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Skin graft is a SURGERY where a FRESH layer of skin from PATIENT body is cut and placed it over the damaged skin of the patient. This METHOD is usually USED in treating patient having third-degree burn.

Skin graft is a surgery where a fresh layer of skin from patient body is cut and placed it over the damaged skin of the patient. This method is usually used in treating patient having third-degree burn.

Occlusive dressing is not used for TREATING wound for long terms, but it is used to PROVIDE immediate control of pressure and to stop bleeding from the wound. It provides a BARRIER between the wound and contamination agent LIKE AIR and water.

Occlusive dressing is not used for treating wound for long terms, but it is used to provide immediate control of pressure and to stop bleeding from the wound. It provides a barrier between the wound and contamination agent like air and water.

BURNS are categorised according to their severity; There are five types of burns:

First-degree burns: First-degree burn involves red, dry and painful blanch on the epidermis. It heals in 1 WEEK without scarring.

Superficial or second degree burns: There is a blister formation and is very painful it includes the superficial dermis. It usually takes 10 to 14 days for healing.

Deep second degree burn: it is less painful than superficial dermis, but it takes more time to HEAL.

Third-degree burn: In this burn, you would observe a leather like texture due to destroyed collagen, and they do not heal spontaneously.

Fourth-degree burn: It extends beyond the skin to FAT, tendon, muscle or bone. In such cases, you need amputation or COMPLEX reconstruction.

Burns are categorised according to their severity; There are five types of burns:

First-degree burns: First-degree burn involves red, dry and painful blanch on the epidermis. It heals in 1 week without scarring.

Superficial or second degree burns: There is a blister formation and is very painful it includes the superficial dermis. It usually takes 10 to 14 days for healing.

Deep second degree burn: it is less painful than superficial dermis, but it takes more time to heal.

Third-degree burn: In this burn, you would observe a leather like texture due to destroyed collagen, and they do not heal spontaneously.

Fourth-degree burn: It extends beyond the skin to fat, tendon, muscle or bone. In such cases, you need amputation or complex reconstruction.

An air EMBOLISM is a medical term used when any large air bubble trapped in blood VESSEL. At some INSTANT of time, this air bubble could block the artery and cut off the blood supply to a particular PART of the body. DEATH may occur if large bubble of gas becomes lodged in the heart.

An air embolism is a medical term used when any large air bubble trapped in blood vessel. At some instant of time, this air bubble could block the artery and cut off the blood supply to a particular part of the body. Death may occur if large bubble of gas becomes lodged in the heart.

While giving subcutaneous injections:

• Injection should not contain fluid more than 1 ml
• Give at 45-90 degrees of angle
• It can be given at outermost part of the upper arm, abdomen, anterior part of the thigh, upper BACK, upper ventral or dorsogluteal AREA. The INSERTION SITE DEPENDS on the nature of medication and patient’s preference.

While giving subcutaneous injections:

Intradermal: Intradermal is the method of INJECTING drugs within the dermis layer of the SKIN.

Intravenous: Intravenous is the method of administering the DRUG or fluid DIRECTLY into the veins

Intradermal: Intradermal is the method of injecting drugs within the dermis layer of the skin.

Intravenous: Intravenous is the method of administering the drug or fluid directly into the veins

The topical drugs are applied to the surface area of the body. The two purpose of topical drugs are

Local Effect: The DRUG is used to relieve the patient from burning, ITCHING or other skin conditions

Systemic Effect: The drug is absorbed through the skin into the BLOODSTREAM

The topical drugs are applied to the surface area of the body. The two purpose of topical drugs are

Local Effect: The drug is used to relieve the patient from burning, itching or other skin conditions

Systemic Effect: The drug is absorbed through the skin into the bloodstream

Different METHODS for administering the medication is

1. Parenteral
2. INTRADERMAL
3. Intramuscular
4. Intravenous
5. Inhalation
6. Vaporization
7. Gas Inhalation
8. Nebulization
9. Topical
10. RECTAL
11. Vaginal

Different methods for administering the medication is

• During patient bed bath, bed should be in HIGH POSITION
• Side rails should be up after the patients bath for the patient who is CONFINED to the bed
• Side rails help to prevent falls for the elderly patient
• Patients call LIGHT should be in reach of the patient
• No smoking is allowed surround the patient bed
• Wash hands after leaving the patient room

For unconscious patients, nurse has to do following things

• At least EVERY four HOURS oral care should be taken care of
• To PREVENT aspiration in the unconscious patient oral suctioning may be required
• A SOFT toothbrush or gauze padded tongue can be used to CLEAN and mouth
• Patient handling in suitable position for drainage and to prevent perspiration.

For unconscious patients, nurse has to do following things

The duties of nursing assistance includes:

• Dressing
• Skin CARE and bathing
• Feeding
• Mouth and Hair care
• Making beds
• Toileting assistance and catheter care
• HELPING patient to walk who can’t
• Assisting with RANGE of motion EXERCISE
• Positioning bedridden patients regularly
• Safety awareness
• Reporting all changes to the nurse
• Observing, reporting and DOCUMENTATION
• Post-mortem care

The duties of nursing assistance includes:

ACCORDING to WHO, a diabetic person has BLOOD sugar 7millimoles PER litre or more and blood GLUCOSE after two hours of eating is 11.1 MILLIMOLES per litre

According to WHO, a diabetic person has blood sugar 7millimoles per litre or more and blood glucose after two hours of eating is 11.1 millimoles per litre

NORMAL blood GLUCOSE in a healthy PERSON is between 4-8 millimoles PER LITRE.

Normal blood glucose in a healthy person is between 4-8 millimoles per litre.

The VARIOUS field where nurse practitioners can provide their service are

1. Neonatology
2. Nurse-midwifery
3. SCHOOL HEALTH
4. Women’s health
5. Family and adult health
6. Paediatrics
7. Mental health
8. Home Care
9. GERIATRICS

The various field where nurse practitioners can provide their service are

The most difficult part of being NURSE is

• You have to take care of many patients at the same time which cause much stress sometimes
• When you see your PATIENT hopeless and SUFFERING from pain
• When you cannot help patient to face a difficult situation
• When you have to work in SHIFT

The most difficult part of being nurse is

Registered nurses primary RESPONSIBILITIES are

• Administering medications
• Managing intravenous lines
• Monitoring and observing patients conditions
• Maintaining records and communicating with DOCTORS
• If necessary provide MORAL support to patients and relatives
• GIVING direction patient and patient relative about medications
• Train other nurses

Registered nurses primary responsibilities are

An LVN nurse are not allowed to PRONOUNCE patient’s death in hospital, however there are different laws for different states, and few FACILITIES ALLOW two RNs to pronounce patient death with a SET protocol.

An LVN nurse are not allowed to pronounce patient’s death in hospital, however there are different laws for different states, and few facilities allow two RNs to pronounce patient death with a set protocol.

The nurse who are willing to or intended to work with radiologic procedure has to register themselves with the regulatory board of that states by filling the form with documents like.

• Current licensure of a registered nurse.
• The name and address of the PRACTITIONER or director of RADIOLOGICAL services under whose GUIDANCE the radiologic procedure has to be performed.
• Once received confirmation of registration, any change in the information shall be INFORMED in 30 days.
• The nurse has to practice according to the regulatory body of the nurse of that state.

The nurse who are willing to or intended to work with radiologic procedure has to register themselves with the regulatory board of that states by filling the form with documents like.

Vocational nurse cannot give any direction or SUGGESTION to the PATIENT in an INDEPENDENT environment to SAFEGUARD patient.

Vocational nurse cannot give any direction or suggestion to the patient in an independent environment to safeguard patient.

The regulatory body for nurses does not GIVE permission to vocational nurse to administer SEDATION drug INTRAVENOUSLY or by any other ROUTE to the patient. However, regulatory board cannot supervise the PHYSICIAN practice.

The regulatory body for nurses does not give permission to vocational nurse to administer sedation drug intravenously or by any other route to the patient. However, regulatory board cannot supervise the physician practice.

The board of nursing of that states determines the PRACTICE for nursing. As FAR as medical SCREENING exam is concerned, it is not under the SCOPE of vocational nurses, regardless of having YEARS of experience. Even if the physician wishes to delegate the assessment of the medical condition, vocational nurse can only perform the task that falls under the act 217.11.

The board of nursing of that states determines the practice for nursing. As far as medical screening exam is concerned, it is not under the scope of vocational nurses, regardless of having years of experience. Even if the physician wishes to delegate the assessment of the medical condition, vocational nurse can only perform the task that falls under the act 217.11.

A VOCATIONAL nurse can initiate intravenous fluids into a peripheral site when

• LVN holds a valid post license certificate in intravenous therapy
• When the infusate is a solution of vitamins, ELECTROLYTE, nutrients, BLOOD or blood products
• When administration is carried out under the supervision of a valid physician order

A vocational nurse can initiate intravenous fluids into a peripheral site when

Vocational nurses may NOT do

• Comprehensive assessments like complete medical analysis
• May not MAKE a medical or nursing diagnosis
• May not assume RESPONSIBILITY for determining nursing interventions for specific patients
• May not independently determine or initiate a course of treatment
• May not PERFORM endotracheal intubation
• May not administer emergency MEDICATION intravenously or via endotracheal tube
• May not apply CASTS
• May not cut a window or bivalve a cast even upon the order of a physician
• May not dispense medication
• May not remove an occlusion by aspiration or other means
• May not initiate or superimpose intravenous fluids into a peripheral site if the infusate contains medications

Vocational nurses may NOT do

General observation that vocational nurse have to do are

• Check for the vital sign in a patient, including apical pulse

• Height and Weight

• General appearance of skin and nails

• Hair masses and swelling of the scalp

• Pupil size, shape, symmetry and reaction to light

• Analysis of the LIPS appearance like color, ulceration, moisture, ETC.

• Check inside the mouth like bleeding gums, dental caries, cracked or chipped teeth

• General appearance of the mouth and color of the sclera

• Abdominal TENDERNESS or see for bowel sounds

• Curvature of the spine, posture, gait or motion problems

• DEFORMITIES and joint injuries

• Peripheral PULSES

• edema and involuntary muscular movements

General observation that vocational nurse have to do are

• Check for the vital sign in a patient, including apical pulse

• Height and Weight

• General appearance of skin and nails

• Hair masses and swelling of the scalp

• Pupil size, shape, symmetry and reaction to light

• Analysis of the lips appearance like color, ulceration, moisture, etc.

• Check inside the mouth like bleeding gums, dental caries, cracked or chipped teeth

• General appearance of the mouth and color of the sclera

• Abdominal tenderness or see for bowel sounds

• Curvature of the spine, posture, gait or motion problems

• Deformities and joint injuries

• Peripheral pulses

• edema and involuntary muscular movements

To stay updated with the NURSING profession, you have to

• Subscribe professional nursing journals and literature like American Journal of Nursing
• REGISTERING with relevant forums and groups
• Attending SEMINARS and vocational TRAINING program
• Learn about new technologies used in field ONLINE

To stay updated with the nursing profession, you have to

Vocational nurse can work ANYWHERE in

• In the HOSPITAL under supervision of LVN, RN or DOCTORS
• Community care facilities
• College or community health clinics
• Private homes
• Nursing homes
• PHYSICIAN OFFICES
• Outpatient care centers

Vocational nurse can work anywhere in

Some of the challenges that nurse have to face is

• Meeting patient expectation
• WORK stress DUE to limited STAFF
• Time MANAGEMENT
• Working in ODD shift
• Conflict between staff members, patient and patient relatives .Nurse.

Some of the challenges that nurse have to face is

Skills required for a VOCATIONAL Nurse is

• He/she should be a people’s PERSON
• Always ready to serve people
• Good at communication and understanding people’s problem
• Must mentally PREPARE to do any WORK
• Must be detail oriented- observing, receiving and obtaining information from lead nurse, doctors and patients

Skills required for a Vocational Nurse is

RN is a Registered Nurse and more responsible in respect of SETTING patient care than LVN. While, LVN is a Licensed Vocation Nurse, and can COLLECT DATA on a patient and carries out clinical duties under the SUPERVISION of licensed physician or RN. Both has to pass a national licensing exam- for LVN it is NCLEX-PN and for RNS it is NCLEX-RN. Without holding the certificate of LVN one cannot work as vocational nurse.

RN is a Registered Nurse and more responsible in respect of setting patient care than LVN. While, LVN is a Licensed Vocation Nurse, and can collect data on a patient and carries out clinical duties under the supervision of licensed physician or RN. Both has to pass a national licensing exam- for LVN it is NCLEX-PN and for RNs it is NCLEX-RN. Without holding the certificate of LVN one cannot work as vocational nurse.

Duties of VOCATIONAL Nurse includes:

• Provide medication regularly or intravenous fluid
• Observe PATIENTS and reporting any changes in patient’s condition
• Sterilize equipment and supplies
• Provide basic patient care like checking patient temperature, treating bedsores, dressing wounds, performing catheterization
• Answer patients call
• Collect samples of urine, BLOOD and sputum and send samples for laboratory TESTS
• ASSEMBLE and sterilize equipment like catheters, tracheotomy tubes and oxygen suppliers
• Prepare the patient for tests, examinations and treatments.

Duties of Vocational Nurse includes:

• Offer them the best care and advice for their GOOD HEALTH
• Provide them comfort and attention by LISTENING to their concerns
• Ensuring that they are TAKING their MEDICATION regularly

To GET the most accurate PATIENT weight, the NURSING ASSISTANT should weigh the patient at the same time every day.

To get the most accurate patient weight, the nursing assistant should weigh the patient at the same time every day.

To apply wrist and ankle restraint:

• Pad the bony AREAS of the restrained area.
• The padded PORTION should be applied at the ankle or wrists correspondingly
• The tie of the restraint should be PULLED through the corresponding slit
• To avoid the tourniquet effect, use a half-bow knot in order to attach the other end to the movable side of the bed
• Be CAREFUL while REMOVING the restraints, because failing to follow them will be considered negligence.

To apply wrist and ankle restraint:

Yes, they both are same “STNA” STANDS for State Tested NURSING ASSISTANT and “CNA” stands for Certified Nursing Assistant.

Yes, they both are same “STNA” stands for State Tested Nursing Assistant and “CNA” stands for Certified Nursing Assistant.

COMPLICATIONS that can develop due to IMMOBILITY are:

• BLOOD clots
• PRESSURE sores
• Contractures
• Constipation

Complications that can develop due to immobility are:

A RESIDENT in a SHOWER chair should be placed facing the DOOR of the shower STALL.

A resident in a shower chair should be placed facing the door of the shower stall.

A GOAL of hospice CARE is to PROVIDE comfort to terminally ill patients and their FAMILIES

A goal of hospice care is to provide comfort to terminally ill patients and their families

As a PRECAUTION, while measuring blood PRESSURE, you NEED to MAKE SURE that you don’t take a BP on an arm with an IV.

As a precaution, while measuring blood pressure, you need to make sure that you don’t take a BP on an arm with an IV.

The right method to correct an error made while charting on a resident’s CHART is to draw ONE line through it, write the WORDS “MISTAKEN entry,” and then INITIAL.

The right method to correct an error made while charting on a resident’s chart is to draw one line through it, write the words “mistaken entry,” and then initial.

( P.Jason ,CNA.) is the CORRECT WAY to SIGN the NAME.

( P.Jason ,CNA.) is the correct way to sign the name.

• HEIMLICH maneuver is a technique used when a person’s airway get chocked. In this technique you Reach around the victim from behind. Circle your HANDS around the victim’s stomach
• Make a fist with your DOMINANT hand. The thumb of the fist should point into the stomach (just above the victim’s navel )
• WRAP your other hand firmly around this fist and give a good inward push by pressing the victim’s abdomen
• These thrusts should be REPEATED until either the item is removed, or the resident loses consciousness.
• Use less force if the victim is a child.

To record intake and output in a resident or patient, follow the STEPS below.

• Locate liquid foods for the resident and record their intake
• Record liquid food intake in cubic centimeters or milliliters as per facility POLICY
• The output is measured by pouring the URINE of the resident into a graduate
• While USING a GLOVED hand to hold the graduate, use a gloveless hand to flush down the toilet
• Disinfect each and every appliance used during the test
• Record the urine output and report any form of the unusual characteristic to nurse.

To record intake and output in a resident or patient, follow the steps below.

A CNA can become LN (Licensed Nurse):

• Need as many as 200 hours of additional EDUCATION in some areas like pediatrics, maternal medicine, and gerontology.
• Need experience in a hospital, CLINIC, or private practice that you can use toward your license
• Need to PASS the national NCLEX-PN exam to work in a hospital setting

A CNA can become LN (Licensed Nurse):

• Knock on the door, call out to the resident by name and begin conversation.
• keep conversation to the POINT and brief.
• Use simple direct questions.
• Be patient and wait for answers.
• Use COMMUNICATION tools like Notepads and pens, scrabble tiles, flash cards, pointing, picture boards and maybe charades.
• REPEAT it back to MAKE sure you heard right what is said.

For handling Urinary drainage bag, CNA should PRACTICE following steps

• Wear gloves before handling urinary SAMPLE or urinary drainage bag
• Empty bag into relevant container without TOUCHING tubing against container
• After emptying URINE wipe drain with alcohol SWAB
• Close or protect drain
• Leave bag close to bed and should not touch floor (use barrier)
• Remove gloves and wash hands

For handling Urinary drainage bag, CNA should practice following steps

Some of the types of post-surgical care that a nursing assistant can be ASKED to provide for PATIENTS include:

• Monitoring and recording of vital signs ( blood pressure, temperature, heart rate, and respiratory rate)
• Post-Operative Pain, make SURE their pain is under CONTROL
• Carefully moving the patient as such tubes or drains are connected with patients body
• Fluid Intake/Output should be monitored

Some of the types of post-surgical care that a nursing assistant can be asked to provide for patients include:

The responsibility of a CNA when he is informed about an admission is to,

• Prepare the room, bed, clothing and other NECESSARY equipment.
• Complete the admission process.
• Make sure the patient’s MEDICATIONS have been received from the PHARMACY and it’s
• Coordinate the patient’s care with the REST of the treatment team.

The responsibility of a CNA when he is informed about an admission is to,

• A CNA must do following things to ASSIST during a code,
• Retrieve emergency equipment, including the code cart or intubation box. Perform other tasks that fall WITHIN a CNA’s scope of practice.
• DOCUMENT the events
• Administer emergency medications as per the physician’s INSTRUCTIONS
• Speak with the family and inform them about what is HAPPENING.

The best way to deal with irritant PATIENT is

• TALK to them
• INFORM them of what you will be doing
• Be kind and gentle
• Always CHECK the ROOM for any hazards or waste
• Be courteous and treat them with respect
• Be vigilant in monitoring what they are doing at all times of the procedure

The best way to deal with irritant patient is

In CNA practice:

• Assault is referred to PHYSICAL VIOLENCE or threat to use violence against SOMEONE.
• Battery is ACTUALLY referred for physical violence or wrongful touching against someone.

In CNA practice: