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Cheatography

Nursing Assistant Skills Cheat Sheet by

Hand Hyiege

1 Address client by name and introduces self to client by name
2 Turns on water at sink
3 Wets hands and wrists thoroughly
4 Applies soap to hands
5 Lathers all surfaces of wrists, hands, and fingers producing friction, for at least 20 (twenty) seconds, keeping hands lower than the elbows and the fingertips down
6 Cleans finger­nails by rubbing fingertips against palms of the opposite hand
7 Rinse all surfaces of wrists, hands, and fingers, keeping hands lower than the elbows and the fingertips down
8 Uses clean, dry paper towel/­towels to dry all surfaces of hands, wrists, and fingers then disposes of paper towel/­towels into waste container
9 Uses clean, dry paper towel/­towels to turn off faucet then disposes of paper towel/­towels into waste container or uses knee/foot control to turn off faucet
10 Does not touch inside of sink at any time
Sing the Happy Birthday song out loud while practi­cing.
When wetting hands start with finger tips and end an inch or so above the wrists.
When rinsing start with wrists and end with finger tips.
Pat dry hands (finge­rtips to wrists)

Apply Knee-High Elastic Stocking

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Client is in supine position (lying down in bed) while stocking is applied
4 Turns stocking inside­-out, at least to the heel
5 Places foot of stocking over toes, foot, and heel
6 Pulls top of stocking over foot, heel, and leg
7 Moves foot and leg gently and naturally, avoiding force and over-e­xte­nsion of limb and joints
8 Finishes procedure with no twists or wrinkles and heel of stocking, if present, is over heel and opening in toe area (if present) is either over or under toe area
9 Signaling device is within reach and bed is in low position
10 After completing skill, wash hands
Line up green square to the bottom of the heel.
CANNOT HAVE WRINKLES OR TWISTS.

Assists To Ambulate Using Transfer Belt

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Before assisting to stand, client is wearing shoes
3 Before assisting to stand, bed is at a safe level
4 Before assisting to stand, checks and/or locks bed wheels
5 Before assisting to stand, client is assisted to sitting position with feet flat on the floor
6 Before assisting to stand, applies transfer belt securely at the waist over clothi­ng/gown
7 Before assisting to stand, provides instru­ctions to enable client to assist in standing including prearr­anged signal to alert client to begin standing
8 Stands facing client positi­oning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearr­anged signal) to alert client to begin standing
9 On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candi­date’s hands are in upward position), and mainta­ining stability of client’s legs
10 Walks slightly behind and to one side of client for a distance of ten (10) feet, while holding onto the belt
11 After ambula­tion, assists client to bed and removes transfer belt
12 Signaling device is within reach and bed is in low position
13 After completing skill, wash hands
When using transfer belt grab it with fingers under, close to body and the thumb on the outside of the belt to have good control.

Assist With Use Of Bedpan

1 Explains procedure speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Before placing bedpan, lowers head of bed
4 Puts on clean gloves before handling bedpan
5 Places bedpan correctly under client’s buttocks
6 Removes and disposes of gloves (without contam­inating self) into waste container and washes hands
7 After positi­oning client on bedpan and removing gloves, raises head of bed
8 Toilet tissue is within reach
9 Hand wipe is within reach and client is instructed to clean hands with hand wipe when finished
10 Signaling device within reach and client is asked to signal when finished
11 Puts on clean gloves before removing bedpan
12 Head of bed is lowered before bedpan is removed
13 Avoids overex­posure of client
14 Empties and rinses bedpan and pours rinse into toilet
15 After rinsing bedpan, places bedpan in designated dirty supply area
16 After placing bedpan in designated dirty supply area, removes and disposes of gloves (without contam­inating self) into waste container and washes hands
17 Signaling device is within reach and bed is in low position
Wash hands before and after procedure.
Provide GOOD privacy (this is embarr­assing for both parties).
Make 100% sure that bedpan is placed correctly (provides comfort).

Cleans Upper and Lower Denture

1 Puts on clean gloves before handling denture
2 Bottom of sink is lined and/or sink is partially filled with water before denture is held over sink
3 Rinses denture in moderate temper­ature running water before brushing them
4 Applies toothpaste to toothbrush
5 Brushes surfaces of denture
6 Rinses surfaces of denture under moderate temper­ature running water
7 Before placing denture into cup, rinses denture cup and lid
8 Places denture in denture cup with moderate temper­ature water/­sol­ution and places lid on cup
9 Rinses toothbrush and places in designated toothbrush basin/­con­tainer
10 Maintains clean technique with placement of toothbrush and denture
11 Sink liner is removed and disposed of approp­riately and/or sink is drained
12 After rinsing equipment and disposing of sink liner, removes and disposes of gloves (without contam­inating self) into waste container and washes hands
Brush all of the denture, not just the teeth.
Sink liner helps prevent germs from spreading in the case that the dentures fall out of hands.

Counts and Records Radial Pulse

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Places fingertips on thumb side of client’s wrist to locate radial pulse
3 Count beats for one full minute
4 Signaling device is within reach
5 Before recording, washes hands
6 After obtaining pulse by palpating in radial artery position, records pulse rate within plus or minus 4 beats of evalua­tor’s reading
Never try and find pulse with thumb

Counts and Records Respir­ations

1 Explains procedure (for testing purposes), speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Counts respir­ations for one full minute
3 Signaling device is within reach
4 Washes hands
5 Records respir­ation rate within plus or minus 2 breaths of evalua­tor’s reading
Do not let the person know that you are taking this, it will cause the patient to focus on their breathing. Making the reading inaccu­rate.

Gowning

1 Picks up gown and unfolds
2 Facing the back opening of the gown places arms through each sleeve
3 Fastens the neck opening
4 Secures gown at waist making sure that back of clothing is covered by gown (as much as possible)
5 Puts on gloves
6 Cuffs of gloves overlap cuffs of gown
7 Before removing gown, with one gloved hand, grasps the other glove at the palm, remove glove
8 Slips fingers from ungloved hand underneath cuff of remaining glove at wrist, and removes glove turning it inside out as it is removed
9 Disposes of gloves into designated waste container without contam­inating self
10 After removing gloves, unfastens gown at neck and waist
11 After removing gloves, removes gown without touching outside of gown
12 While removing gown, holds gown away from body without touching the floor, turns gown inward and keeps it inside out
13 Disposes of gown in designated container without contam­inating self
14 After completing skill, washes hands
Never touch outside of gown or outside of gloves!

Dresses Patient With Weak Right Side

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Asks which shirt he/she would like to wear and dresses him/her in shirt of choice
4 While avoiding overex­posure of client, removes gown from the unaffected side first, then removes gown from the affected side and disposes of gown into soiled linen container
5 Assists to put the right (affec­ted­/weak) arm through the right sleeve of the shirt before placing garment on left (unaff­ected) arm
6 While putting on shirt, moves body gently and naturally, avoiding force and over-e­xte­nsion of limbs and joints
7 Finishes with clothing in place
8 Signaling device is within reach and bed is in low position
9 After completing skill, washes hands
Always let the patient make the decision on what they want to wear. Allows them to feel that they are still indepe­ndent.
Always start with the affected side first then the unaffected side.

Feed Client Who Cannot Feel Self

1 Explains procedure to client, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Before feeding, looks at name card on tray and asks client to state name
3 Before feeding client, client is in an upright sitting position (75-90 degrees)
4 Places tray where the food can be easily seen by client
5 Candidate cleans client’s hands with hand wipe before beginning feeding
6 Candidate sits facing client during feeding
7 Tells client what foods are on tray and asks what client would like to eat first
8 Using spoon, offers client one bite of each type of food on tray, telling client the content of each spoonful
9 Offers beverage at least once during meal
10 Candidate asks client if they are ready for next bite of food or sip of beverage
11 At end of meal, candidate cleans client’s mouth and hands with wipes
12 Removes food tray and places tray in designated dirty supply area
13 Signaling device is within client’s reach
14 After completing skill, washes hands
Always make sure it's the right person due to food allergies.
75-90 degrees to help prevent choking.

Gives Modified Bed Bath (face & one arm)

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Removes gown and places in soiled linen container, while avoiding overex­posure of the client
4 Before washing, checks water temper­ature for safety and comfort and asks client to verify comfort of water
5 Puts on clean gloves before washing client
6 Beginning with eyes, washes eyes with wet washcloth (no soap), using a different area of the washcloth for each stroke, washing inner aspect to outer aspect then proceeds to wash face
7 Dries face with towel
8 Exposes one arm and places towel underneath arm
9 Applies soap to wet washcloth
10 Washes arm, hand, and underarm keeping rest of body covered
11 Rinses and dries arm, hand, and underarm
12 Moves body gently and naturally, avoiding force and over-e­xte­nsion of limbs and joints
13 Puts clean gown on client
14 Empties, rinses, and dries basin
15 After rinsing and drying basin, places basin in designated dirty supply area
16 Disposes of linen into soiled linen container
17 Avoids contact between candidate clothing and used linens
18 After placing basin in designated dirty supply area, and disposing of used linen, removes and disposes of gloves (without contam­inating self) into waste container and washes hands
19 Signaling device is within reach and bed is in low position

Measures and Records Blood Pressure

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Before using stetho­scope, wipes bell/d­iap­hragm and earpieces of stetho­scope with alcohol
3 Client’s arm is positioned with palm up and upper arm is exposed
4 Feels for brachial artery on inner aspect of arm, at bend of elbow
5 Places blood pressure cuff snugly on client’s upper arm, with sensor­/arrow over brachial artery site
6 Earpieces of stetho­scope are in ears and bell/d­iap­hragm is over brachial artery site
7 Candidate inflates cuff between 160 mm Hg to 180 mm Hg. If beat heard immedi­ately upon cuff deflation, completely deflate cuff. Re-inflate cuff to no more than 200 mm Hg
8 Deflates cuff slowly and notes the first sound (systolic reading), and last sound (diastolic reading) (If rounding needed, measur­ements are rounded UP to the nearest 2 mm of mercury)
9 Removes cuff
10 Signaling device is within reach
11 Before recording, washes hands
12 After obtaining reading using BP cuff and stetho­scope, records both systolic and diastolic pressures each within plus or minus 8 mm of evalua­tor’s reading
Pulse found up from the pinky.

Measures and Records Urinary Input and Output

1) Puts on clean gloves before handling bedpan
2) Pours the contents of the bedpan into measuring container without spilling or splashing urine outside of container
3) Measures the amount of urine at eye level with container on flat surface
4) After measuring urine, empties contents of measuring container into toilet
5) Rinses measuring container and pours rinse into toilet
6) Rinses bedpan and pours rinse into toilet
7) After rinsing equipment, and before recording output, removes and disposes of gloves (without contam­inating self) into waste container and washes hands
8) Records contents of container within plus or minus 25 ml/cc of evalua­tor’s reading

Meaures and Records Weight of Ambulatory Client

1) Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2) Client has shoes on before walking to scale
3) Before client steps on scale, candidate sets scale to zero
4) While client steps onto scale, candidate stands next to scale and assists client, if needed, onto center of scale; then obtains client’s weight
5) While client steps off scale, candidate stands next to scale and assists client, if needed, off scale before recording weight
6) Before recording, washes hands
7) Records weight based on indicator on scale. Weight is within plus or minus 2 lbs of evalua­tor’s reading (If weight recorded in kg weight is within plus or minus 0.9 kg of evalua­tor’s reading)
Always set scale to zero first

Preform Modified PROM For One Knee or Ankle

1) Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2) Privacy is provided with a curtain, screen, or door
3) Instructs client to inform candidate if pain is experi­enced during exercise
4) Supports leg at knee and ankle while performing range of motion for knee
5) Bends the knee and then returns leg to client’s normal position (exten­sio­n/f­lexion) (AT LEAST 3 TIMES unless pain is verbal­ized)
6) Supports foot and ankle close to the bed while performing range of motion for ankle
7) Pushes­/pulls foot toward head (dorsi­fle­xion), and pushes­/pulls foot down, toes point down (plantar flexion) (AT LEAST 3 TIMES unless pain is verbal­ized)
8) While supporting the limb, moves joints gently, slowly, and smoothly through the range of motion, discon­tinuing exercise if client verbalizes pain
9) Signaling device is within reach and bed is in low position
10) After completing skill, washes hands
Always ask if there is pain felt.

PROM on One Shoulder

1) Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2) Privacy is provided with a curtain, screen, or door
3) Instructs client to inform candidate if pain experi­enced during exercise
4) Supports client’s upper and lower arm while performing range of motion for shoulder
5) Raises client’s straig­htened arm from side position upward toward head to ear level and returns arm down to side of body (flexi­on/­ext­ension) (AT LEAST 3 TIMES unless pain is verbal­ized). Supporting the limb, moves joint gently, slowly, and smoothly through the range of motion, discon­tinuing exercise if client verbalizes pain
6) Moves client’s straig­htened arm away from the side of body to shoulder level and returns to side of body (abduc­tio­n/a­ddu­ction) (AT LEAST 3 TIMES unless pain is verbal­ized). Supporting the limb, moves joint gently, slowly, and smoothly through the range of motion, discon­tinuing exercise if client verbalizes pain
7) Signaling device is within reach and bed is in low position
8) After completing skill, washes hands
Steps 5 and 6 are most important.

Positions On One Side

1) Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2) Privacy is provided with a curtain, screen, or door
3) Before turning, lowers head of bed
4) Raises side rail on side to which body will be turned
5) Slowly rolls onto side as one unit toward raised side rail
6) Places or adjusts pillow under head for support
7) Candidate positions client so that client is not lying on arm
8) Supports top arm with supportive device
9) Places supportive device behind client’s back
10) Places supportive device between legs with top knee flexed; knee and ankle supported
11) Signaling device is within reach and bed is in low position
12) After completing skill, washes hands

Catheter Care for Female

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Before washing, checks water temper­ature for safety and comfort and asks client to verify comfort of water
4 Puts on clean gloves before washing
5 Places linen protector under perineal area before washing
6 Exposes area surrou­nding catheter while avoiding overex­posure of client
7 Applies soap to wet washcloth
8 While holding catheter at meatus without tugging, cleans at least four inches of catheter from meatus, moving in only one direction (i.e., away from meatus) using a clean area of the cloth for each stroke
9 While holding catheter at meatus without tugging, rinses at least four inches of catheter from meatus, moving only in one direction, away from meatus, using a clean area of the cloth for each stroke
10 While holding catheter at meatus without tugging, dries at least four inches of catheter moving away from meatus
11 Empties, rinses, and dries basin
12 After rinsing and drying basin, places basin in designated dirty supply area
13 Disposes of used linen into soiled linen container and disposes of linen protector approp­riately
14 Avoids contact between candidate clothing and used linen
15 After disposing of used linen and cleaning equipment, removes and disposes of gloves (without contam­inating self) into waste container and washes hands
16 Signaling device is within reach and bed is in low position
Careful with cleaning to not hurt the patient

Foot Care on One Foot

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Before washing, checks water temper­ature for safety and comfort and asks client to verify comfort of water
4 Basin is in a comfor­table position for client and on protective barrier
5 Puts on clean gloves before washing foot
6 Client’s bare foot is placed into the water
7 Applies soap to wet washcloth
8 Lifts foot from water and washes foot (including between the toes)
9 Foot is rinsed (including between the toes)
10 Dries foot (including between the toes)
11 Applies lotion to top and bottom of foot, removing excess (if any) with a towel
12 Supports foot and ankle during procedure
13 Empties, rinses, and dries basin
14 After rinsing and drying basin, places basin in designated dirty supply area
15 Disposes of used linen into soiled linen container
16 After cleaning foot and equipment, and disposing of used linen, removes and disposes of gloves (without contam­inating self) into waste container and washes hands
17 Signaling device is within reach

Mouth Care

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Before providing mouth care, client is in upright sitting position (75-90 degrees)
4 Puts on clean gloves before cleaning mouth
5 Places clothing protector across chest before providing mouth care
6 Secures cup of water and moistens toothbrush
7 Before cleaning mouth, applies toothpaste to moistened toothbrush
8 Cleans mouth (including tongue and surfaces of teeth), using gentle motions
9 Maintains clean technique with placement of toothbrush
10 Candidate holds emesis basin to chin while client rinses mouth
11 Candidate wipes mouth and removes clothing protector
12 After rinsing toothb­rush, empty, rinse and dry the basin and place used toothbrush in designated basin/­con­tainer
13 Places basin and toothbrush in designated dirty supply area
14 Disposes of used linen into soiled linen container
15 After placing basin and toothbrush in designated dirty supply area, and disposing of used linen, removes and disposes of gloves (without contam­inating self) into waste container and washes hands
16 Signaling device is within reach and bed is in low position
Make sure to be gentle, sensit­ivity changes depending on the person

Peri-Care for Female

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Before washing, checks water temper­ature for safety and comfort and asks client to verify comfort of water
4 Puts on clean gloves before washing perineal area
5 Places pad/ linen protector under perineal area before washing
6 Exposes perineal area while avoiding overex­posure of client
7 Applies soap to wet washcloth
8 Washes genital area, moving from front to back, while using a clean area of the washcloth for each stroke
9 Using clean washcloth, rinses soap from genital area, moving from front to back, while using a clean area of the washcloth for each stroke
10 Dries genital area moving from front to back with towel
11 After washing genital area, turns to side, then washes and rinses rectal area moving from front to back using a clean area of washcloth for each stroke. Dries with towel
12 Reposi­tions client
13 Empties, rinses, and dries basin
14 After rinsing and drying basin, places basin in designated dirty supply area
15 Disposes of used linen into soiled linen container and disposes of linen protector approp­riately
16 Avoids contact between candidate clothing and used linen
17 After disposing of used linen, and placing used equipment in designated dirty supply area, removes and disposes of gloves­(wi­thout contam­inating self) into waste container and washes hands
18 Signaling device is within reach and bed is in low position
An embarr­assing procedure for both parties, be sure to have unders­tanding for this and provide as much privacy as possible

Transfer From Bed to Wheelchair with Transfer Belt

1 Explains procedure, speaking clearly, slowly, and directly, mainta­ining face-t­o-face contact whenever possible
2 Privacy is provided with a curtain, screen, or door
3 Before assisting to stand, wheelchair is positioned along side of bed, at head of bed facing foot or foot of bed facing head
4 Before assisting to stand, footrests are folded up or removed
5 Before assisting to stand, bed is at a safe level
6 Before assisting to stand, locks wheels on wheelchair
7 Before assisting to stand, checks and/or locks bed wheels
8 Before assisting to stand, client is assisted to a sitting position with feet flat on the floor
9 Before assisting to stand, client is wearing shoes
10 Before assisting to stand, applies transfer belt securely at the waist over clothi­ng/gown
11 Before assisting to stand, provides instru­ctions to enable client to assist in transfer including prearr­anged signal to alert when to begin standing
12 Stands facing client positi­oning self to ensure safety of candidate and client during transfer. Counts to three (or says other prearr­anged signal) to alert client to begin standing
13 On signal, gradually assists client to stand by grasping transfer belt on both sides with an upward grasp (candi­dates hands are in upward position) and mainta­ining stability of client’s legs
14 Assists client to turn to stand in front of wheelchair with back of client’s legs against wheelchair
15 Lowers client into wheelchair
16 Positions client with hips touching back of wheelchair and transfer belt is removed
17 Positions feet on footrests
18 Signaling device is within reach
19 After completing skill, washes hands
Make sure patient has non-sl­iding shoes on and feet are flat on floor to prevent falls.
 

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