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CNA: Nursing Assistant Certification, California Edition Textbook

CNA: Nursing Assistant Certification, California Edition, brings together all of the California Department of Public Health (CDPH) training requirements for today’s nursing assistant. Written in easy-to-understand language, this one-of-a-kind textbook is formatted specifically for CDPH’s 17 prescribed modules. All topics, sub-sections, and skills reflect 2019 CDPH guidelines for a Nurse Assistant Certification Training Program. Look inside to learn from author and registered nurse Carrie L. Jarosinski to prepare students for the CNA exam and to achieve caregiver excellence.

  • Reviewed and endorsed by California CNA instructors.
  • Formatted for CDPH 17 prescribed modules for Nurse Assistant Certification Training Program.
  • Corresponds with 160-hour training program requirements (60 hours of classroom training and 100 hours of clinical training).
  • Module skills are divided into when, why, and what statements, followed by “starting up” and “finishing up” steps to prepare your students for their role as nursing assistants.
  • Workbook corresponds with each module and supports learning with a range of exercises. Sold separately.
  • Free instructor portal with access to CNA skills videos, additional test bank

Table of Contents

    • A Note to Instructors xix
    • A Note to Students xxi
    • Visual Walkthrough xxii
    • Acknowledgements xxvii
    • About the Author xxix
    • Introduction Healthcare Yesterday and Today 1
    • California and Certification as a Nursing Assistant 2
      • What Is the California Department of Public Health? 2
    • The History of Nursing 2
      • 1800s in Healthcare 2
      • 1900s in Healthcare 4
      • Healthcare Today 4
        • Levels of Care in Geriatrics 4
        • How Healthcare Is Paid For 5
      • What to Expect From This Training 7
    • Module 1 Introduction 9
      • 1A Roles and Responsibilities of the Nursing Assistant (CNA) 10
        • Work Settings for the Nursing Assistant 10
          • Acute Care Settings 10
          • Subacute or Rehabilitation Facility 11
          • Long-Term Care 11
          • Assisted-Living Communities 11
          • Home Healthcare 12
          • Hospice Services 12
          • Respite Services 13
        • Members of the Healthcare Team 13
        • Scope of Practice for the Nursing Assistant 14
        • Chain of Command 14
        • Delegated Tasks 14
        • Teaching Versus Reinforcing 16
        • Time Management and Organization 16
        • Employee Rights 17
      • 1B Title 22, Division 5, CCR, Overview 18
      • 1C Requirements for Nurse Assistant Certification 18
        • Education and Certification 18
          • Nurse Aide Registry 19
          • Continuing Education 19
        • Requirements for Nurse Assistant Certification 19
      • 1D Professionalism 19
        • Acting Like a Professional 19
          • Dependability 20
          • Promptness 20
          • Customer Service 20
          • Flexibility 20
          • Hygiene 20
      • 1E Ethics and Confidentiality 21
        • Employee Responsibilities and Ethics 21
          • Following the Care Plan 21
          • Mandatory Reporting 21
        • Resident Rights and Confidentiality 22
          • Health Insurance Portability and Accountability Act (HIPAA) 22
          • Informed Consent 22
    • Module 2 Patients’ Rights 23
      • 2A Title 22 24
        • California Title 22 24
      • 2B Health and Safety Code 26
      • 2C Code of Federal Regulation 27
      • 2D Preventing, Recognizing, and Reporting Residents’ Right Violations 28
        • Laws 28
          • Invasion of Privacy 28
          • Misappropriation of Funds 28
          • Negligence 28
          • Abandonment 29
          • False Imprisonment 29
          • Neglect 29
          • Assault and Battery 29
          • Abuse 29
    • Module 3 Interpersonal Skills 31
      • 3A Communications 32
        • Communication in Healthcare 32
        • Verbal Versus Nonverbal Communication 32
          • Verbal Communication 32
          • Nonverbal Communication 33
        • Therapeutic Communication 33
        • Communication Disorders 34
        • Communication With the Hearing-Impaired Resident 34
        • Communication With the Speech-Impaired Resident 34
        • Emotional Communication Deficits 35
      • 3B Defense Mechanisms 36
      • 3C Sociocultural Factors 37
        • Cultural Awareness 37
      • 3D Attitudes Toward Illness and Health Care 37
      • 3E Family Interaction 38
        • Meeting the Needs of Loved Ones 38
    • Module 4 Prevention and Management of Catastrophe and Unusual Occurrences 41
      • 4A Emergency 42
      • 4B General Safety Rules 42
        • Safety 42
        • The Physical Environment 42
        • Exposure to Blood-Borne Pathogens and Chemicals 43
        • Latex Allergies 44
        • Workplace Violence 45
      • 4C Fire and Disaster Plans 46
        • Fire Safety 46
        • Natural Disasters 47
        • Bomb Threats 47
      • 4D Roles and Procedures for Certified Nurse Assistants (CNA) 50
      • 4E Patient Safety 50
        • Individual Room Requirements 50
        • Noise and Odor Control 51
          • Noise Control 51
          • Odor Control and Cleanliness 52
    • Module 5 Body Mechanics 55
      • 5A Basic Rules of Body Mechanics 56
        • Injury Prevention 56
          • Ergonomics 56
          • Ways to Move Residents 56
          • Lifestyle Choices to Prevent Back Injuries 56
          • Slips, Trips, and Falls 56
      • 5B Transfer Techniques 57
        • Safety During Transfers 57
          • Dangling 57
          • Footwear 58
          • Gait Belt 58
          • One- and Two-Assist Transfers 58
          • Mechanical Devices Used for Transfers 59
        • Log Rolling a Resident 61
        • Moving a Resident From Bed to Stretcher 61
        • Method to Transfer a Bariatric Resident 61
        • Method to Transport a Resident in a Wheelchair 62
      • 5C Ambulation 71
        • Safety Measures Used During Ambulation 71
      • 5D Proper Use of Body Mechanics and Positioning Techniques 72
        • Frequency of Repositioning Residents 72
        • Basic Positions for Residents in Bed 72
        • Common Positioning Using Proper Body Mechanics 72
          • Supine 72
          • Fowler’s Position 73
          • Prone Position 74
          • Side-Lying Position 74
          • Sims’s Position 74
          • Tripod Position 74
        • Wheelchair Positioning 75
        • Method to Move a Resident in Bed 75
        • Use of a Lift Sheet 76
    • Module 6 Medical and Surgical Asepsis 81
      • 6A Microorganisms 82
        • The Importance of Hand Washing 82
          • Germ Theory 82
          • Global Society and Spread of Disease 83
          • Chain of Infection 83
          • Primary Prevention 84
      • 6B Universal (Standard) Precautions 85
        • Standard Precautions 85
          • Personal Protective Equipment (PPE) 85
        • Drug-Resistant Infections 87
          • MRSA Infection 87
          • VRE 87
        • Specialty Precautions 87
        • Airborne Precautions 87
        • Droplet Precautions 88
        • Contact Precautions 88
        • Transporting a Resident to and From an Isolation Room 88
        • Blood Spill Kits 89
        • Double-Bagging Technique 89
      • 6C Basic Principles of Asepsis 95
        • Body Defense Mechanisms 95
        • Hand Hygiene 96
    • Module 7 Weights and Measures 103
      • 7A The Metric System 104
      • 7B Weight, Length, and Liquid Volume 104
        • Weight 104
          • Measuring Weight Using a Bed Scale 104
          • Measuring Weight Using a Mechanical Lift 104
        • Length 106
        • Volume 106
      • 7C Military Time 112
    • Module 8 Patient Care Skill 115
      • 8A Bathing and Medicinal Baths 116
        • Routine Bathing 116
        • Distressed Bathing 116
          • Alternatives to Tub Bathing and Showering 117
          • Ways to Ease Distressed Bathing 117
        • Rinseless Systems 117
        • Peri-Care 118
        • Bed Baths 121
          • Partial Bed Bath 121
          • Complete Bed Bath 122
        • Shower and Tub Baths 122
          • Shower 122
          • Whirlpool Tub Bath 123
          • Medicinal Baths 124
      • 8B Dressing 137
        • Dressing 137
          • Dressing a Resident With One-Sided Weakness 137
          • Dressing a Resident With an IV 137
          • Dressing a Resident Who Requires Anti-Embolism Stockings 137
        • Vision and Hearing 138
          • Glasses 138
          • Hearing Aids 138
      • 8C Oral Hygiene 142
        • Oral Care 142
      • 8D Hair Care, Hair Shampoo, Medicinal Shampoo, Nail Care, and Shaving 148
        • Hair Care 148
        • Nail and Foot Care 149
          • Nail Care 149
          • Foot Care 149
        • Shaving 150
      • 8E Prosthetic Devices 158
        • The Resident With a Prosthesis 158
          • Prosthesis Overview 158
          • Types of Prostheses 159
          • Care Measures 159
      • 8F Skin Care Including Prevention of Decubitus Ulcers 163
        • The Importance of Healthy Skin 163
        • Types of Skin Breakdown 163
          • Rashes 163
          • Friction and Shearing 163
          • Pressure Injuries 164
        • Stages of Pressure Injuries 165
        • Risk Factors for Developing Pressure Injuries 166
        • Interventions for Preventing Skin Breakdown 167
          • Inspection and Cleanliness 167
          • Positioning and Turning 167
          • Pressure-Relieving Devices 168
          • Positioning Devices 168
          • Incontinence Care 169
          • Nutrition and Hydration 169
          • Reducing the Microclimate 169
        • Preventing Friction and Shearing Injuries 169
      • 8G Elimination Needs 172
        • Introduction 172
        • Urinary Elimination via Catheter 172
        • Bowel Elimination 172
        • Incontinence 173
          • Care of a Resident Who Is Incontinent 173
          • Types of Incontinence Products 173
        • Urostomy 173
        • Ostomies 174
        • Devices Used for Elimination 174
        • Digestive Tract Bleeding 175
      • 8H Bowel and Bladder Retraining 182
      • 8I Weighing and Measuring the Patient 183
        • Height 183
        • Weight 184
    • Module 9 Patient Care Procedures 185
      • 9A Collection of Specimens, Including Stool, Urine, and Sputum 186
        • Basic Principles of Collection and Transport 186
        • Urine Specimens 186
        • Straining for Kidney Stones 187
        • Fecal Specimens 187
        • Occult Blood 188
        • Sputum Specimens 189
      • 9B Care of Patients With Tubing 193
        • Catheter Care 194
          • Types of Catheters 194
          • The Nursing Assistant’s Role in Care of a Resident With a Catheter 194
          • Securing the Catheter 194
          • Cleaning the Catheter 194
          • Changing the Collection Bag to a Leg Bag 195
          • Positioning the Resident With a Collection Bag 195
          • Protecting the Privacy of the Resident Who Uses a Catheter 195
          • Emptying the Collection or Leg Bag 196
          • Cleaning Collection and Leg Bags 196
        • Intravenous Therapy 196
        • Why Supplemental Oxygen Is Needed 197
        • The Nursing Assistant’s Role in Oxygen Therapy 197
        • Delivery Routes 197
        • Delivery Systems 198
        • Interventions to Ease Anxiety Related to Breathing Difficulties 199
        • Interventions to Aid Lung Function 199
          • Coughing and Deep Breathing Exercises 199
          • Incentive Spirometry 200
      • 9C Intake and Output 206
      • 9D Bedmaking 208
        • Linens 208
        • Infection Control 209
        • Body Mechanics 210
        • The Closed Versus Open Bed 210
        • How to Make the Unoccupied and Occupied Bed 211
          • Unoccupied Bed 211
          • Occupied Bed 211
      • 9E Cleansing Enemas and Laxative Suppositories 216
        • Bowel Elimination—Suppositories and Laxatives 216
      • 9F Admission, Transfer, and Discharge 219
        • Transfers and Discharges 220
        • Hospital and Skilled Nursing Facility Transfers 220
        • The Medical Resident 220
        • The Postsurgical Resident 220
        • Diet for the Postsurgical Resident 221
        • Activity for the Postsurgical Resident 221
        • Weight-Bearing Status 221
        • Respiratory Complications 222
        • Cardiac Complications 222
      • 9G Bandages and Nonsterile Dressing Changes, Including Non-Legend Ointments 226
        • Bandages and Non-Legend Topical Ointments 226
    • Module 10 Vital Signs 229
      • 10A Purpose of Vital Signs 230
        • When Vital Signs Are Taken 230
        • Infection Control 230
      • 10B Factors Affecting Vital Signs 230
        • Temperature 230
        • Pulse 230
        • Respiration 232
        • Blood Pressure 232
      • 10C Normal Ranges 233
      • Temperature 233
        • Pulse 233
        • Respiration 233
        • Blood Pressure 233
      • 10D Methods of Measurement 233
        • Temperature 233
        • Pulse 234
        • Respiration 234
        • Blood Pressure 234
      • 10E Temperature, Pulse, Respiration 242
        • Temperature 242
        • Pulse 242
        • Respiration 242
      • 10F Blood Pressure 242
      • 10G Abnormalities 243
        • Temperature 243
        • Pulse 243
        • Respiration 243
        • Blood Pressure 243
      • 10H Recording 243
    • Module 11 Nutrition 245
      • 11A Proper Nutrition 246
        • MyPlate 246
        • Nutrients Essential for Life 246
          • Calories 246
          • Carbohydrates 246
          • Proteins 247
          • Fats 248
          • Vitamins and Minerals 248
        • Water and Fluid Needs 248
        • Food Groups 250
          • Grains 250
          • Fruits 251
          • Vegetables 251
          • Dairy Products 251
          • Protein 252
      • 11B Feeding Techniques 252
        • Feeding Dependent Residents 252
        • Adaptive Tools Used at Meal Times 254
      • 11C Diet Therapy 257
        • Types of Diets 257
          • Specialty Diets 257
          • Mechanically Altered Diets and Fluids 259
          • Thickened Fluids 260
          • Diets for the Postsurgical Resident 260
          • Mechanical Feeding 261
        • Problems With Digestion 261
          • Nausea, Vomiting, and Diarrhea 261
          • Malnutrition and Overeating 262
    • Module 12 Emergency Procedures 263
      • 12A Signs and Symptoms of Distress 264
      • 12B Immediate and Temporary Intervention 264
        • Airway Obstruction 264
        • Cardiac Arrest 265
        • Syncope 266
        • Seizures 266
        • Hemorrhage 267
        • Shock 267
        • Burns 268
        • Poisoning 268
        • Risk Factors for Falling 269
          • Care During a Fall 270
          • Care After a Fall 270
          • How to Prevent Fall Injuries 270
          • Alarm Systems 271
          • Other Strategies 271
        • Restraints 272
          • Ways to Work With Restraints 272
          • Types of Restraints 273
          • Risks of Using Restraints 274
          • Side Rails 274
          • Restraint Alternatives 274
      • 12C Emergency Codes 283
    • Module 13 Long-Term Care Patient 285
      • 13A1 Special Needs of Persons With Developmental and Mental Disorders Including Intellectual Disability, Cerebral Palsy, Epilepsy, Parkinson’s Disease, and Mental Illness 286
        • Better Understanding Special Needs Populations 286
          • Intellectual Disability 286
          • Cerebral Palsy 286
          • Epilepsy 286
          • Parkinson’s Disease 286
          • Mental Illness 287
      • 13A2 Special Needs of Persons with Alzheimer’s Disease and Related Dementias 287
        • Types of Dementia 287
        • Risk Factors for Dementia 288
        • Treatment of Dementia 288
        • Diagnosing Dementia 288
          • Stages of Alzheimer’s Dementia 288
          • Common Signs, Symptoms, and Behaviors Associated With Dementia 289
        • Managing the Behaviors Associated With Dementia 291
          • Meeting Unmet Needs of the Resident 291
          • Therapeutic Interventions 291
          • Maintaining Function 292
          • Approach to Specific Behaviors 292
          • Improving Meal Time 293
          • Managing Pain 293
          • Sleep Disturbances 294
          • Toileting Interventions 294
          • Bathing Interventions 294
          • Wandering and Elopement Safety Measures 295
          • Discouraging Sexual Inappropriateness 295
        • Remember the Families 296
        • Caregiver Strain 296
      • 13B Introduction to Anatomy and Physiology 296
        • Basic Structures 296
        • Tissue Types 297
        • Body Systems 297
          • Integumentary System 297
          • Musculoskeletal System 299
          • Respiratory System 301
          • Cardiovascular System 302
          • Nervous System 304
          • Sensory Organs 306
          • Endocrine System 307
          • Digestive System 310
          • Urinary System 311
          • Reproductive System 312
      • 13C Physical and Behavioral Needs and Changes 314
        • Holistic Care 314
        • Maslow’s Hierarchy of Needs 314
          • Human Needs 314
          • Application of Maslow’s Hierarchy to Caregiving 315
        • Growth and Development 316
      • 13D Community Resources Available 317
      • 13E Psychological, Social, and Recreational Needs 317
        • Quality of Life 317
        • Activities Therapy 319
      • 13F Common Diseases and Disorders Including Signs and Symptoms 320
        • Understanding Disease Processes 320
        • Risk Factors 320
        • Emergency Medical Services 321
        • Common Diseases and Disorders 321
          • Integumentary System 321
          • Musculoskeletal System 323
          • Respiratory System 325
          • Cardiovascular System 326
          • Nervous System 329
          • Sensory Organs 332
          • Endocrine System 333
          • Digestive System 336
          • Urinary System 339
          • Reproductive System 341
          • Care for a Resident With a Positive HIV Status 342
          • Care for the Resident With Cancer 345
    • Module 14 Rehabilitative Nursing 351
      • 14A Promoting Patients’ Potential 352
        • Promoting Independence 352
        • Therapy Services Overview 352
          • Physical Therapy 352
          • Occupational Therapy 352
          • Speech Therapy 353
        • Restorative Care 354
      • 14B Devices and Equipment 354
        • Assistive Devices for Ambulation 354
        • Crutches 355
        • Adaptive Tools 356
      • 14C Activities of Daily Living 357
      • 14D Family Interactions 358
      • 14E Complications of Inactivity 358
        • Why We Move 358
          • Complications of Inactivity 358
          • Self-Esteem 358
          • Effects on the Digestive System 359
          • Effects on the Cardiovascular System 359
          • Effects on the Integumentary System 359
          • Effects on the Musculoskeletal System 359
          • Why Falls and Immobility Are Dangerous 360
      • 14F Ambulation 360
        • Levels of Assistance 360
      • 14G Range of Motion 364
        • Range-of-Motion Exercises 364
        • Soothing Sore Muscles 365
    • Module 15 Observation and Charting 369
      • 15A Observation of Patients and Reporting Responsibility 370
        • Subjective Versus Objective Data 370
        • Oral Reporting 371
      • 15B Patient Care Plan 372
      • 15C Patient Care Documentation 375
      • 15D Legal Issues of Charting 379
        • Written Documentation and Legal Issues of Charting 379
        • Causes of Medical Errors 379
      • 15E Medical Terminology and Abbreviations 381
        • Common Medical Abbreviations 383
        • Directional Terms 384
        • ISMP’s List of Error-Prone Abbreviations, Symbols, and Dose Designations 385
    • Module 16 Death and Dying 387
      • 16A Stages of Grief 388
      • 16B Emotional and Spiritual Needs of the Patient and Family 389
        • Care for the Family 389
        • Hospice Care 390
      • 16C Rights of the Dying Patient 390
        • The Rights of the Dying 390
      • 16D Signs of Approaching Death 391
        • Body System Changes 391
          • Respiratory Changes 391
          • Cardiovascular Changes 392
          • Nervous System and Sensory Organ Changes 392
          • Digestive Changes 392
          • Urinary Changes 392
      • 16E Monitoring of the Patient 392
      • 16F Post-Mortem Care 393
    • Module 17 Abuse 397
      • 17A Preventing, Recognizing, and Reporting Instances of Resident Abuse 398
        • Resident Rights 398
          • Health Insurance Portability and Accountability Act (HIPAA) 398
          • Informed Consent 398
          • Long-Term Care Resident Rights 399
          • Ombudsman 399
          • Complaints 399
        • Resident Responsibilities 400
        • Employee Responsibilities 400
          • Following the Care Plan 400
          • Mandatory Reporting 400
        • Laws 401
          • Invasion of Privacy 401
          • Misappropriation of Funds 402
          • Negligence 402
          • Abandonment 402
          • False Imprisonment 402
          • Neglect 402
          • Assault and Battery 403
          • Abuse 403
          • California Health and Safety Codes 404
    • Glossary 407
    • Index 412