Restorative Care Fundamentals for the Certified Nursing Assistant

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ISBN: 9780827381414 | 0827381417
Cover: Paperback
Copyright: 7/30/1999

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This comprehensive text provides the content necessary for training nursing assistants to provide restorative care in long-term care facilities, as required by OBRA law. The content includes measurable objectives and interventions to optimize resident care and to enable facilities to gain maximum reimbursement. This text provides all the information necessary to train nursing assistants in restorative care, as well as, the information required to implement a restorative care training program. It enables the necessary training to advance the certified nursing assistant to the restorative nursing assistant level. Thus, facilities to attain the goal of maintaining or improving residents' conditions. The text focuses on techniques to promote resident involvement, thereby improving resident independence and self-esteem. ALSO AVAILABLE - INSTRUCTOR SUPPLEMENTS CALL CUSTOMER SUPPORT TO ORDER Instructor's Manual ISBN: 0-8273-8142-5 Computerized Testbank ISBN: 0-7668-1433-5

Foreword

viii

Preface

Abbreviations and Acronyms

Section I Introduction to Restorative Nursing

(80)

Introduction to Rehabilitation and Restorative Nursing Care

(10)

The OBRA `87 Legislation

(1)

Restorative Nursing Care and Rehabilitation in the Long-Term Care Facility

(1)

The Restorative Nursing Assistant

(2)

Financing Health Care

(1)

Paying for Rehabilitation and Restorative Care

(1)

Declines in Condition

(1)

Emotional Impact of Declines

(1)

Safety Concerns

(1)

The Dangers of Immobility

(2)

The Nursing Process in Restorative Nursing Care

(15)

Resident's Condition on Admission to a Long-Term Care Facility

(1)

The Interdisciplinary Approach to Restorative Care

(3)

The Nursing Process

(1)

The Resident Assessment Instrument

(2)

Care Planning

(7)

Risk Factors

(2)

The Elderly in Long-Term Care

(14)

The Elderly

(1)

Aging Changes

(3)

Common Diseases and Conditions Seen in Long-Term Care Facility Residents

(1)

Basic Human Needs

(4)

Developmental Tasks

(1)

Resident Comfort

(3)

Procedure 1 Relaxation Activities

(1)

Relaxation Activities

(1)

Rest

(1)

Sleep

(3)

Infection Control

(23)

Overview of Infection Control

(1)

Standard Precautions

(1)

General Guidelines for Preventing the Spread of Infection

(1)

Personal Protective Equipment

(3)

General Guidelines for Times to Wash Your Hands

(2)

Transmission-Based Precautions

(3)

Special Circumstances

(4)

Sterile Procedures

(1)

General Guidelines for Assisting with Sterile Procedures

(3)

Procedure 2 Opening a Sterile Package or Tray

(1)

Procedure 3 Applying Sterile Gloves

(1)

Infection Control Practices and Routine Cleaning Procedures

(6)

Princiles of Restorative Nursing and Rehabilitation

(17)

The Person with a Disability

(3)

History of Restorative Care

(1)

Principles of Rehabilitation and Restoration

(1)

Rehabilitation and Restorative Care

(1)

Establishing the Restorative Nursing Program

(2)

Preparation for Resident Care

(4)

The Restorative Nursing Assistant's Responsibilities

(2)

General Guidelines for Restorative Care

(4)

Section II Caring for Residents with Musculoskeletal, Neurological, and Integumentary Conditions

(66)

Restorative Care of Residents with Musculoskeletal System Conditions

(19)

Arthritis

(1)

Osteoporosis

(1)

Fractures

(5)

Procedure 4 Applying an Arm Sling

(2)

Procedure 5 Applying a Clavicle Strap

(1)

Hip Fractures

(2)

Amputation

(3)

Heat and Cold Treatments

(2)

General Guidelines for Using Heat and Cold Applications

(2)

General Guidelines for Monitoring Hydrotherapy Equipment

(3)

Restorative Care of Residents with Common Neurological Conditions

101

(16)

Common Neurological Problems

101

(1)

Cerebrovascular Accident

101

(3)

Parkinson's Disease

104

(4)

Huntington's Disease

108

(1)

Multiple Sclerosis

108

(2)

Brain Damage

110

(1)

Spinal Cord Injuries

110

(1)

Communication Disorders

110

(4)

Procedure 6 Care of an Artificial Eye

112

(1)

Procedure 7 Warm Eye Compresses

113

(1)

Procedure 8 Cool Eye Compresses

114

(1)

General Guidelines for Communicating with Residents with Aphasia and Other Speech Disorders

114

(3)

Restorative Care of Residents with Integumentary System Disorders

117

(16)

The Integumentary System

117

(1)

Pressure Ulcers

118

(9)

Leg Ulcers

127

(3)

Basic Body Positions

130

(3)

Consideration of Special Needs

133

(14)

Restorative Equipment and Supplies

133

(5)

Procedure 9 Applying a Footboard

136

(2)

Positioning Aids

138

(2)

Procedure 10 Making a Trochanter Roll

138

(2)

Procedure 11 Applying a Bed Cradle to the Bed

140

(1)

Elasticized Bandages

140

(1)

Procedure 12 Applying an Elasticized Bandage

141

(1)

Restraint Reduction

141

(6)

Section III Preventing Personal Injury

147

(10)

Preventing Musculoskeletal Injuries

148

(9)

Back Injuries in Health Care Workers

148

(1)

Body Mechanics

149

(1)

Ergonomics

150

(1)

General Guidelines for Using Good Body Mechanics While Lifting and Moving

151

(6)

Section IV Lifting, Moving, and Ambulation Procedures

157

(62)

Restorative Exercise and Bed Mobility

158

(17)

Exercise

158

(2)

Procedure 13 Active Group Exercises

160

(1)

Therapeutic Exercises

160

(2)

Procedure 14 Sample Isometric Exercises

162

(1)

Range of Motion Exercises

162

(9)

Procedure 15 Resistive Exercises

166

(2)

Procedure 16 Passive Range of Motion Exercises

168

(3)

General Guidelines for Assisting Residents with Range of Motion Exercises

171

(1)

Assisting the Resident with Independent Bed Movement

171

(4)

Procedure 17 Assisting the Resident to Move Independently in Bed

172

(3)

Progressive Mobility: Transfer Training and Wheelchair Mobility

175

(27)

The Nursing Process and Restorative Mobility Programs

175

(1)

Wheelchairs

176

(4)

Procedure 18 Assisting the Resident to Dangle

177

(3)

Wheelchair Size

180

(3)

Wheelchair Mobility

183

(1)

Wheelchair Safety

184

(1)

Transfer Activities

184

(2)

General Guidelines for Using the Transfer Belt

186

(8)

Procedure 19 Using the Transfer Belt

187

(2)

Procedure 20 Teaching the Resident to Transfer from Bed to Chair

189

(1)

Procedure 21 Moving to Front Edge of Chair Using Side-to-Side Weight Shift

190

(1)

Procedure 22 Moving to Front Edge of Chair Using Pelvic Slide

190

(1)

Procedure 23 Teaching Wheelchair Push-Ups

191

(1)

Procedure 24 Moving to Front Edge of Chair Using Sitting Push-Up

191

(1)

Procedure 25 Teaching the Resident to Transfer from Wheelchair to Toilet

192

(2)

Procedure 26 Transferring the Resident into a Car

194

(1)

Special Wheelchair Procedures

194

(3)

Procedure 27 Tilting the Wheelchair Backward

195

(1)

Procedure 28 Using a Wheelchair on Ramps and Inclines

195

(1)

Procedure 29 Moving a Wheelchair up Curbs

196

(1)

Procedure 30 Moving a Wheelchair Up or Down Stairs

196

(1)

Sliding Board Transfers

197

(2)

Procedure 31 Sliding Board Transfer from Bed to Wheelchair

197

(1)

Procedure 32 Sliding Board Transfer from Wheelchair to Bed

198

(1)

Procedure 33 Push-Up Transfer from Wheelchair to Bed

198

(1)

Positioning the Resident in a Chair or Wheelchair

199

(3)

Procedure 34 Positioning the Resident in a Chair or Wheelchair

199

(1)

Procedure 35 Leaning to the Side for Pressure Relief

200

(2)

Ambulation and Assistive Devices

202

(17)

Ambulation

202

(2)

Gait

204

(2)

General Guidelines for Assisting Residents in Ambulation Programs

206

(1)

Procedure 36 Ambulating a Resident who Begins to Fall

207

(1)

Assistive Devices Used for Ambulation

207

(1)

Selecting Assistive Ambulation Devices

208

(5)

Gait Patterns

213

(3)

Special Situations

216

(3)

Section V Restorative Approaches to Meeting Residents' Nutrition, Hydration, ADL, and Personal Care Needs

219

(36)

Restorative Approaches to Meeting Residents' Nutrition and Hydration Needs

220

(15)

Nutrition in the Elderly

220

(1)

Factors Influencing Residents' Appetite

221

(2)

Alternative Nutrition

223

(2)

Planning Nutritional Interventions

225

(1)

The Restorative Dining Program

226

(1)

General Guidelines for Assisting Residents to Eat Independently

227

(1)

Restorative Feeding Retraining

227

(1)

Establishing the Restorative Feeding Program

228

(4)

Hydration

232

(3)

Restorative Self-Care

235

(20)

Restorative ADL Programs

235

(4)

The Restorative ADL Process

239

(1)

Developing the Care Plan

239

(3)

Working with the Resident

242

(4)

General Guidelines for Assisting Residents with Restorative ADL Procedures

246

(1)

Special Resident Conditions and Needs

247

(1)

General Guidelines for Assisting Residents with Hemiplegia with Restorative ADL Programs

247

(2)

Assisting Residents with Dressing

249

(1)

General Guidelines for Selecting Clothing for Restorative Dressing Procedures

249

(1)

General Guidelines for Assisting Residents with Restorative Dressing Procedures

250

(1)

General Guidelines for Dressing Residents with Hip Precautions

251

(1)

Assisting Residents with Restorative Hygiene and Grooming Programs

252

(1)

General Guidelines for Assisting Residents with Behavior Problems with ADLs

253

(2)

Section VI Restorative Care of Residents with Special Needs

255

(30)

Restorative Care of Residents with Respiratory Disorders

256

(8)

Role of the Restorative Nursing Assistant in Care of Residents with Respiratory Disorders

256

(1)

Caring for Residents with Respiratory Conditions

256

(1)

Breathing Treatments and Techniques

257

(7)

Procedure 37 Coughing and Deep Breathing Exercises

258

(1)

Procedure 38 Pursed-Lip Breathing

259

(1)

Procedure 39 Diaphragmatic Breathing

259

(2)

Procedure 40 Assisting with Postural Drainage

261

(1)

Procedure 41 Incentive Spirometry

262

(2)

Bowel and Bladder Management

264

(12)

Problems Related to the Urinary System

264

(1)

Urinary Incontinence

265

(3)

Bowel Incontinence

268

(1)

The Restorative Toileting Program

268

(1)

General Guidelines for Assisting with Elimination Programs

268

(1)

Bowel and Bladder Management

268

(1)

Restorative Bowel and Bladder Retraining

269

(7)

Restorative Care of Residents with Psychosocial and Behavioral Issues

276

(9)

Restorative Care of Residents with Behavior Problems and Psychosocial Needs

276

(1)

The ABCs of Behavior Management

277

(2)

General Guidelines for Assisting Residents Who Have Behavior Problems

279

(1)

General Guidelines for Assisting Residents with Depression

279

(1)

Other Therapeutic Modalities

280

(5)

Section VII Documenting Restorative Care

285

(13)

Documenting Restorative Care

286

(12)

Purpose of Documentation

286

(1)

Contents of the Medical Record

287

(1)

Documenting in the Medical Record

288

(10)

Appendix A Employment Information

298

(7)

Sample Job Description for Restorative Nursing Assistant

298

(1)

Aristocrat West/West Park Health Care Facilities Restorative Nursing Assistant Job Description

298

(2)

Aristocrat West/West Park Health Care Restorative Flow Sheet

300

(2)

Restorative Nursing Assistant Education and Orientation Record

302

(1)

Aristocrat West/West Park Health Care Bowel and Bladder Assessment Tool

303

(1)

Performance Review Checklist

304

(1)

Appendix B Exercise and Mobility

305

(9)

Sequence of Joint Range of Motion

305

(2)

Teaching the Resident with Hemiplegia AAROM

307

(1)

Normal Joint Range of Motion

308

(2)

Skeletal System

310

(1)

Muscular System---Front of Body

311

(1)

Muscular System---Back of Body

311

(1)

Peripheral Nervous System

312

(1)

Functional Areas of the Brain

312

(1)

Gait Patterns

313

(1)

Appendix C Useful Information

314

(4)

Environmental Factors to Consider to Reduce the Risk of Illness and Injury

314

(1)

Risk Factors for Falls

314

(1)

Adult Normal Body Weight Over Age 51

315

(1)

USDA Food Guide Pyramid

316

(1)

Portion Size Guide for Food Guide Pyramid

317

(1)

Degree Measurements

317

(1)

Appendix D Communication

318

(1)

Communication Cards

318

(1)

Appendix E Basic Nursing Assistant Procedure Review

319

(6)

Guidelines for Giving a Whirlpool Bath

319

(1)

Procedure for Giving a Whirlpool Bath

319

(1)

Procedure for Assisting the Resident with a Suspected Fracture

319

(1)

Procedure for Application of Cold Packs to Strains and Bruises

320

(1)

Procedure for Moving the Resident to the Side of the Bed

320

(1)

Procedure for Turning the Resident on the Side Toward You

321

(1)

Procedure for Turning the Resident on the Side Away from You

321

(1)

Procedure for Assisting the Resident to Move to the Head of the Bed

321

(1)

Procedure for Moving the Resident to the Head of the Bed with a Lifting (Draw) Sheet

321

(1)

Procedure for Moving the Resident Up in Bed with One Assistant

322

(1)

Procedure for Assisting the Resident to Transfer to Chair or Wheelchair, One Person, with Transfer Belt

322

(1)

Procedure for Assisting the Resident to Transfer to Chair or Wheelchair, Two Persons, with Transfer Belt

322

(1)

Procedure for Assisting the Resident to Transfer from Bed to Chair or Wheelchair, One Assistant

323

(1)

Procedure for Transferring the Resident Using a Mechanical Lift

323

(1)

Procedure for Applying Anti-Embolism Stockings

323

(1)

Procedure for Assisting the Resident with Dressing and Undressing

323

(2)

Appendix F Professional Organizations and Continuing Education Resources

325

(4)

National Groups and Publications

325

(1)

Regional and State Groups and Publications

326

(1)

Professional Nursing Organizations Related to Restorative Nursing

327

(1)

Other Resources Listed in the Text

328

(1)

Appendix G Federal Law

329

(8)

Quality of Care (OBRA 483.25)

329

(1)

Interpretive Guidelines for Restorative Care

330

(7)

Appendix H The Americans with Disabilities Act

337

(3)

Introduction

337

(1)

Summary of the ADA

337

(1)

Overview of the Americans with Disabilities Act

337

(3)

Glossary

340

(7)

Index

347

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Restorative Care Fundamentals for the Certified Nursing Assistant

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