1

Introduction to Health Care Agencies

1

Agency Purposes

2

Types of Agencies

2

Organization

4

The Nursing Team

7

Nursing Care Patterns

8

Paying For Health Care

8

Meeting Standards

9

2

The Person's Rights

12

Patients' Rights

12

Residents' Rights

12

Ombudsman Program

19

3

The Nursing Assistant

21

History and Current Trends

22

Federal and State Laws

22

Roles and Responsibilities

25

Delegation

27

4

Ethics and Laws

34

Ethical Aspects

35

Legal Aspects

31

Reporting Abuse

39

5

Work Ethics

46

Health, Hygiene, and Appearance

41

Getting a Job

41

Preparing for Work

55

Teamwork

55

Managing Stress

58

Harassment

59

Resigning from a Job

60

Losing a Job

60

Drug Testing

60

6

Communicating With the Health Team

63

Communication

64

The Medical Record

64

The Kardex

61

Reporting and Recording

61

Medical Terms and Abbreviations

11

Computers and Other Electronic Devices

14

Phone Communications

75

Dealing With Conflict

16

7

Assisting With the Nursing Process

79

Assessment

80

Nursing Diagnosis

82

Planning

82

Implementation

86

Evaluation

86

Your Role

86

8

Understanding the Person

89

Caring for the Person

90

Basic Needs

90

Culture and Religion

91

Effects of Illness and Disability

92

Persons You Will Care For

93

Communicating With the Person

94

Persons With Disabilities

100

Family and Friends

101

Behavior Issues

102

9

Body Structure and Function

105

Cells, Tissues, and Organs

106

The Integumentary System

101

The Musculo-Skeletal System

108

The Nervous System

110

The Circulatory System

113

The Lymphatic System

114

The Respiratory System

115

The Digestive System

116

The Urinary System

111

The Reproductive System

111

The Endocrine System

119

The Immune System

120

10

Growth and Development

123

Principles

123

Infancy (Birth to 1 Year)

124

Toddlerhood (1 to 3 Years)

727

Preschool (3 to 6 Years)

128

School Age (6 to 9 or 10 Years)

129

Late Childhood (9 or 10 to 12 Years)

130

Adolescence (12 to 18 Years)

131

Young Adulthood (18 to 40 Years)

132

Middle Adulthood (40 to 65 Years)

132

Late Adulthood (65 Years and Older)

133

11

Care of the Older Person

135

Psychological and Social Changes

136

Physical Changes

138

Housing Options

141

12

Safety

149

A Safe Setting

150

Accident Risk Factors

150

Identifying the Person

156

Preventing Burns

151

Preventing Poisoning

158

Preventing Suffocation

163

Preventing Equipment Accidents

167

Wheelchair and Stretcher Safety

169

Handling Hazardous Substances

170

Fire Safety

171

Disasters

176

Workplace Violence

177

Risk Management

180

13

Preventing Falls

184

Causes and Risk Factors For Falls

184

Fall Prevention Programs

185

Transfer/Gait Belts

190

The Falling Person

192

14

Restraint Alternatives and Safe Restraint Use

196

History of Restraint Use

191

Restraint Alternatives

191

Safe Restraint Use

191

15

Preventing Infection

212

Microorganisms

213

Infection

214

Medical Asepsis

216

Isolation Precautions

223

Bloodborne Pathogen Standard

235

Surgical Asepsis

238

16

Body Mechanics

244

Principles of Body Mechanics

246

Ergonomics

247

Positioning the Person

249

17

Safely Moving and Transferring the Person

254

Preventing Work-Related Injuries

255

Moving Persons in Bed

258

Turning Persons

267

Sitting on the Side of the Bed (Dangling)

270

Transferring Persons

273

Re-Positioning in a Chair or Wheelchair

285

18

The Person's Unit

287

Comfort

287

Room Furniture and Equipment

290

General Rules

301

19

Bedmaking

304

Types of Beds

304

Linens

304

Making Beds

307

20

Personal Hygiene

320

Daily Care

322

Oral Hygiene

323

Bathing

331

The Back Massage

344

Perineal Care

346

Reporting and Recording

351

21

Grooming

353

Hair Care

354

Shampooing

358

Shaving

361

Nail and Foot Care

363

Changing Clothing and Hospital Gowns

366

22

Urinary Elimination

375

Normal Urination

376

Urinary Incontinence

384

Catheters

392

Bladder Training

403

23

Bowel Elimination

406

Normal Bowel Elimination

406

Factors Affecting Bowel Elimination

408

Common Problems

409

Bowel Training

413

Suppositories

414

Enemas

415

The Person With an Ostomy

421

24

Nutrition and Fluids

425

Basic Nutrition

427

Meeting Nutritional Needs

433

Special Diets

436

Fluid Balance

439

Meeting Food and Fluid Needs

443

Foodborne Illnesses

450

25

Nutritional Support and IV Therapy

454

Enteral Nutrition

455

Parenteral Nutrition

458

IV Therapy

459

26

Measuring Vital Signs

466

Measuring and Reporting Vital Signs

467

Body Temperature

467

Pulse

477

Respirations

482

Blood Pressure

484

Pain

489

27

Exercise and Activity

491

Bedrest

492

Range-of-Motion Exercises

495

Ambulation

501

28

Comfort, Rest, and Sleep

509

Comfort

510

Pain

510

Rest

514

Sleep

515

29

Admissions, Transfers, and Discharges

520

Admissions

521

Moving the Person to a New Room

530

Transfers and Discharges

531

30

Assisting with the Physical Examination

534

Your Role

534

Equipment

535

Preparing the Person

535

Positioning and Draping

537

Assisting With the Exam

537

31

Collecting and Testing Specimens

540

Urine Specimens

541

Stool Specimens

550

Sputum Specimens

553

Blood Glucose Testing

555

32

The Person Having Surgery

560

Psychological Care

561

Pre-Operative Care

561

Sedation and Anesthesia

567

Post-Operative Care

567

33

Wound Care

576

Skin Tears

579

Circulatory Ulcers

579

Wound Healing

582

Dressings

586

Binders and Compression Garments

589

Heat and Cold Applications

590

Meeting Basic Needs

590

34

Pressure Ulcers

593

Risk Factors

595

Persons at Risk

596

Pressure Ulcer Stages

596

Sites

598

Prevention and Treatment

598

Complications

601

Reporting and Recording

603

35

Heat and Cold Applications

605

Heat Applications

606

Cold Applications

608

Applying Heat and Cold

608

Cooling and Warming Blankets

612

36

Oxygen Needs

614

Factors Affecting Oxygen Needs

615

Altered Respiratory Function

616

Assisting With Assessment and Diagnostic Tests

617

Meeting Oxygen Needs

620

Assisting With Oxygen Therapy

624

37

Respiratory Support and Therapies

631

Artificial Airways

632

Suctioning the Airway

634

Mechanical Ventilation

636

Chest Tubes

637

38

Rehabilitation and Restorative Nursing Care

640

Restorative Nursing

641

Rehabilitation and the Whole Person

641

The Rehabilitation Team

645

Rehabilitation Programs and Services

645

Quality of Life

641

39

Hearing, Speech, and Vision Problems

649

Ear Disorders

650

Speech Disorders

655

Eye Disorders

656

40

Cancer, Immune System, and Skin Disorders

668

Cancer

669

Immune System Disorders

614

Skin Disorders

616

41

Nervous System and Musculo-Skeletal Disorders

679

Nervous System Disorders

619

Musculo-Skeletal Disorders

685

42

Cardiovascular, Respiratory, and Lymphatic Disorders

696

Cardiovascular Disorders

691

Respiratory Disorders

702

Lymphatic Disorders

706

43

Digestive and Endocrine Disorders

710

Digestive Disorders

710

Endocrine Disorders

716

44

Urinary and Reproductive Disorders

719

Urinary System Disorders

719

Reproductive Disorders

724

45

Mental Health Problems

727

Basic Concepts

725

Anxiety Disorders

728

Schizophrenia

730

Mood Disorders

731

Personality Disorders

732

Substance Abuse and Addiction

752

Eating Disorders

736

Suicide

736

Care and Treatment

757

46

Confusion and Dementia

740

Confusion

740

Dementia

741

Alzheimer's Disease

742

Care of Persons With AD and Other Dementias

749

47

Developmental Disabilities

757

Intellectual Disabilities

758

Down Syndrome

759

Fragile X Syndrome

760

Cerebral Palsy

760

Autism

761

Spina Bifida

761

Hydrocephalus

763

48

Sexuality

765

Sex and Sexuality

766

Sexual Relationships

767

Injury, Illness, and Surgery

761

Sexuality and Older Persons

761

Meeting Sexual Needs

762

The Sexually Aggressive Person

769

Sexually Transmitted Diseases

769

49

Caring For Mothers and Newborns

771

Infant Safety and Security

777

Helping Mothers Breast-Feed

774

Bottle-Feeding Babies

776

Burping the Baby

779

Diapering

780

Care of the Umbilical Cord

782

Care of the Circumcision

783

Bathing an Infant

783

Nail Care

787

Weighing Infants

787

Care of the Mother

788

50

Assisted Living

791

Purpose

795

ALR Residents

793

Resident Rights

793

Staff Requirements

794

Service Plan

794

Transfer, Discharge, and Eviction

797

51

Basic Emergency Care

799

Emergency Care

800

Basic Life Support For Adults

801

Basic Life Support For Children and Infants

810

Choking

816

Hemorrhage

816

Fainting

811

Shock

811

Stroke

811

Seizures

818

Burns

819

52

End-of-Life Care

822

Terminal Illness

823

Attitudes About Death

823

The Stages of Dying

824

Comfort Needs

825

The Family

827

Legal Issues

827

Signs of Death

827

Care of the Body After Death

828

Review Question Answers

832

APPENDICES

836

A

National Nurse Aide Assessment Program (NNAAP^®) Written Examination Content Outline and Skills Evaluation

836

B

Minimum Data Set: Selected Pages

837

C

Key Recommendations from Dietary Guidelines 2010

839

Illustration Credits

840

Glossary

843

Key Abbreviations

854

Index

856