CNA: Nursing Assistant Certification, Accelerated Edition

Master the skills you need to succeed as a nursing assistant with CNA: Nursing Assistant Certification, Accelerated Edition. This accelerated guide is written in easy-to-understand language and focuses on real-world situations you’ll encounter on the job.

Learn from author and registered nurse Carrie L. Engelbright what it takes to be a nursing assistant and achieve caregiver excellence.

  • Role and Scope of Practice includes the skills, responsibilities, and actions permitted and expected of a nursing assistant.
  • Lessons apply to long-term, acute, and subacute care settings.
  • Workbook corresponds with each chapter and supports learning with a range of exercises. Sold separately.
  • New Videos provide a unique classroom experience and reiterate the roles and responsibilities of a nursing assistant.

Table of Contents

  • A Note to Nursing Assistant Instructors xvii
  • A Note to the Students xix
  • Visual Walkthrough xx
  • Acknowledgements xxv
  • About the Author xxvii
  • Chapter 1: Healthcare Yesterday and Today 1
    • 1.1 A Brief History of Healthcare in the United States 1
    • 1.2 The Beginning of Modern Healthcare 2
      • The Modernization of Medicine 2
    • 1.3 The Cost of Healthcare 3
    • 1.4 Healthcare Today 4
    • 1.5 Who Is Your Client? 4
    • 1.6 Consumerism in America 4
    • 1.7 Home Healthcare Versus Facility Care 5
    • 1.8 Why the Nursing Assistant Needs to Know These Trends 6
  • Chapter 2: The Nursing Assistant Role: Where You Fit In! 7
    • 2.1–2.3 Work Settings for the Nursing Assistant 7
      • Acute Care Settings 7
      • Subacute or Rehabilitation Facility 8
      • Long-Term Care 8
      • Assisted-Living Communities 9
      • Home Healthcare 10
      • Hospice Services 10
      • Respite Services 10
    • 2.4 Members of the Healthcare Team 11
    • 2.5 Scope of Practice for the Nursing Assistant 11
    • 2.6 Chain of Command 12
    • 2.7 Delegated Tasks 12
    • 2.8 Teaching Versus Reinforcing 14
  • Chapter 3: Communication 15
    • 3.1 Causes of Medical Errors 15
    • 3.2 Subjective Versus Objective Data 16
    • 3.3 Oral Reporting 17
    • 3.4 Written Documentation and the Nursing Assistant 17
    • 3.5 Verbal Versus Nonverbal Communication 18
      • Verbal Communication 18
      • Nonverbal Communication 19
    • 3.6 Therapeutic Communication 19
    • 3.7 Communication Disorders 19
    • 3.8 Communication With the Hearing-Impaired Client 20
    • 3.9 Communication With the Speech-Impaired Client 20
  • Chapter 4: Professionalism in Ethics 22
    • 4.1 Education and Certification 22
      • Nurse Aide Registry 23
      • Continuing Education 23
    • 4.2 Acting Like a Professional 23
      • Dependability 23
      • Promptness 23
      • Flexibility 23
      • Hygiene 23
    • 4.3 Employee Rights 24
    • 4.4 Employee Responsibilities 24
      • Following the Care Plan 24
      • Mandatory Reporting 25
    • 4.5 Client Rights 25
      • Health Insurance Portability and Accountability Act (HIPAA) 25
      • Informed Consent 25
    • 4.6 Client Responsibilities 26
    • 4.7 Laws 26
      • Invasion of Privacy 26
      • Misappropriation of Funds 26
      • Negligence 27
      • Abandonment 27
      • False Imprisonment 27
      • Neglect 27
      • Assault and Battery 27
      • Abuse 27
    • 4.8 Cultural Awareness 28
  • Chapter 5: Body Structures and Functioning Processes 29
    • 5.1 Basic Structures 29
    • 5.2 Tissue Types 29
    • 5.3 Body Systems 30
      • Integumentary System 30
      • Musculoskeletal System 31
      • Respiratory System 32
      • Cardiovascular System 34
      • Nervous System 35
      • Sensory Organs 36
      • Endocrine System 38
      • Digestive System 39
      • Urinary System 40
      • Reproductive System 41
  • Chapter 6: Common Diseases and Disorders 43
    • 6.1 Common Diseases and Disorders 43
      • Integumentary System 43
      • Musculoskeletal System 44
      • Respiratory System 46
      • Cardiovascular System 47
      • Nervous System 48
      • Sensory Organs 51
      • Endocrine System 52
      • Digestive System 53
      • Urinary System 54
      • Reproductive System 55
  • Chapter 7: Infection Control Practices 56
    • 7.1 Chain of Infection 56
    • 7.2 Primary Prevention 56
    • 7.3 Hand Hygiene 57
    • 7.4 Standard Precautions 58
      • Personal Protective Equipment (PPE) 59
    • 7.5 Specialty Precautions 61
      • Airborne Precautions 62
      • Droplet Precautions 62
      • Contact Precautions 62
      • Transporting a Client to and From an Isolation Room 62
      • Blood Spill Kits 62
    • 7.6 Drug-Resistant Infections 62
      • MRSA Infection 62
      • VRE 63
  • Chapter 8: Body Mechanics and Workplace Safety 68
    • 8.1 Exposure to Blood-Borne Pathogens and Chemicals 69
    • 8.2 Injury Prevention 69
      • Ergonomics 69
      • Ways to Move Clients 70
      • Lifestyle Choices to Prevent Back Injuries 70
      • Slips, Trips, and Falls 70
    • 8.3 Fire Safety 71
    • 8.4 Natural Disasters 71
    • 8.5 Workplace Violence 72
  • Chapter 9: Reducing Client Injury and Falls 73
    • 9.1 Why Falls and Immobility Are Dangerous 73
    • 9.2 Risk Factors for Falling 74
    • 9.3 Care During a Fall 74
    • 9.4 Care After a Fall 75
    • 9.5 How to Prevent Fall Injuries 75
    • 9.6 Alarm Systems 76
    • 9.7 Other Strategies 76
  • Chapter 10: Restraints and Restraint Alternatives 80
    • 10.1 Restraints 80
    • 10.2 Ways to Work With Restraints 81
    • 10.3 Types of Restraints 81
    • 10.4 Risks of Using Restraints 82
    • 10.5 Side Rails 82
    • 10.6 Restraint Alternatives 83
  • Chapter 11: Basic First Aid Measures 85
    • 11.1 Airway Obstruction 85
    • 11.2 Cardiac Arrest 86
    • 11.3 Syncope 86
    • 11.4 Seizures 87
    • 11.5 Hemorrhage 88
    • 11.6 Shock 88
    • 11.7 Burns 89
    • 11.8 Poisoning 90
  • Chapter 12: Holistic Care of Clients 95
    • 12.1 Holistic Care 95
    • 12.2 Maslow’s Hierarchy of Needs 95
      • Human Needs 96
      • Application of Maslow’s Hierarchy to Caregiving 96
    • 12.3 Growth and Development 97
    • 12.4 Quality of Life 98
    • 12.5 Meeting the Needs of Loved Ones 100
  • Chapter 13: Client Room Environment 101
    • 13.1 Safety 101
    • 13.2 The Physical Environment 102
    • 13.3 Individual Room Requirements 102
    • 13.4 Noise and Odor Control 103
      • Noise Control 103
      • Odor Control and Cleanliness 104
    • 13.5 Transfers and Discharges 104
    • 13.6 Current Trends 105
  • Chapter 14: Preventing Skin Breakdown 106
    • 14.1 The Importance of Healthy Skin 106
    • 14.2 Types of Skin Breakdown 106
      • Rashes 107
      • Friction and Shearing 107
      • Pressure Injuries 108
    • 14.3 Stages of Pressure Injuries 108
    • 14.4 Risk Factors for Developing Pressure Injuries 109
    • 14.5 Interventions for Preventing Skin Breakdown 110
      • Inspection and Cleanliness 110
      • Positioning and Turning 111
      • Pressure-Relieving Devices 111
      • Positioning Devices 112
      • Incontinence Care 112
      • Nutrition and Hydration 113
      • Reducing the Microclimate 113
  • Chapter 15: Bedmaking 114
    • 15.1 Linens 114
    • 15.2 Infection Control 115
    • 15.3 Body Mechanics 116
    • 15.4 The Closed Versus Open Bed 116
    • 15.5 How to Make the Unoccupied and Occupied Bed 117
      • Unoccupied Bed 117
      • Occupied Bed 117
  • Chapter 16: Moving, Transferring, and Transporting Clients 123
    • 16.1 Frequency of Repositioning Clients 123
    • 16.2 Basic Positions for Clients in Bed 123
    • 16.3 Position to Relieve Pressure Injuries 124
      • Supine 124
      • Fowler’s Position 124
      • Prone Position 125
      • Side-Lying Position 125
      • Sims’s Position 126
      • Tripod Position 126
    • 16.4 Wheelchair Positioning 126
    • 16.5 Method to Move a Client in Bed 127
    • 16.6 Different Types of Transfers 127
      • Dangling 127
      • Footwear 127
      • Gait Belt 128
      • One- and Two-Assist Transfers 128
      • Mechanical Devices Used for Transfers 129
    • 16.7 Method to Transfer a Bariatric Client 131
    • 16.8 Method to Transport a Client in a Wheelchair 131
  • Chapter 17: Ambulation and Exercises for Clients 141
    • 17.1 Why We Move 141
      • Self-Esteem 141
      • Effects on the Digestive System 141
      • Effects on the Cardiovascular System 142
      • Effects on the Integumentary System 142
      • Effects on the Musculoskeletal System 142
    • 17.2 Levels of Assistance 142
    • 17.3 Safety Measures Used During Ambulation 143
    • 17.4 Assistive Devices for Ambulation 143
    • 17.5 Range-of-Motion Exercises 144
    • 17.6 Therapy Services Overview 145
      • Physical Therapy 145
      • Occupational Therapy 145
      • Speech Therapy 146
    • 17.7 Activities Therapy 147
    • 17.8 Restorative Care 147
    • 17.9 The Client With a Prosthesis 148
    • 17.10 Adaptive Tools 149
  • Chapter 18: Vital Signs 153
    • 18.1 When Vital Signs Are Taken 153
    • 18.2 Infection Control 154
    • 18.3 How to Accurately Measure Vital Signs 154
      • Temperature 154
      • Pulse 156
      • Respiration 156
      • Blood Pressure 157
      • Height 158
      • Weight 159
  • Chapter 19: Bathing 167
    • 19.1 Routine Bathing 168
    • 19.2 Distressed Bathing 169
      • Alternatives to Tub Bathing and Showering 169
      • Ways to Ease Distressed Bathing 169
    • 19.3 Rinseless Systems 169
    • 19.4 Peri-Care 169
    • 19.5 Bed Baths 172
      • Partial Bed Bath 172
      • Complete Bed Bath 172
    • 19.6 Shower and Tub Baths 173
      • Shower 173
      • Whirlpool Tub Bath 174
      • Hair Care 175
    • 19.7 Responsibilities on Bath Day 175
  • Chapter 20: Grooming 189
    • 20.1 Promoting Independence 189
    • 20.2 Dressing 189
      • Dressing a Client With One-Sided Weakness 190
      • Dressing a Client Who Requires Anti-Embolism Stockings 190
    • 20.3 Vision and Hearing 190
      • Glasses 190
      • Hearing Aids 190
    • 20.4 Shaving 191
    • 20.5 Oral Care 191
    • 20.6 Nail and Foot Care 193
      • Nail Care 193
      • Foot Care 193
  • Chapter 21: Nutrition 204
    • 21.1 MyPlate 204
    • 21.2 Nutrients Essential for Life 205
      • Calories 205
      • Carbohydrates 205
      • Proteins 205
      • Fats 205
      • Vitamins and Minerals 206
    • 21.3 Water and Fluid Needs 206
    • 21.4 Food Groups 208
      • Grains 208
      • Fruits 208
      • Vegetables 208
      • Dairy Products 208
      • Protein 209
    • 21.5 Types of Diets 209
      • Specialty Diets 209
      • Mechanically Altered Diets and Fluids 209
      • Thickened Fluids 210
    • 21.6 How to Feed Dependent Clients 210
  • Chapter 22: Elimination and Specimen Collection 214
    • 22.1 Urinary Elimination via Catheter 214
      • Types of Catheters 214
      • The Nursing Assistant’s Role in Care of the Client With a Catheter 215
      • Securing the Catheter 215
      • Cleaning the Catheter 215
      • Positioning the Client With a Collection Bag 216
      • Protecting the Privacy of the Client Who Uses a Catheter 216
      • Emptying the Collection Bag 216
    • 22.2 Incontinence 216
      • Care of the Client Who Is Incontinent 216
      • Types of Incontinence Products 216
    • 22.3 Bowel Elimination 217
    • 22.4 Ostomies 217
    • 22.5 Digestive Tract Bleeding 218
    • 22.6 Devices Used for Elimination 218
    • 22.7 Urine Specimens 219
    • 22.8 Fecal Specimens 219
  • Chapter 23: Care for the Client With Dementia 228
    • 23.1 Types of Dementia 228
    • 23.2 Treatment of Dementia 228
    • 23.3 Ways to Diagnose Dementia 229
      • Stages of Alzheimer’s Dementia 229
      • Common Signs, Symptoms, and Behaviors Associated With Dementia 229
    • 23.4 How to Manage the Behaviors Associated With Dementia 231
      • Ways to Meet Unmet Needs of the Client 231
      • Therapeutic Interventions 231
      • Ways to Maintain Function 232
      • Approaches to Specific Behaviors 232
      • Ways to Improve Meal Time 232
      • Ways to Manage Pain 232
      • Sleep Disturbances 233
      • Toileting Interventions 233
      • Bathing Interventions 234
      • Wandering and Elopement Safety Measures 234
      • Ways to Discourage Sexual Inappropriateness 234
    • 23.5 Caregiver Strain 235
  • Chapter 24: End-of-Life Care 236
    • 24.1 Body System Changes 236
      • Respiratory Changes 237
      • Cardiovascular Changes 237
      • Nervous System and Sensory Organ Changes 237
      • Digestive Changes 237
      • Urinary Changes 237
    • 24.2 Special Care for the Dying Client 238
    • 24.3 Faith and Religion 238
    • 24.4 Care for the Family 238
    • 24.5 Post-Mortem Care 239
  • Common Medical Abbreviations and Directional Terminology 243
  • ISMP’s List of Error-Prone Abbreviations, Symbols, and Dose Designations 245
  • Glossary 249
  • Index 253