General Discussion

CVA – Cerebrovascular Accident (Stroke)

What’s Happening:   A stroke occurs when blood flow to part of the brain is blocked (ischemic) or a blood vessel bursts (hemorrhagic). Without oxygen, brain cells begin to die within minutes. This leads to weakness, speech problems, and possible paralysis.

CNA Management Using APIE

• Assessment:

• Look for FAST signs: Facial drooping, Arm weakness, Speech difficulty, Time to act

• Monitor consciousness, swallowing, mobility

• Planning:

• Prevent choking and falls

• Support communication and hygiene

• Intervention:

• Assist with feeding (thickened liquids if ordered)

• Reposition every 2 hours

• Use communication aids

• Keep environment safe

• Evaluation:

• Is the patient swallowing safely?

• Are pressure areas protected?

• Is communication improving?

❤️ MI – Myocardial Infarction (Heart Attack)

What’s Happening:   An MI happens when blood flow to the heart muscle is blocked, usually by a clot. Without oxygen, heart tissue begins to die. This causes chest pain, shortness of breath, and can lead to heart failure or death.

CNA Management Using APIE

• Assessment:

• Chest pain, sweating, nausea

• Monitor pulse, BP, breathing

• Planning:

• Reduce stress and exertion

• Support breathing and comfort

• Intervention:

• Keep patient calm and seated upright

• Monitor vitals

• Assist with oxygen if ordered

• Help with ADLs gently

• Evaluation:
  

• Is pain reduced?

• Are vitals stable?

• Is the patient tolerating care?

💔 CHF – Congestive Heart Failure

What’s Happening:   The heart is too weak to pump blood effectively. Fluid backs up into the lungs and legs, causing swelling, shortness of breath, and fatigue. It’s a chronic condition that worsens over time.

CNA Management Using APIE

• Assessment:

• Swelling in legs/feet

• Difficulty breathing when lying down

• Weight gain

• Planning:

• Reduce fluid overload

• Prevent skin breakdown

• Intervention:

• Elevate legs

• Monitor weight and fluid intake/output

• Reposition to ease breathing

• Assist with oxygen if ordered

• Evaluation:
  

• Is swelling reduced?

• Is breathing easier?

• Is skin intact?

🩸 CKD – Chronic Kidney Disease

What’s Happening:   Kidneys lose their ability to filter waste and fluid. Toxins build up in the body, causing swelling, fatigue, and confusion. Dialysis may be needed to remove waste manually.

CNA Management Using APIE

• Assessment:

• Decreased urine output

• Swelling, itchy skin

• Fatigue, confusion

• Planning:

• Support comfort and hygiene

• Monitor fluid balance

• Intervention:

• Track intake/output

• Assist with dialysis prep and recovery

• Provide skin care

• Watch for infection signs

• Evaluation:

• Is fluid balance maintained?

• Is skin healthy?

• Is the patient tolerating dialysis?

🫁 Pneumonia

What’s Happening:   Pneumonia is an infection in the lungs causing inflammation and fluid buildup. It makes breathing difficult and can be life-threatening, especially in older adults or those with weak immune systems.

CNA Management Using APIE

• Assessment:

• Cough with sputum

• Fever, chills

• Shortness of breath

• Planning:

• Promote lung function

• Prevent spread of infection

• Intervention:

• Encourage coughing and deep breathing

• Assist with oxygen therapy

• Monitor temperature and breathing

• Follow droplet precautions

• Evaluation:

• Is breathing improved?

• Is fever reduced?

• Is the patient clearing secretions?