Chapter 18, 19, 20 review

Chapter 18, 19, 20 Review

Multiple Choice

the back lying position is called:

• Fowlers position

• the supine position

• the lateral position

• Sim's position

The supine position (dorsal recumbent) is the back lying position. Pg 263

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Multiple Choice

Patients and residents are re-positioned at least every:

• 15 minutes

• 30 minutes

• 2 hours

• 3 hours

Whether the patient is in bed or a chair, the person is repositioned at least every 2 hours or more often if needed. Follow the persons care plan if you are unsure how often to turn (Pg 261)

Multiple Choice

In Fowlers position:

• the bed is flat

• the head of the bed is raised 45 to 60 degrees.

• the persons's head is turned to 1 side

• the feet hang over the edge of the mattress

In fowlers position the head of the bed is raised 45 - 60 degrees.

In Semi fowlers the head of the bed is raised 30 degrees.

In High fowlers the head of the bed is raised 60 - 90 degrees.

(Pg 262)

Multiple Choice

A patient with a spinal injury is turned with:

• the logrolling procedure

• a transfer belt

• a mechanical lift

• a pillow under the head and neck

When a patient has a spinal injury they are turned as a whole using the logrolling method. When you turn a patient this way the head, neck, and spine are all kept straight and turned together (Pg 280)

Multiple Choice

A person needs to move up in bed. The person can assist, you should:

• stand by for safety but not assist

• move the person up in bed by yourself

• tell the person not to assist to avoid injury

• ask for help and get a friction reducing device

To move a patient with an assistive device you must have a coworker with you to help. Place the device under the patient and pull tight to remove any wrinkles. Then slide the patient up in bed with your coworker (pg 274)

Multiple Choice

to protect the persons skin when moving in bed

• slide the person

• move the mattress

• use a transfer belt

• Roll the person

To reduce friction and shearing while moving the patient in bed you would roll the person and use assistive devices like a lift sheet if needed. (Pg 269)

Multiple Choice

You are using a stand assist mechanical lift. Which is unsafe?

• the person is holding the lifts hand grips

• the persons feet are on the footplate

• the lifts base is narrow when lifting

• the persons knees are against the knee pad

When using a mechanical lift you want the base of the lift to be wide when transferring a patient. This provides more balance and support with the lift. (Pg 302)

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Multiple Choice

A stand and pivot transfer is unsafe for a person who:

• is hard of hearing but can follow directions

• can bear some weight with the legs

• is confused and combative

• uses a transfer belt

A patient must be able to follow commands to safely do a stand and pivot transfer. The patient who is confused cannot follow commands. (Pg 290)

Multiple Choice

When using a mechanical lift:

• position the lift on the persons strong side

• collect a sling, battery, and transfer belt

• compare the persons weight to the lifts weight limit

• allow the person to control the lift.

Always be sure to check the patients weight vs the maximum weight on the lift. If the patient exceeds the lift you cannot use it on them. (Pg 300)

Multiple Choice

For a safe transfer with a full sling mechanical lift, at least:

• 1 worker is needed

• 2 workers are needed

• 4 workers are needed

• 3 workers are needed.

At least 2 staff members are needed in order to operate a mechanical lift with a patient. (Pg 301)

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Multiple Choice

A pillow is placed against the persons back in:

• a chair while restraints are used

• the prone position

• the lateral position

• sims position

In the lateral position the patient is lying on their side with a pillow under their back to keep them at a 45 degree angle with the mattress. (Pg 264)

Multiple Choice

Before turning a person onto his or her side, you:

• move the person to the middle of the bed

• move the person to the opposite side of the bed

• raise the head of the bed

• position pillows for comfort

Move the person to the opposite side of the bed before turning otherwise the patient will be lying on the side of the bed and not in the middle after being turned on their side. (Pg 276)

Multiple Choice

Which is unsafe for a stand and pivot transfer to a wheelchair?

• the wheelchairs front rigging is removed

• the persons feet are flat on the floor

• the person is wearing slip resistant footwear

• the wheelchair is behind you

You want the wheelchair to be at angle to the patient while doing a stand and pivot transfer. You want to stand the patient up and then just pivot them into the chair. (Pg 291)

Multiple Choice

to transfer a person from a wheelchair to a toilet

• position the wheelchair facing the toilet

• remove the transfer belt when lowering clothing

• tell the person to hold on to the towel bar for support

• lock the wheelchair wheels

Steps to transfer to a toilet

1. When transferring a patient to the toilet you would position the wheelchair at a right angle to the toilet. Preferably with the patients strong side closer to the toilet.

2. Lock the wheels

3. raise the foot plates if needed

4. apply gait belt and begin transfer (Pg 297)

Subject | Subject

Multiple Choice

When a person cannot keep his or her upper body erect in a chair

• a vest restraint can be used

• postural supports help maintain alignment

• A geriatric chair with a tray provides support

• a belt restraint can be applied

Pg 264

• Some patients may use positioners, pillows, or postural supports to keep them upright while in a chair.

• Pillows cannot be used if patient is restrained

Multiple Choice

People with heart and respiratory disorders usually can breathe more easily in the:

• fowlers position

• semi fowlers position

• supine position

• prone position

A patient with heart or respiratory disorders can benefit from the fowlers position. This position allows for more expansion of the lungs which helps make breathing easier for the patient.

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Pg 262

Multiple Choice

Which CNA is using the rules of good body mechanics to move a heavy object.

• CNA A pushes, slides, or pulls the object

• CNA B reaches upwards to grab the object

• CNA C bends forward to lift the object

• CNA D works alone to control the object

Pg 258

• You want to push, slide, or pull heavy objects whenever you can instead of lifting them.

  • pushing is easier than pulling

• do not do any unnecessary bending or reaching

  • this puts strain on your back

Subject | Subject

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Multiple Choice

Which term describes the level of help that is needed if a person requires help to turn, re position, sit up, and move in bed?

• Total dependance

• extensive assistance

• limited assistance

• supervision

This patient requires total care by staff, this puts them at the level of total dependance. That means they are dependent on staff to do everything for them like: moving, feeding, toileting, and repositioning. (Pg 268)

Multiple Choice

You can move a person up in bed by yourself if the:

• Person can assist using a trapeze

• rest of the staff is busy and cannot help

• nurse tells you to use a lift sheet or slide sheet

• nurse tells you to move the person alone.

You can move a patient by yourself if they are lightweight and can use a trapeze to assist.

However it is best if you have help and an assistive device. (Pg 272)

Multiple Choice

When delegated to turn a person, which information do you need from the nurse and the care plan?

• whether the person has given informed consent

• which staff helped when the person was last turned

• whether the doctor has ordered turning

• what supportive devices are needed for positioning

You must know how much help and what equipment are needed to transfer the patient.

Follow the nurses direction and care plan if you are unsure about their assistive devices.

(Pg 270, Box 19-1)

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Multiple Choice

You can reduce friction and shearing by:

• rolling the person.

• using a transfer belt.

• positioning the person in Fowler’s position.

• sliding the person.

To reduce friction and shearing when moving the person in bed roll them or use friction reducing devices (Pg 269)

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Multiple Choice

When moving a person in segments, what do you move first?

• The legs and feet

• The middle of the body

• The upper part of the body

• The head

When moving a person to the side of the bed in segments, you start at the upper body. Then the lower part of the body is moved and finally the legs are moved. (Pg 276)

Multiple Choice

You are going to transfer a resident from the wheelchair back to bed. Where should you position the wheelchair?

• On the person’s strong side

• On the person’s weak side

• Where it was when the person was transferred from the bed to the wheelchair

• Wherever the person prefers

If a person is weak on 1 side then transfer the person so that their strong side moves first. (Pg 295)

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Multiple Choice

A transfer belt is not needed to transfer a resident from the bed to a chair. For the transfer, how should you hold on to the person?

• Have the person put her arms around your waist.

• Have the person put her arms around your neck.

• Place your hands under the person’s arms and around her shoulder blades.

• Hold the person’s weak arm while she supports herself with her strong arm.

When a patient does not need a transfer belt according to their care plan, You would put your arms around the person and grasp their shoulders as they transfer. (Pg 292, Safety and comfort box)

Multiple Choice

For a lateral transfer, you should make sure the bed rails are down.

• True

• False

​When transferring a patient laterally it is important to make sure the side rails are lowered and out of the way. This prevents the patient from hitting them and makes the transfer easier for staff

Multiple Choice

When using an assist device to move a person to the side of the bed, you need at least 1 co-worker to help you.

• True

• False

When moving a patient using an assistive device at least 2 staff members must be present. (Pg 274)

Multiple Choice

You need to reposition a person in the chair. Which is correct?

• Follow the nurse’s directions and the care plan.

• Pull the person up from behind.

• Use a transfer belt.

• Ask the person what to do.

Always follow the care plan and nurses directions for transferring a patient. Each patient transfers differently so it is important to talk with the nurse or follow the care plan if your unsure how a patient transfers.

Multiple Choice

How many workers are needed for safe stretcher transfers?

• just 1

• 2 or 3

• 3 or 4

• at least 4