Chapter 4 CNA

5/17/15
4
Communication and Cultural Diversity
1. Define the term communication
Define the following term:
communication
the process of exchanging information with others by sending
and receiving messages.
4 Communication and Cultural Diversity
Transparency 4-1: Communication Process
4
1. Define the term communication
Remember these points about the communication process:
All three steps must occur before the process is complete.
During a conversation the process is repeated over and over.
Effective communication is a critical part of an NAs job.
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2. Explain verbal and nonverbal communication
Define the following terms:
verbal communication
communication involving the use of spoken or written words
or sounds.
nonverbal communication
communicating without using words.
Transparency 4-2: Body Language
4
2. Explain verbal and nonverbal communication
Think about these questions:
Are there ever conflicts between what a person is communicating
verbally and nonverbally?
How can an NA use observation as a form of nonverbal
communication with a resident?
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3. Describe ways different cultures communicate
cultural diversity
the different groups of people with varied backgrounds and
experiences who live together in the world.
bias
prejudice.
culture
a system of learned behaviors, practiced by a group of
people, that is considered to be the tradition of that people
and is passed on from one generation to the next.
4
Think about this question:
How might culture influence or affect communication between an
NA and a resident?
4
Cultural background can affect all of these communication
issues:
Distance/personal space
Touch
Eye contact
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4. Identify barriers to communication
clichs
phrases that are used over and over again and do not really
mean anything.
Transparency 4-3: Barriers to Communication
4
4. Identify barriers to communication
What are some examples of slang expressions?
Do residents and NAs have the same understanding of slang?
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5. List ways to make communication accurate and explain how to
develop effective interpersonal relationships
These techniques can help an NA communicate clearly and
effectively:
Be a good listener.
Provide feedback.
Bring up topics of concern.
Allow pauses.
Tune in to other cultures.
4
Techniques to help an NA communicate clearly and effectively
(contd):
Accept residents religion or lack of religion.
Understand touch.
Ask for more information.
Make sure communication aids are clean and working.
4
REMEMBER:
Providing excellent care requires good communication and also
requires that NAs build effective relationships with residents,
family members, and the care team.
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The following tips are helpful in building positive relationships:
Avoid changing the subject.
Do not ignore requests.
Do not talk down to people.
Sit near the resident.
Lean forward when a resident is speaking.
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Tips for building positive relationships (contd):
Talk directly to the resident you are assisting.
Approach the person who is talking.
Be empathetic.
Have time for residents families and friends too.
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6. Explain the difference between facts and opinions
What are some examples of facts? Examples of opinions?
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6. Explain the difference between facts and opinions
REMEMBER:
Understanding the difference between facts and opinions will help
an NA communicate her observations of residents in a more
professional way.
4
7. Explain objective and subjective information and describe how
to observe and report accurately
objective information
information based on what a person sees, hears, touches, or
smells; also called signs.
subjective information
information that a person cannot or did not observe, but is
based on something reported to the person that may or may
not be true; also called symptoms.
incontinence
the inability to control the bladder or bowels.
Transparency 4-4: Using Your Senses
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7. Explain objective and subjective information and describe how
to observe and report accurately
What are some specific observations an NA might make using
each of the senses shown on the transparency (smell, sight,
hearing, touch)?
4
8. Explain how to communicate with other team members
NAs should keep the following in mind when communicating with
their team members:
Keep the nurse informed of all important issues during the
shift.
Communicate with other care team members as needed to
provide quality care.
Always respect residents privacy when communicating with
other care team members.
Be careful with communicationdo not share information
about diagnoses/condition changes.
When in doubt about what you can or should communicate,
ask the nurse.
Use the chain of command to voice complaints.
4
9. Describe basic medical terminology and abbreviations
cyanotic
skin that is blue or gray.
root
part of a word that contains its basic meaning or definition.
prefix
the word part that precedes the root to help form a new
word.
suffix
the word part added to the end of a root that helps form a
new word.
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Handout 4-1: Abbreviations

a
before
AAROM active-assistive range of
motion
abd
abdomen
ABR
absolute bedrest
ac, a.c. before meals
AD
Alzheimers disease
ADC
AIDS dementia complex
ad lib
as desired
ADLs
activities of daily living
adm.
admission
AED
automated external
defribrillator
AHA
American Heart Association
AIDS
AIIR
AKA
acquired immune
deficiency
syndrome
airborne infection isolation
room
above-knee amputation,
also known as
am, AM
AMA
amb
AMD
amt.
ANS
ant.
morning
against medical advice,
American Medical
Association
ambulate, ambulatory
age-related macular
degeneration
amount
autonomic nervous system
anterior
a.p./AP
approx.
AROM
ASAP
assist
as tol
A, T, D
apical pulse
approximately
active range of motion
as soon as possible
assistance
as tolerated
admission, transfer, and
discharge
ax
axillary
BID, b.i.d. two times a day

BKA
bld
BLS
BM
BP, B/P
BPH
BPM
BR
BRP
BSC
BSE
C
c
Ca/CA
CAD
cal
cath.
CBC
below-knee amputation
blood
basic life support
bowel movement
blood pressure
benign prostatic
hypertrophy
beats per minute
bedrest
bathroom privileges
bedside commode
breast self examination
centigrade, Celsius
with
calcium, cancer, carcinoma
coronary artery disease
calorie
catheter
complete blood count
CBI
CBR
CCMS
CDC
CDE
C. diff
CEP
CEU
CHD
CHF
chol
ck
cl liq
cm
continuous bladder irrigation

complete bedrest
clean-catch midstream
Centers for Disease Control
and
Prevention
certified diabetes educator
clostridium difficile
competency evaluation
(testing)
programs
continuing education unit
coronary heart disease
congestive heart failure
cholesterol
check
clear liquid
centimeter

CMS
CNA
CNP
CNS
c/o
CO2
COLD
COPD
CP
CPM
CPR
CRF
C.S.
CSF
Centers for Medicare and

Medicaid Services
certified nursing assistant
certified nurse practitioner
central nervous system
complains of, in care of
carbon dioxide
chronic obstructive lung
disease
chronic obstructive
pulmonary
disease
cerebral palsy
continuous passive motion
cardiopulmonary
resuscitation
chronic renal failure
Central Supply
cerebrospinal fluid
CVA
CVP
CVS
CXR
DAT
DJD
DKA
DM
DNR
DO
DOA
DOB
DON
Dr.
DRG
drsg
cerebrovascular accident,
stroke
central venous pressure
cardiovascular system
chest x-ray
diet as tolerated
degenerative joint disease
diabetic ketoacidosis
diabetes mellitus
do not resuscitate
doctor of osteopathy
dead on arrival
date of birth
director of nursing
doctor
diagnostic related group
dressing
DVT
Dx/dx
deep vein thrombosis

diagnosis
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ECG, EKG electrocardiogram
ED
emergency department
EENT
eye, ear, nose, and throat
e.g.
for example
EMS
emergency medical
services
ER
emergency room
ESRD
end-stage renal disease
et al.
and other things
ETOH
alcohol
exam
examination
F
Fahrenheit, female
FBS
fasting blood sugar
FDA
Food and Drug
Administration
Fe
iron
FF
force fluids
FH
family history
fld
fluid
FS
FSBS
ft
F/U, f/u
FUO
FWB
fx
FYI
GAD
gal
GB
GERD
fingerstick
fingerstick blood sugar
foot
follow-up
fever of unknown origin
full weight-bearing
fracture
for your information
generalized anxiety disorder
gallon
gallbladder
gastroesophageal reflux
disease
geri chair geriatric chair
GI
gastrointestinal
g
gram
GP
general practitioner
GSW
GTT
gunshot wound
glucose tolerance test

GU
genitourinary
GYN/gyn gynecology
h, hr, hr. hour
water
H20
H202
hydrogen peroxide
H/A
headache
HAART
highly active antiretroviral therapy
HAV
hepatitis A virus
HBV
hepatitis B virus
HCV
hepatitis C virus
HDV
hepatitis D virus
HEV
hepatitis E virus
Hg
mercury
HHA
home health aide
Hi-cal
high calorie
HIPAA
Health Insurance
Portability and
Accountability Act
HIV
HOB
HOH
H&P
HPV
HS/hs
ht
HTN
H.U.C.
Hx
hyper
human immunodeficiency
virus
health maintenance
organization
head of bed
hard of hearing
history and physical
human papillomavirus
hours of sleep
height
hypertension
Health Unit Coordinator
history
above normal, too fast, rapid
hypo
IBD
IBS
low, less than normal

irritable bowel disease
irritable bowel syndrome
HMO

IICU
ICU
ID
I&D
i.e.
IM
In
inc
inf
I&O
IQ
irr., irrig
isol
I.V., IV
K+
kg
intermediate intensive
care unit
intensive care unit
identification
incision and drainage
that is
intramuscular
inch
incontinent
inferior
intake and output
intelligence quotient
irrigation
isolation
intravenous
potassium
kilogram
lab
lb
LBP
LE
lg
liq
LLE
LLQ
LOC
laboratory
pound
low back pain
lower extremity
large
liquid
left lower extremity
left lower quadrant
level of consciousness, level
of care
Low-cal low-calorie
Low-fat/ low-fat, low-calorie
Low-cal
Low-Na low-sodium
LPN
Licensed Practical Nurse
LTC
long-term care
LTCF
long-term care facility
KS
l, L
L, lt
Kaposis sarcoma
liter
left
LUQ
left upper quadrant
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LVN
M.D.
MD
MDROs
Licensed Vocational Nurse

medical doctor
muscular dystrophy
multidrug-resistant
organisms
MDR-TB multidrug-resistant
tuberculosis
MDS
minimum data set
meds
medications
med-surg medical-surgical
mg
milligram
MI
myocardial infarction
min
minute
mL
milliliter
mm
mm Hg
MO
mod
millimeter
millimeters of mercury
microorganism
moderate
MRI
MRSA
magnetic resonance imaging

methicillin-resistant
staphylococcus aureus
MS
multiple sclerosis
MSDs
musculoskeletal disorders
MSDS
material safety data sheet
MSW
medical social worker
MUFA
monounsaturated fat
MVA
motor vehicle accident
Na
sodium
N/A
not applicable
NA
nursing assistant
NaCl
sodium chloride
NAS
no added salt
NATCEP Nurse Aide Training and
Competency Evaluation
Program
N/C
no complaints, no call
NCS
no concentrated sweets

neg
NF
NG, ng
NIBP
NKA
NKDA
no
noc
NPO
NVD
NWB
O2
OB
ob/gyn
OBRA
occ
negative
nursing facility
nasogastric
non-invasive blood
pressure
monitoring
no known allergies
no known drug allergies
number
night
nothing by mouth
nausea, vomiting, and
diarrhea
non-weight-bearing
oxygen
obstetrics
obstetrics and gynecology
Omnibus Budget
Reconciliation Act
occasionally
OCD
OD
O.D.
OG
OOB
O&P
OPD
O.R.
ord.
ORIF
ortho
os
O.S.
OSHA
OT
obsessive-compulsive
disorder
overdose
right eye
orogastric
out of bed
ova and parasites
outpatient department
operating room
orderly, ordered
open reduction, internal
fixation
orthopedics
mouth
left eye
Occupational Safety and
Health Administration
occupational therapist,
occupational therapy

OTC
PET
O.U.
oz
p
P.A.
PAD
pc, p.c.
PCA
over-the-counter
(medication)
both eyes
ounce
after
physicians assistant
peripheral artery disease
after meals
patient-controlled
anesthesia
PDR
Physicians Desk
Reference
PE
pulmonary embolism
Peds/peds pediatrics
PEG
percutaneous
endoscopic
gastrostomy
peri care
perineal care
per os
by mouth
pH
PH
PHI
phy. ex.
PID
PM/pm
PMH
PNS
PO
pos.
post op
PPD
PPE
pre op
prep
positron emission
tomography
parts hydrogen
past history
protected health information
physical exam
pelvic inflammatory disease
afternoon
past medical history
peripheral nervous system
(per os) by mouth
positive
after surgery
purified protein derivative
(test for tuberculosis)
personal protective
equipment
before surgery
preparation
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p.r.n., prn when necessary
prog.
Progress
PROM
passive range of motion
Pt/pt
patient
pt.
pint
PT
physical therapist,
physical therapy
PTH
parathyroid hormone
PTSD
post-traumatic stress
disorder
PUFA
polyunsaturated fat
PVD
peripheral vascular
disease
PWB
partial weight-bearing
q
every
q2h, q3h, every two hours,
q4h
every three hours,
every four hours
QA
quality assurance
Q&A
questions and answers
qam
qd
qh, qhr
qhs
q.o.d.
qt.
quad
R
R, rt.
RA
RBC
RDT
reg.
rehab
REM
req.
res.
resp.
RF
RLE
every morning
every day
every hour
every night at bedtime
every other day
quart
quadrant, quadriplegic
respirations, rectal
right
rheumatoid arthritis
red blood cell
registered dietician
regular
rehabilitation
rapid eye movement
requisition
resident
respiration
restrict fluids
right lower extremity

RLQ
RN
RNA
R/O
ROM
RR
RT
RUE
RUQ
Rx
s
S&A
s.c.
SCA
SCDs
SIDS
right lower quadrant

registered nurse
restorative nursing
assistant
rule out
range of motion
respiratory rate
respiratory therapy/
therapist
right upper extremity
right upper quadrant
prescription, treatment
without
sugar and acetone
subcutaneously
sudden cardiac arrest
sequential compression
devices
sudden infant death
syndrome
sl
SLE
sublingually
systemic lupus
erythematosus
SLP
speech-language pathologist
sm.
small
SNAFU
situation normal, all fouled
up (slang)
SNF
skilled nursing facility
SNS
somatic nervous system
SOB
shortness of breath
SP
Standard Precautions
S.P.D.
Supply, Processing, and
Distribution
spec.
specimen
ss
one-half
S&S, S/S signs and symptoms
SSE
soapsuds enema
ST
standard, speech therapy
staph
staphylococcus

STAT/stat immediately
Std prec
Standard Precautions
STDs
sexually-transmitted
diseases
STIs
sexually-transmitted
infections
strep
streptococcus
supp.
suppository
surg.
surgery
T., temp
temperature
TB
tuberculosis
tbsp.
tablespoon
T, C, DB
turn, cough, and deep
breathe
THR
total hip replacement
TIA
transient ischemic
attack
t.i.d., tid
three times a day
TKR
total knee replacement
TLC
tender loving care
TPN
T.P.R.
total parenteral nutrition

temperature, pulse, and
respiration
trach.
tracheostomy
tsp.
teaspoon
TWE
tap water enema
Tx, tx
traction, treatment
U/A, u/a urinalysis
UE
upper extremity
UGI
upper gastrointestinal
UNK, unk unknown
URI
upper respiratory infection
US
ultrasound
USDA
United States Department
of Agriculture
UTI
urinary tract infection
vag.
vaginal
VAP
ventilator-acquired
pneumonia
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VRE
VS, vs
W/A, WA
WBC
w/c, W/C
WNL
wt.
yr.
vancomycin-resistant
enterococcus
vital signs
while awake
white blood cell/count
wheelchair
within normal limits
weight
year
Handout 4-2: Prefixes, Roots, Suffixes

Prefixes
a, an: without, not, lack of
analgesic = without pain
ante: before, in front of
antepartum = before delivery
bi: two, twice, double
bifocal = two lenses
brady: slow
bradycardia = slow pulse,
heartbeat
contra: against
contraceptive = prevents
pregnancy
dis: apart, free from
disinfected = free from
microorganisms
dys: bad, painful

dysuria = painful urination
endo: inner
endoscope = instrument for
examining the inside of an organ
epi: on, upon, over
epidermis = outer layer of skin
erythro: red
erythrocyte = red blood cell
ex: out, away from
exhale = to breathe out
hemi: half
hemisphere = one of two parts of
the brain
hyper: too much, high
hypertension = high blood
pressure

Prefixes (contd)
olig: small, scant
hyper: too much, high
hypertension = high blood
pressure
hypo: below, under
hypotension = low blood pressure
inter: between, within
interdisciplinary = between
disciplines
leuk: white
leukocyte = white blood cell
mal: bad, illness, disorder
malformed = badly made
micro: small
microscopic = too small for the
eye to see
oliguria = small amount of urine

patho: disease, suffering
pathology = study of disease
per: by, through
perforate = to make a hole
through
peri: around
pericardium = sac around the
heart
poly: many, much
polyuria = much urine
post: after, behind
postmortem = period after death
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Prefixes (contd)
pre: before, in front of
prenatal = period before birth
sub: under, beneath
subcutaneous = beneath the skin
supra: above, over
suprapelvic = located above the
pelvis
tachy: swift, fast, rapid
tachycardia = rapid heartbeat

Roots
brachi(o): arm
abdomin(o): abdomen
brachial = pertaining to the arm
abdominal = pertaining to the

abdomen
bronchi, bronch(o): bronchus
aden(o): gland
adenitis = inflammation of a
gland
angi(o): vessel
angioplasty = surgical repair of a
vessel using a balloon
arterio: artery
arteriosclerosis = hardening of
artery walls
bronchopneumonia =
inflammation of lungs
card, cardi(o): heart
cardiology = study of the heart
cephal(o): head
cephalalgia = headache
cerebr(o): cerebrum
cerebrospinal = pertaining to the
brain and spinal cord
arthr(o): joint
arthrotomy = cut into a joint

Roots (contd)
cyan(o): blue
chole, chol(o): bile
cholecystitis = inflammation of
the gall bladder
colo: colon
colonoscopy = examination of the
large intestine or colon with a
scope
cost(o): rib
costochondral = pertaining to a
rib
crani(o): skull
craniotomy = cutting into the
skull
cyanosis = blue, gray, or purple

tinge to the skin due to lack of
oxygen in the blood
cyst(o): bladder, cyst
cystitis = inflammation of the
bladder
derm, derma: skin
dermatitis = inflammation of the
skin
duoden(o): duodenum
duodenal = pertaining to the
duodenum, the first part of the
small intestine
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Roots (contd)
gyneco, gyno: woman
encephal(o): brain
encephalitis = inflammation of
the brain
gynecology = study of diseases of

the female reproductive organs
hema, hemato, hemo: blood
gaster(o), gastro: stomach
hematuria = blood in the urine
gastritis = inflammation of the

stomach
hepato: liver
geron: aged
hepatomegaly = enlargement of
the liver
gerontology = study of the aged
hyster(o): uterus
gluco: sweet
hysterectomy = surgical removal

of the uterus
glucometer = device used to

measure blood glucose
glyco, glyc: sweet
glycosuria = glucose (sugar) in
the urine

Roots (contd)
mast(o): breast
ile(o), ili(o): ileum
ileorrhaphy = surgical repair of
the ileum
laryng(o): larynx
laryngectomy = excision of the
larynx
lymph(o): lymph
lymphocyte = type of white blood
cell
mamm(o): breast
mammogram = x-ray of the
breast
mastectomy = excision of the

breast
melan(o): black
melanoma = mole or tumor, may
be cancerous
mening(o): meninges;
membranes covering the spinal
cord and brain
meningitis = inflammation of the
membranes of the spinal cord or
brain
necro: death
necrotic = dead tissue

Roots (contd)
ot(o): ear
nephr(o): kidney
otology = science of the ear
nephrectomy = removal of a
kidney
pharyng(o): pharynx pharyngitis

= inflammation of the throat, sore
throat
neur(o): nerve
neuritis = inflammation of a
nerve
phleb(o): vein
phlebitis = inflammation of a vein
onc(o): tumor
pneo/pnea: breathing
oncology = study of tumors
tachypnea = rapid breathing
ophthalm(o): eye
pneum: air, gas, respiration
ophthalmologist = eye doctor
pneumonia = inflammation of the

lung
oste(o): bone
osteoarthritis = disease of the
joints
pod(o): foot
podiatrist = foot doctor
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Roots (contd)
thorac(o): chest
proct(o): anus, rectum
proctology = study of the rectum
pulm(o): lung
pulmonary = relating to the lungs
splen(o): spleen
splenomegaly = enlarged spleen
stomat(o): mouth
stomatitis = inflammation of
mouth
therm(o): hot, heat
thermoplegia = heatstroke
thoracotomy = incision into chest

wall
thromb(o): blood clot
thrombus = blood clot blocking a
vessel
toxic(o), tox(o): poison
toxicology = study of poisons
trache(o): trachea, windpipe
tracheostomy = incision to make
an artificial airway
urethr(o): urethra
urethritis = inflammation of
urethra

Suffixes
-itis: inflammation
-cyte: cell
stomatitis = inflammation of the

mouth
leukocyte = white blood cell

-ectomy: excision, removal of
splenectomy = removal of spleen
-emesis: vomiting
hyperemesis = excessive
vomiting
-emia: blood condition
anemia = lack of red blood cells
-ism: a condition
hyperthyroidism = condition
caused by an excessive
production of thyroid hormones
-logy: study of
hematology = study of the blood
-megaly: enlargement
splenomegaly = enlarged spleen
-oma: tumor
melanoma = mole or tumor, may
be cancerous
-osis: condition
halitosis = bad breath

Suffixes (contd)
-ostomy: creation of an opening
ileostomy = creation of an
opening into the ileum
-phagia: to eat
dysphagia = difficulty swallowing
-phasia: speaking
aphasia = absence of speaking
-otomy: cut into
-phobia: exaggerated fear
laparotomy = cutting into the

abdomen
acrophobia = fear of high places
-pathy: disease
myopathy = disease of the
muscle
-penia: lack
leukopenia = a lack of white
blood cells
-plasty: surgical repair

angioplasty = surgical repair of a
vessel using a balloon
-plegia: paralysis
paraplegia = paralysis of lower
portion of the body
-rrhage: excessive flow
hemorrhage = excessive
flow of blood
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Suffixes (contd)
-scopy: examination using a
scope
colonoscopy = examination of the
large intestine or colon with a
scope
-stomy: creation of an opening
colostomy = opening into the
colon
-tomy: incision, cutting into
thoracotomy = incision into chest
wall
-uria: condition of the urine
dysuria = painful urination
4
10. Explain how to give and receive an accurate report of a
residents status
All
of the following occurrences should be reported immediately:

Falls
Chest pain
Severe headache
Difficulty breathing
Abnormal pulse, respiration, or blood pressure
Change in mental status
Sudden weakness or loss of mobility
4
residents status
Occurrences to report immediately (contd):
High fever
Loss of or change in consciousness
Bleeding
Change in condition
Signs of abuse
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4
residents status
REMEMBER:
An NA must use facts, not opinions, in making reports.
4
residents status
Why should an NA make written notes about reports given to a
supervisor?
4
residents status
An NA should document the following about an oral report:
When
Why
About what
To whom
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4
11. Explain documentation and describe related terms and forms
A medical chart is a legal record of a residents care. It includes
the following information:
Admission sheet
Residents medical history
Doctors orders
Progress notes
Lab/test results
Graphic sheet
Nurses notes
Flow sheet/ADL sheet (see Figure 4-9, p. 44 of text)
4
Current documentation is very important for many reasons:
Guarantees clear and complete communication
Provides legal record of treatment
Protects NA and employer
Provides up-to-date record of residents status
4
NAs should always follow these guidelines for documentation:
Document care immediately after it is given.
Think before writing. Be brief and clear.
Use facts, not opinions.
Write neatly with black ink.
Correct errors properly (see Figure 4-10, p. 45 of text).
Sign full name and title.
Document per care plan.
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4
REMEMBER:
If something is not documented, legally speaking it was not
done. It is very important for NAs to document carefully, and
immediately after care is given.
Transparency 4-5: 24-hour Clock
4
These guidelines are helpful when converting regular time to
military time:
To change the regular hours between 1:00 p.m. to 11:59
p.m. to military time, add 12 to the regular time.
Minutes and seconds do not change.
Midnight may be written as 0000 or 2400; NAs should follow
facility policy.
20
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4
12. Describe incident reporting and recording
incident
an accident, problem, or unexpected event during the course
of care that is not part of the normal routine in a healthcare
facility.
sentinel event
an accident or incident that results in grave physical or
psychological injury or death.
4
The following events are considered incidents:
Falls
Damage
Mistakes in care
Requests outside scope of practice
Sexual advances or remarks
Unsafe or uncomfortable situations
Injuries
Blood or body fluids exposure
4
NAs must follow these guidelines for incident reporting:
Tell what happened.
Tell how the person tolerated the incident.
State facts only.
Do not write about anything in the incident report on the
medical record.
Describe action taken.
Include suggestions for change.
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4
13. Demonstrate effective communication on the telephone
Effective telephone communication involves the following steps:
Identify yourself politely before asking to speak to someone.
Ask for the person with whom you need to speak.
State the reason for your call.
Leave a brief message if the person you are calling is not
available.
Thank the person who takes the message for you.
4
The following steps are important when answering the telephone:
Identify the facilitys name, self, and position.
Place caller on hold if necessary.
Write down messages. Ask for correct spelling of names. Get
a number.
Say, Thank you, and Goodbye.
4
REMEMBER:
NAs should never give out information about staff or residents
over the phone.
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4
14. Understand guidelines for basic office machines and
computers
The following office machines may be in use at LTCFs:
Photocopier
Fax machine
Calculator
Computer
4
14. Understand guidelines for basic office machines and
computers
REMEMBER:
HIPAA privacy guidelines apply to computer use. If a facility uses
computers for documentation, the NAs must make sure that
nobody can see private information on the screen.
4
15. Explain the resident call system
REMEMBER:
An NA must always answer call lights, no matter what. Call lights
must be left within residents reach and answered promptly
every time the resident pushes the button.
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4
16. List guidelines for communicating with residents with special
needs
impairment
a loss of function or ability.
farsightedness
the ability to see objects in the distance better than objects
nearby; also known as hyperopia.
nearsightedness
the ability to see things near but not far; also known as
myopia.
4
needs
cerebrovascular accident (CVA)
a condition that occurs when blood supply to a part of the
brain is blocked or a blood vessel leaks or ruptures within the
brain; also called a stroke.
hemiplegia
paralysis on one side of the body.
hemiparesis
weakness on one side of the body.
4
needs
expressive aphasia
slurred speech or an inability to speak.
receptive aphasia
inability to understand spoken or written words.
emotional lability
laughing or crying without any reason, or when it is
inappropriate.
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4
needs
dysphagia
difficulty swallowing.
combative
violent or hostile behavior.
4
needs
The following guidelines are important when communicating with
residents with hearing impairment:
Make sure hearing aid is on and working. Clean hearing aid as
instructed.
Reduce or remove noise.
Get residents attention first.
Speak clearly, slowly, and in good lighting.
Do not shout or mouth words in an exaggerated way.
Lower pitch of voice.
Keep hands away from face while talking.
4
needs
Guidelines for communicating with residents with hearing
impairment (contd):
Speak to side with better hearing.
Use short sentences and simple words.
Repeat what was said using different words if necessary.
Use picture cards or notepads.
Be patient and empathetic.
Ask resident to repeat what was said when necessary.
Observe body language.
Be understanding and supportive.
25
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4
needs
residents with vision impairment:
Make sure eyeglasses are on, clean, and in good condition.
Identify self when entering room.
Make sure there is proper lighting. Face resident when
speaking.
Orient residents to new areas.
Use imaginary clock as a guide.
Tell resident what you are doing. Talk directly to resident.
Do not move items. Put anything you move back where it was
found.
4
needs
Guidelines for communicating with residents with vision
impairment (contd):
Tell resident where the call light is.
Leave door completely open or closed.
When assisting resident with walking, walk slightly ahead,
letting resident grasp your arm.
Encourage use of other senses.
Use large clocks or clocks that chime.
Offer large-print books, audio books, digital books, and Braille
books if necessary.
Do not play with guide dogs.
4
needs
residents who have experienced CVA/stroke:
Keep questions and directions simple.
Phrase questions that can be answered with a yes or no.
Agree on signals.
Give residents plenty of time to respond.
Use a pencil and paper if possible.
26
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4
needs
Guidelines for communicating with residents who have
experienced CVA/stroke (contd):
Use terms weaker or involved to refer to affected side.
Keep call light within reach.
Use verbal and nonverbal communication.
Use communication boards or special cards.
4
needs
REMEMBER:
Even if residents are not able to speak, it is important that care
team members not talk about them as if they are not there.
4
needs
residents who are demonstrating combative behavior:
Block blows or step out of way.
Allow the resident time to calm down before the next
interaction.
Ensure resident is safe and give him space.
Remain calm. Lower tone of voice.
Be flexible and patient.
Stay neutral. Do not respond to verbal attacks or argue.
Do not use gestures that could frighten or startle resident.
Be reassuring and supportive.
Consider what provoked the resident.
27
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4
needs
residents who are demonstrating angry behavior:
Stay calm.
Do not respond to verbal attacks or argue.
Empathize.
Try to find out cause.
Be respectful. Explain what you are going to do.
Answer call lights promptly.
Stay at a safe distance.
4
needs
There is a difference between assertive and aggressive behavior.
A person is behaving assertively when he
Expresses thoughts, feelings, and beliefs in a direct and
honest way.
Respects his own needs and feelings and those of other
people.
A person is behaving aggressively when he
Expresses thoughts, feelings, and beliefs in ways that
humiliate, disgrace, or overpower the other person.
Shows little or no respect for the needs or feelings of others.
4
needs
REMEMBER:
NAs should report aggressive behavior from residents.
28
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4
needs
residents who are demonstrating inappropriate behavior:
Report behavior.
Be professional and do not overreact.
Try distraction.
Gently direct resident to private area.
4
needs
REMEMBER:
An NA must never hit a resident, no matter how the resident
behaves. Hitting is considered abuse and may result in
termination and/or legal action.
4
Exam
Multiple Choice. Choose the correct answer.
1. What is the correct order of the three-step communication process?
(A) Sender sends message. Receiver receives message. Receiver provides
feedback.
(B) Receiver sends message. Receiver receives message. Sender provides
feedback.
(C) Sender sends message. Sender receives message. Receiver provides
feedback.
(D) Receiver sends message. Receiver receives message. Receiver provides
feedback.
2.
Which of the following is an example of nonverbal communication?

(A) Asking for a cookie
(B) Pointing to a cookie
(C) Writing a note requesting a cookie
(D) Shouting for a cookie
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4
Exam
3.
Types of verbal communication include

(A) Reading
(B) Nodding ones head
(C) Crossing ones arms
(D) Writing
4.
Which of the following is an example of a barrier to communication?

(A) NA uses medical terminology with the resident.
(B) NA asks the resident to repeat a sentence.
(C) NA speaks the same language as the resident.
(D) NA speaks clearly using a professional tone of voice.
4
Exam
5.
Which of the following are ways for NAs to avoid barriers to communication?
(A) The NA should use slang so that the resident understands more easily.
(B) The NA should respond with Why? when resident makes a statement.
(C) The NA should use medical terminology when talking with the resident
so the resident will more easily understand his condition.
(D) The NA should ask open-ended questions that require more than yes or
no responses.
6.
An example of active listening is

(A) NA looking around the room while the resident is speaking
(B) NA finishing the residents sentences to make communication faster
(C) NA focusing on the resident and providing feedback
(D) NA talking constantly so that there are no pauses in the conversation
4
Exam
7.
Which of
(A) Mrs.
(B) Mrs.
(C) Mrs.
(D) Mrs.
the following statements is an example of a fact?

Silva needed help to get to the bathroom today.
Silva needs more friends.
Silva looks happy when her daughter visits.
Silva is too thin.
8.
Which of the following is an example of objective information?

(A) Mrs. Johnson says she has a rash on her torso.
(B) There are raised, red marks the size of pinpricks on Mrs. Johnsons
torso.
(C) Mrs. Johnson must have a rash because she looks uncomfortable.
(D) Mrs. Johnson needs some lotion.
30
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4
Exam
9.
Why is it important for an NA to consider a residents cultural background

when communicating with him?
(A) It is not important to consider cultural background.
(B) Because the resident will certainly want to tell stories about his culture.
(C) Because the NA might know somebody with the same background and
she can tell the resident about that person.
(D) Because cultural background helps determine how people communicate
and can help the NA communicate better with the resident.
10. What is a proper way for an NA to respond if a resident does not hear her or
does not understand her?
(A) The NA should speak more quickly.
(B) The NA should speak more softly or whisper.
(C) The NA should speak slowly and clearly.
(D) The NA should shout.
4
Exam
11. Which of the following statements is true of touch?
(A) All people like to be touched.
(B) Nursing assistants do not need to touch residents.
(C) Nursing assistants can softly pat residents shoulders to communicate
caring.
(D) All residents will feel more comfortable when there is little physical
contact.
12. Positive responses to cultural diversity include
(A) Valuing and respecting each person as an individual
(B) Seeing all people from a certain culture as being the same
(C) Preferring people of one culture over those of other cultures
(D) Making assumptions about a person based on stereotypes about their
culture
4
Exam
13. Which of the following senses is not used in making observations?
(A) Sight
(B) Touch
(C) Smell
(D) Taste
14. With whom should nursing assistants use medical terms and abbreviations?
(A) Residents
(B) Nurses
(C) Residents friends
(D) Visitors
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4
Exam
15. Which of the following should an NA report about a resident to the nurse
immediately?
(A) Family fighting
(B) Chest pain, high fever
(C) Watching too much TV
(D) Acting lonely
16. The part of the word that is added to the end of a root to form a new word
is called a(n)
(A) Root
(B) Prefix
(C) Suffix
(D) Abbreviation
4
Exam
17. When should documentation be recorded?
(A) Immediately after care is given
(B) At the end of the shift
(C) Whenever there is time
(D) Before the care is given
18. Careful charting is important because
(A) The NA does not want to get in trouble.
(B) The resident must be able to read the chart.
(C) The family will want to take the chart home regularly to study it.
(D) It is the only way to guarantee clear and complete communication
among the care team.
4
Exam
19. Which of the following shows the correct conversion of 0530 to regular
time?
(A) 12:30 a.m.
(B) 12:30 p.m.
(C) 5:30 a.m.
(D) 5:30 p.m.
20. Which of the following shows the correct conversion of 2:35 p.m. to military
time?
(A) 2435 hours
(B) 1435 hours
(C) 2235 hours
(D) 1235 hours
32
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4
Exam
21. Which of the following occurrences is considered an incident and requires a
report to be completed?
(A) A resident uses the call light frequently.
(B) A resident yells at a family member.
(C) A resident accuses an NA of abusing her.
(D) The NA arrives 10 minutes late to work.
22. Which of the following is an example of proper telephone communication at
work?
(A) Good morning, Linda Manor Care Facility, Susan Jones speaking.
(B) Were all really busy right now. Youll have to call back later.
(C) Sandra is not working today. Her cell phone number is 555-1212.
(D) Jeanie no longer works here. She was fired two months ago.
4
Exam
23. A nursing assistant may ignore a residents call light when
(A) The resident uses it too often for unimportant reasons
(B) The nursing assistant has had conflict with the resident in the past
(C) The nursing assistant just finished giving care to that resident
(D) Never
24. Why must an NA be concerned about privacy if documentation is done on a
computer?
(A) Because it is common for computer hackers to target long-term care
facilities
(B) Because the federal government is monitoring all computers in LTC
facilities to ensure that HIPAA is followed
(C) Because residents will probably try to sneak a look at other residents
information
(D) Because the information is confidential and somebody who is not part
of the care team might see the screen
4
Exam
25. If a
(A)
(B)
(C)
(D)
resident has a hearing impairment, the NA should

Face away from the resident when speaking
Face the resident with the light on the NAs face
Shout so that the resident can hear the NA
Exaggerate the words so that the resident can read the NAs lips
26. One way that an NA can help a resident who is visually impaired is to
(A) Move the furniture to make it easier for the resident to get around
(B) Keep the lights very low
(C) Use the face of an imaginary clock to explain the position of objects
(D) Walk behind the resident, lightly pushing the client forward
33
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4
Exam
27. What can a nursing assistant do to help with communication with a resident
who has had a stroke?
(A) The NA should ask questions that require longer answers to help keep
the resident mentally active.
(B) The NA should refuse to use pictures to communicate so that the
resident will be motivated to speak more.
(C) The NA should talk constantly so the resident wont feel uncomfortable
if speaking is difficult for him.
(D) The NA should use smiles or gestures to convey information.
4
Exam
28. What is the best way a nursing assistant can respond to a combative
resident?
(A) The NA should tell the resident that he will be discharged from the
facility if he does not stop what he is doing.
(B) The NA should let the resident know that other NAs will refuse to care
for him if he continues the behavior.
(C) The NA should remain calm and lower the tone of her voice.
(D) The NA should stand as close as possible to the resident.
29. Why is it important for a nursing assistant not to overreact when a resident
behaves inappropriately?
(A) It may actually reinforce the behavior.
(B) Other residents may then copy the behavior.
(C) The NAs supervisor will be angry with him.
(D) The NA might surprise the resident.
34

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5/17/15

4 Communication and Cultural Diversity

Transparency 4-1: Communication Process

4 Communication and Cultural Diversity

Transparency 4-2: Body Language

4 Communication and Cultural Diversity

Transparency 4-3: Barriers to Communication

4 Communication and Cultural Diversity

Transparency 4-4: Using Your Senses

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

continuous bladder irrigation

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

Centers for Medicare and

deep vein thrombosis

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

low, less than normal

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

left upper quadrant

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

Licensed Vocational Nurse

magnetic resonance imaging

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

right lower quadrant

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

total parenteral nutrition

4 Communication and Cultural Diversity

Handout 4-1: Abbreviations

4 Communication and Cultural Diversity

Handout 4-2: Prefixes, Roots, Suffixes

dys: bad, painful

4 Communication and Cultural Diversity

Handout 4-2: Prefixes, Roots, Suffixes

oliguria = small amount of urine

4 Communication and Cultural Diversity

Handout 4-2: Prefixes, Roots, Suffixes

4 Communication and Cultural Diversity

Handout 4-2: Prefixes, Roots, Suffixes

brachial = pertaining to the arm

abdominal = pertaining to the

bronchi, bronch(o): bronchus

4 Communication and Cultural Diversity

Handout 4-2: Prefixes, Roots, Suffixes

cyanosis = blue, gray, or purple

4 Communication and Cultural Diversity

Handout 4-2: Prefixes, Roots, Suffixes

gynecology = study of diseases of

gaster(o), gastro: stomach