CNA

Physical care skills make up the largest share of the nurse aide written test and nearly every task on the skills evaluation. This section covers the activities of daily living (hygiene, dressing, eating, elimination, and rest), the basic nursing skills of measuring and observing, infection control and safety, emergency response, care of the dying resident, therapeutic procedures, observation and reporting, and restorative care that helps residents stay as independent as possible.

Principles of Personal Hygiene

Personal hygiene is the set of practices that keep the body clean and promote health. As a CNA you assist residents who cannot perform hygiene independently because of illness, disability, age, or weakness. Good hygiene prevents infection, maintains skin integrity, promotes comfort, and supports self-esteem and psychological well-being.

Bathing

Bathing cleanses the skin, stimulates circulation, provides light exercise, and gives you an opportunity to observe the resident's condition. Types of baths include the complete bed bath, the partial bath, the tub bath, the shower, and therapeutic baths ordered for a specific purpose.

Completebedbath:Keysteps

Gather supplies

Basin, washcloths, towels, clean linens, bath blanket, clean gown, soap, lotion, and gloves.

Prepare the water

Fill the basin with water at 105–110°F (40–43°C) and check the temperature with a bath thermometer or the inside of your wrist.

Cover the resident

Place a bath blanket over the resident and remove the top linens without exposing the body.

Wash from clean to dirty

Wash the eyes, face, ears, neck, arms, hands, chest, abdomen, legs, feet, back, and perineum, in that order. Use a separate washcloth for the face and for the perineum.

Clean the eyes correctly

Wash each eye from the inner corner (canthus) to the outer corner using plain water and no soap, with a clean part of the washcloth for each eye.

Rinse, dry, and change the water

Rinse and dry each area thoroughly before moving on, especially skin folds, under the breasts, between the toes, and the axillae. Change the water whenever it becomes cool, soapy, or dirty.

Finish

Apply lotion to dry areas but not between the toes, where moisture encourages skin breakdown and fungal infection.

BathType	KeyPoints
Partialbath	Washestheface hands axillae back andperineum Givenondaysbetweencompletebathsorwhen , , , , .
	theresidentcannottolerateafullbath .
Tubbathandshower	Checktheresident'sabilitytotransferandstandsafely andmakesurethetuborshowerisclean , .
	Place a non-skid mat adjust the water temperature before the resident enters keep the call light , ,
	within reach and help with hard -to-reach areas Never leave the resident unattended , . .

Perineal Care

Perineal care prevents infection and protects skin integrity. Provide it at least daily and after every episode of incontinence. Always work from the cleanest area toward the dirtiest, and use a clean part of the washcloth for each stroke.

Separate the labia and wash from front to back (urethra toward

If uncircumcised, retract the foreskin. Wash the tip of the penis

the anus), cleaning the labia and urethral area first and the

in a circular motion from the urethral opening outward, then the

rectal area last.

shaft, scrotum, and rectal area. Return the foreskin to its normal position.

Oral Hygiene

Oral care prevents infection, keeps the tissues of the mouth healthy, improves appetite, and provides comfort. Give oral care at least twice a day and after meals.

Situation	Procedure
Consciousresident	Raisetheheadofthebedto45degreesorhigherandplaceatowelunderthechin Applytoothpasteto .
	amoistenedbrushandbrushalltoothsurfacesandthetonguegently Havetheresidentrinseandspit .
	intoanemesisbasin andapplylipmoisturizerifneeded , .
Unconsciousresident	Positiontheresidentonthesidewiththeheadturnedsofluiddrainsoutofthemouthandisnot
	aspirated Holdthemouthopenwithapaddedtonguebladeandcleantheteeth gums tongue and . , , ,
	innercheekswithswabsmoistenedwithadilutedcleaningsolution Useonlyasmallamountofliquid . ,
	suctionifneeded andapplylipmoisturizer Explainwhatyouaredoing becauseanunconscious , . ,
	residentmaystillhearyou .
Denturecare	Handledenturesoverabasinlinedwithawashcloth(orpartlyfilledwithwater)topreventbreakage .
	Brushallsurfaceswithadenturebrushandcleanserandrinseincoolwater Storeinalabeleddenture .
	cupwithcoolwaterwhennotinuse Neverusehotwater whichcanwarpdentures Cleanthegumsand . , .
	tongueevenwhentheresidenthasnonaturalteeth .

Hair, Nail, and Shaving Care

Task	KeyPoints
Haircare	Brush or comb daily; hair care promotes self -esteem prevents scalp problems and lets you observe the , ,
	scalp Shampooasneeded usuallyweekly . , .
Shampooinbed	Positiontheresidentdiagonallywiththeheadattheedgeofthebed Placeawaterproofpadandtrough .
	undertheheadtodirectwaterintoabasinonthefloor Wetthehair applyshampoo massagethescalp . , ,
	withthefingertips rinsethoroughly andrepeatifneeded Drycompletelyandstyleastheresident , , .
	prefers .
Texturedortightlycurled	May need specific products and techniques Use a wide-toothed comb or pick rather than a fine-toothed .
hair	comb applymoisturizingproductsasappropriate andaskabouttheresident'spreferredstyling; , ,
	braidinghelpspreventtangling .
Nailcare	Cleanunderthenailswithanorangewoodstickandpushcuticlesbackgently Trimfingernailsstraight .
	acrossorinaslightcurveifyourfacilityallows Donottrimtoenails orthenailsofaresidentwith . ,
	diabetesorpoorcirculation unlessyouarespecificallyauthorized;theseresidentsareoftenseenbya ,
	podiatrist Reportthick discolored oringrownnails . , , .
Shaving	Useanelectricrazorforresidentstakinganticoagulantsorwithbleedingdisorders Withasafetyrazor . ,
	softenthebeardwithawarmtowel applyshavingcream shaveinthedirectionofhairgrowthwithshort , ,
	strokes rinsetherazoroften rinsetheface andapplyaftershaveifdesired Reportanycuts , , , . .