CNA Chap 9 Video - rehab and restorative care PDF

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rehab and restorative care...

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Chapter 9: Video #1- Rehabilitation and Restorative Care Notes: 1. Define the following terms: o Rehabilitation – care that is given by specialists to help improve or restore function after an illness or injury o Restorative care – care given after rehabilitation to maintain a resident’s functioning, to improve his quality of life, and to increase independence o Ambulation – walking o Ambulatory – capable of walking o Assistive/adaptive devices – special equipment that helps a person who is ill or disabled to perform activities of daily living o Amputation - the surgical removal of some or all a body part, usually an arm, hand, leg, or foot o Phantom sensation – warmth, itching, or tingling in a body part that has been amputated o Phantom limb pain – pain in the limb (or extremity) that has been amputated o Prosthesis – a device that replaces a body part that is missing or deformed because of an accident, injury, illness, or birth defect; used to improve a person’s ability to function and/or to improve appearance o Range of motion (ROM) - exercises that put a joint through its full arc of motion o Abduction – moving a body part away from the midline of the body o Adduction – moving the body part toward the midline of the body o Dorsiflexion – bending backward o Rotation – turning a joint o Extension – straightening a body part o Flexion – bending a body part o Pronation – turning downward o Supination – turning upward o Opposition – touching the thumb to any other finger

2. Rehabilitation seeks to move resident from: o Illness to health o Disability to ability o Dependence to independence

3. Goals of a rehabilitation program include the following: o To help a resident regain function or recover from illness o To develop and promote a resident’s independence o To help a resident feel in control of their own life o To help a resident adjust or adapt to the limitations of a disability

4. Guidelines for assisting with rehabilitation and restorative care: o Be patient o Be positive and supportive o Focus on small tasks and small accomplishments o Recognize that setbacks occur o Be sensitive to the residents’ needs o Encourage independence o Provide privacy o Involve residents in their care

5. NAs should observe for and report the following signs and symptoms during rehabilitation and restorative care: o Increase or decrease in abilities o Change in attitude or motivation o Change in general health o Signs of depression or mood changes

6. REMEMBER: it is extremely important to encourage residents’ independence while assisting with or performing all tasks. Studies show that the more active a person is, the better the mind and body work

7. Lack of mobility can cause these problems: o Loss of self-esteem o Depression o Anxiety o Boredom o Pneumonia o Urinary tract infections (UTIs) o Skin breakdown and pressure injuries o Constipation o Blood clots o Dulling of the senses o Muscle atrophy o Contractures o Problems with independence and self-esteem

8. Regular ambulation and exercise improve these things: o Quality and health of the skin o Circulation o Strength

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Sleep and relaxation Mood Self-esteem Appetite Elimination Blood flow Oxygen level

9. REMEMBER: NAs should always check the care plan before helping a resident to ambulate, and must keep the resident’s limitations in mind

10. NAs should remember these guidelines for cane or walker use: o Make sure cane or walker is in good condition o Make sure the resident is wearing securely fastened, nonskid footwear o Resident should place cane on stronger side o Resident should place both hands on the walker, and walker should be placed no more than six inches in front of resident o Stay near resident on weaker side o Do not hang purses or clothing on walker o Report to nurse if cane or walker seems to be the wrong height

11. REMEMBER: there are many devices available to help people who are recovering from or adapting to a physical condition. NAs should be aware that residents may need time to adjust to using these devices. Residents using new aids to ambulate will likely be off-balance. NAs should stay close by and observe residents for signs of dizziness

12. REMEMBER: proper body alignment aids in recovery and prevents injury to muscles and joints

13. Guidelines to maintain proper body alignment: o Observe principles of alignment o Keep body parts in natural positions o Prevent external rotation of hips o Change positions often, at least every 2 hours o Give back rubs as ordered

14. NAs should remember these guidelines for amputation and prosthetic devices: o Be supportive o Help residents with their ADLs

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Handle prostheses carefully and follow the care plan Follow the nurse’s or therapist’s instructions in applying and removing the prosthesis. Follow manufacturer’s care directions Keep prosthesis and skin under it dry and clean Apply stump sock if ordered Observe skin on the stump and watch for signs of breakdown Never try to fix a prosthesis yourself Do not show negative feelings about the stump during care Treat phantom limb pain as real pain If caring for an artificial eye, wash your hands before handling the eye. Wear gloves. Never clean or soak the eye in rubbing alcohol – it will crack and destroy it Store artificial eye in water or saline. Make sure the container is labeled with resident’s name and room number

15. There are different types of ROM exercises: o PROM – NA does all the work, and the resident does none o AROM – NA encourages, but resident does all the work o AAROM – NA assists and supports the resident in doing the work

16. When assisting with bowel or bladder retraining, it is important that NAs follow these guidelines: o Follow standard precautions. Wear gloves when handling body waste o Explain the training schedule to the resident. Follow the schedule closely o Keep a record of the resident’s bladder and bowel habits. This will help you predict when a resident needs to eliminate o Offer a bedpan or a trip to the bathroom before beginning a long procedure o Encourage plenty of fluids o Encourage foods that are high in fiber o Answer call lights promptly o Provide privacy for elimination, both in the bed and in the bathroom o If a resident has trouble urinating, try running water in the sink and have them lean forward slightly o Do not rush the resident o Assist with careful perineal care o Discard wastes properly o Discard clothing protectors and incontinence briefs properly o If your facility uses washable bed protectors or briefs, follow Standard Precautions when handling these items o Keep an accurate record of urination and bowel movements --> includes episodes of incontinence o Do not talk to residents as if they are children o Never show frustration or anger

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Be positive and patient. Praise and encouragement are essential. Report changes in skin

17. REMEMBER: it is very important that NAs keep a positive attitude when assisting residents who are going through retraining. Imagining what it would feel like if you were unable to control your own bowel and bladder, this can help you create empathy for residents...