Here’s a few example skills a certified nursing assistent needs to have.
1. Taking a Patient’s Blood Pressure
Detecting changes in blood pressure can help detect a much more serious condition that requires immediate treatment. You will be asked to monitor blood pressure by a physician, and you will then be able to assist the medical team in providing the best care for a patient.
Before you begin, wash your hands thoroughly. Tell the patient you are going to check their blood pressure. Verify the identity of your patient using the wristband. Wrap the blood pressure cuff around the patient’s arm, positioning it above the elbow. Place the bell of the stethoscope on top of the brachial artery, found in the crook of the elbow. Start squeezing the bulb of the cuff. Look at the gauge on the cuff, and keep pumping the cuff until the needle on the gauge measures between 150 and 180 mmHg. Begin slowly releasing the pressure by loosening the dial on the bulb while listening through the stethoscope for a pulse. When you first hear a pulse, remember the number on the gauge. This upper measurement is called the systolic pressure.
Keep listening to the pulse until you hear it fade away. Again, remember the reading on the meter. This lower number is called the diastolic blood pressure. Record the results in the patient’s chart, and give it to the patient if desired. The blood pressure measurement is one of the important tools in medical offices. When you measure and record this information, you help to create a vital record used by doctors to determine treatment.
2. Transferring a Patient from Bed to Wheelchair
Moving a patient from the bed to a wheelchair correctly can prevent injuries to the patient or the aide. Before you begin, position the wheelchair as close to the bed as you can and lock the wheels. Move footplates and leg pads out of the way to prevent tripping. Move the bed to the lowest position, and elevate the head of the bed. Tell the patient you are going to help him into a wheelchair. Tell the patient what you are doing during each step so that he can assist as much as he is able.
Begin by moving your patient to the side of the bed and into a sitting position where the legs are dangling from the side of the bed. Move so you are standing in front of the patient in a wide stance for stability. Help the patient lean forward and then stand by supporting the patient’s torso. When the patient is standing, have them pivot so they have their back to the wheelchair. Ask the patient to place his hands on the armrests for stability, and then move backward until the seat is touching the back of the legs. Assist the patient into a sitting position. Position the patient’s legs on the leg pads and foot rests.
Completing this process slowly will reduce the chance of falls. Whenever you transport a patient in a wheelchair, monitor them as you move to ensure they do not become dizzy or fall.
3. Range of Motion Exercises
Range of motion checks on a patient can speed the patient’s recovery and reduce complications from contracted joints. Range of motion exercises are performed when you give a patient his. To begin, wash your hands. Explain that you will be checking the patient’s range of motion and helping them complete several exercises. Raise the bed until you can assist the patient. Each exercise will be performed 10 times, and you should start with the head and move to the feet.
Here are the exercises you will do:
• Tell the patient to turn their head from side to side. Do not perform this check on a patient with a neck or spinal injury.
• Tell the patient to bend and extend both arms at the elbows. Next, ask the patient to cross the arms back and forth over the body. Have the patient bend the wrists and flex the fingers.
• Have the patient lift each leg and move it back and forth toward the center of the body. Then, ask them to bend and straighten the knee at the leg. Have the patient rotate the ankle and wiggle the toes on each food.
If your patient is non-ambulatory, checks need to be performed once or two times each day to prevent contractures. If the patient complains of stiffness or is unable to move a joint, it can be an indication of contracture. When you do the tests, monitor the patient for signs of inflammation in any joint. If your patient complains of severe pain or exhibits respiratory distress, notify staff immediately.
These are just a few examples. Obviously there is a lot more to becoming a CNA.
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