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Adult Foster Care Training Questions
and Answers
What are the 4 required qualifications for employees? - โ Must be 18, criminal history check, necessary training, and ability to do required work. What are the 3 ways for Foster Providers to hire assistance? - โ Hire someone from an agency, Hire an independent contractor, or Hire an employee What is the difference between an employee and an independent contractor? - โ Independent contractor is in business for themselves, where as an employee is working directly through you. What are the 3 things to remember when hiring an employee? - โ Keep up with paperwork and record requirements, pay minimum wage, know the laws and regulations. What is the Oregon Administrative Rule? - โ (OAR) A set of standards and practices that ensure that services in Oregon are in compliance with federal and local guidelines. How many hours of training annually are required by the department for providers, resident managers, and substitute caregivers? - โ At least 12 hours What is required of the facility according to facility standards? - โ Good general condition, up to date documentations, clean furnishings and building, adequately lighted. What is required of the sanitary of the facility according to standards? - โ Good septic tank, adequate control of insects and rodents, caretakers must take precautions to prevent injuries from sharps What is required of bathrooms according to facility standards? - โ Provide privacy, clean and free of odors, utilities must be in good repair, grab bar for toilets. What is required of meals according to facility standards? - โ 3 nutricious meals served daily, have menus for current and next week, food storage and prep areas and equipment must be clean and free of odors, and in good repair. What is required of telephones according to facility standards? - โ Must be accessible, emergency numbers must be posted by the phone, limitations of phone use must be specified.
What are the "Best Practice Guidelines" directed at? - โ Protecting health and safety of the individuals under care. What are the 4 "Best Practice Guidelines"? - โ Six Rights, Five Always, Five Nevers, Five Musts, What are the "Six Rights" regarding to? - โ Medication administration What are the "Six Rights" - โ Right Medication, Dose, Person, Time, Route, and Documentation What are the "Five Always"? - โ Always have health providers orders for every medication treatment (including OTC), Always wash your hands before giving medications, Always pour medications directly into medical cup, Always stay with the patient until medication is swallowed, Always keep medication storage locked, and clean. What are the "Five Nevers"? - โ Never leave medication with the person/on table, never give medication prescribed for one person to another, Never give medication that was prepared by someone else, Never use medication that is outdated or unlabeled, Never give medication you have questions about. What are the "Five Musts"? - โ Must have MAR present when giving medications, Must read the label and compare it with the MAR before giving medications, Must ensure the person is in a good position for medication administration, Must record the administration of medication immediately on the MAR, Must know the reason for medication. What is the MAR? - โ Medication Administration Record What is to be recorded on the MAR - โ The patient's name, Current month/year, any allergy/history of adverse reactions, name of medication, dosage and number of tablets, specific time the medication is to be given, and route it is to be given, your full signature and initials After giving the medication what is the next step? - โ Immediately record on the MAR, the correct date, time, and medication and your full signature and initial If medication is not given, how should you record it on the MAR? - โ Initial the box for the correct medication, date, and time and circle your initials, also write explanation as to why it was not given on the back of MAR When a medication is discontinued, how would you record that in the MAR? - โ Write in large letters "DISCONTINUE" or the abbreviation "DISC" or "DC", followed by the date, time, and your initials. Remove medication from cabinet.
p.r.n/PRN - โ as needed q or Q - โ every q.o.d. - โ every other day q.I.d. - โ 4 times daily s - โ without SL - โ sublinqual stat. - โ Immediately tab - โ tablet t.i.d. - โ 3 times daily x - โ times cap. - โ capsule cc - โ cubic centimeters gtts. - โ drops gr - โ grains hs or HS - โ bedtime ml - โ millilter mg - โ milligram @ - โ at ฤ - โ before a.c. or ac - โ before meals a.d. - โ right ear a.s. - โ left ear
a.u. - โ both ears b.I.d. - โ Twice daily c - โ with What are the four medical conditions known as the "Fatal Four"? - โ Aspiration, Dehydration, Constipation, and Seizures What is aspiration? - โ Process by which either oral or stomach contents enter the airway. What causes aspiration? - โ items such as food and fluids meant for gastrointestinal system are taken into the respiratory system What is the normal swallowing process? - โ Food is chewed and mixed with saliva, becomes a bolus, pushed back to the pharynx by tongue, pharynx stimulates s wallow reflex, epiglottis closes off the trachea preventing the swallowed item from going into the lungs, peristalsis moves the bolus through the rest of the GI tract. What 4 major medical conditions put individuals with disabilities at risk for aspiration? - โ Neuromuscular conditions, deformities of neck, spine, or trunk, neurological conditions, Increased incidence of GER What 5 physical conditions may put individuals with disabilities at risk for aspiration? - โ Decreased alertness, periodontal disease, swallowing impairments, fed by others, Gastric tubes When the person is coughing or choking while eating what is this a risk of? - โ Aspiration When you notice food or fluid falling out of a person's mouth, what might they be at risk for? - โ Aspiration and Dehydration When someone else is feeding a person, what could the person be at risk for? - โ Aspiration and Dehydration If a person regularly refuses food or drinks, what could the person be at risk for? - โ Aspiration and Dehydration If a person has frequent pneumonia, rattling when breathing, persistent cough, or chronically uses cough/asthma medication, what might they be at risk for? - โ Aspiration
If the person's blood pressure is lower than normal, what might they be at risk for? - โ Dehydration If the person shows signs of medication toxicity, what might they be at risk for? - โ Dehydration If the person is routinely using assistance to get something to drink or receive fluids, what might they be at risk for? - โ Dehydration If a person has heart or kidney disease, what should you do before give patients extra fluids? - โ Check with physician When a person is dehydrated when should you call 911? - โ When the person appears gray or gravely ill and you are concerned about their immediate health and safety. What is constipation? - โ hardness of bowel movement, difficulty in the passage of stool, infrequency of passing stool If a person as low or absent muscle tone, what might they be at risk for? - โ Constipation If a person is non-mobile/non ambulatory, what might they be at risk for? - โ Constipation and Dehydration If the person routinely takes bowel medications, what might they be at risk for? - โ Constipation If the person (within the last year, has had trouble moving their bowels, complained of pain with bowel movements (BM) or had BM that is hard and small, what might they be at risk for? - โ Constipation What are some measures to take that can help prevent Constipation? - โ Add dietary fiber to diet, add more fluids to diet, adjust positioning/physical activity, provide more opportunities for routine toileting/privacy What are treatments for Constipation - โ Fiber products, Stool softeners, lubricants, stimulants, suppositories, enemas, and digital stimulation (all of these must have orders) When a person has Constipation when should you call 911? - โ The person appears gravely ill and you are concerned for their immediate health and safety, is vomiting material that smells like BM, has a very hard protruding abdomen, or has severe abdominal pain.
Obstruction - โ A blockage in the intestines that doesnt allow passage of food or fluids. Perforation - โ A tear in the lining of the intestine allowing contents to leak into the abdominal cavity, this results in infection or sepsis Sepsis - โ infection that spreads into the bloodstream Peritonitis - โ a very serious an infection of the membrane lining of the abdominal cavity can result in death Atonic Bowel - โ A relaxed bowel that lacks normal muscle tone Mega colon - โ Extremely dilated colon Seizures - โ Sudden, excessive, and disorderly electrical discharge in an apparently healthy brain Epilepsy - โ Sudden, recurrent, unprovoked seizures that occur in a brain that has an injury If a person as pre or post natal injuries such as trauma, lack of oxygen, or brain infections, what might they be at risk for? - โ Seizures If a person has had a brain tumor or stroke after infancy, what is the person at risk for? - โ Seizures Generalized tonic clonic seizures - โ also known as grand mal seizures - pose immediate danger due to loss of muscle tone and/or consciousness Tonic seizures - โ characterized by tension/contraction of muscles - pose immediate danger due to loss of muscle tone and/or consciousness Clonic seizures - โ characterized by alternate contraction/relaxation of muscles - pose immediate danger due to loss of muscle tone and conscious ness Atonic seizures - โ Also known as drop seizures - pose immediate danger due to loss of muscle tone and consciousness Myoclonic seizures - โ Characterized by jerking - may be so brief that muscle tone and consciousness are preserved Complex partial seizures - โ Pose immediate danger due to loss of awareness of surroundings
Challenging behavior can be a direct result of illness, pain, medications, side effects, medical procedures, life history, or doctors visits. when analyzing a person's behavior what should you look at? - โ Possible medical causes Meaningful relationships are achieved by - โ modeling positive interactions in our own relationships and helping the individual develop relationships with others. Some people who are adults now may have been institutionalized at an early age and have little to no contact with their families. This may cause the person to: - โ avoid forming close relationships with others Relationships people have developed may have been disrupted every time the person moves from one living situation to another or when a caregiver stops working. This may cause the person to: - โ avoid forming close relationships with others Abusive techniques - โ Techniques that humiliate or deliberately cause pain or discomfort to the individual for which intervention is used. Under no circumstances should abusive techniques be applied.. Abuse OF techniques - โ abuse may occur by applying physical interventions when unnecessary, before really necessary, or for too long of a period of time after an individual is no longer a threat to health or safety. Abuse may also occur when unauthorized restraints or other interventions are applied. Neglect - โ Occurs when a support personf ails to act in a timely manner to decrease the chances of an avoidable injury When should Physical intervention be used? - โ Only in emergencies, when someone is in danger of being physically harmed, only used until a person is no longer a threat, if intervention is used more than 3 times in 6 months, it prompts an ISP team meeting. How soon should the services coordinator be notified of problematic behaviors? - โ No longer than the next working day when a protective intervention is used; If injury results, then notification should be immediate. How soon should an incident report be written and forwarded to the services coordinator after an problematic behavior incident? - โ Within 5 working days Any death caused by other than accidental or natural means or occurring in unusual circumstances is: - โ Abuse any physical injury caused by anything other than accidental means is: - โ Abuse willful infliction of physical pain or injury is: - โ Abuse
Sexual harassment or exploitation including but not limited to: any sexual contact between an employee, provider, or other caregiver and the adult, unwelcome sexual contact directed toward the adult by anyone else, consensual or non consensual with staff, rape or sexual assault included is: - โ Abuse Neglect that leads to physical harm or significant mental injury through withholding of services necessary to maintain health and well-being. (medications, food, hydration etc.) is: - โ Abuse If any abuse or neglect of any form occurs you must: - โ complete an unusual incident report, contact service provider and Community program (CMHP/CDDP) Who are mandatory reporters? - โ Any public or private official who, while acting in an official capacity, comes in contact with and has reasonable cause to believe that the adult has suffered abuse, or that any person with whom the official comes in contact while acting in an official capacity, has abused the adult. Can a person, facility, or community program retaliate against any person who reports abuse/neglect in good faith? - โ No. If you think a crime is happening: - โ you must report it to police as well as the community program How long does the abuse investigation last from the time of the initial report? - โ 45 days If you are interviewed: - โ Be honest, provide as much information as you can, it is ok to say "I don't know" if you don't know, It is ok to ask for a break, it is preferable not to talk to others about the case. You may ask the investigator to review the interview with you for accuracy, you may contact the investigator if you have any further information, the investigator may contact you for follow up interview. Although the final report of a case is confidential, some inf ormation is disclosed and redacted: - โ The names of the victim and witnesses are removed, any clinical or medical records/summaries, and PHI. The provider must conduct unannounced evacuation drills when individuals are present, one every ___ days with at least one drill per year occurring during hours of ______. - โ 90; sleep Fire drill documentation is required and must be made at the time of the drill and kept by the provider for at least ____ years following the drill. - โ 2
