
• Continuing education.
• Competency evaluation before working independently.
OBRA (Omnibus Budget Reconciliation Act of 1987)