CNA Certification (Written Exam)Restorative SkillsHard
A resident has severe contractures in both hands, making it difficult to maintain hygiene and prevent skin breakdown. What is the most effective nursing assistant intervention to address this issue?
- ASoaking the hands in warm water for extended periods each day.
- BApplying tight bandages to the hands to keep fingers extended.
- CPerforming passive range of motion exercises on the hands daily.
- DPlacing rolled washcloths or hand cones in the resident's palms.
Show answer & explanationAnswer & explanation
Correct answer: D. Placing rolled washcloths or hand cones in the resident's palms.
For severe hand contractures, placing rolled washcloths or hand cones in the palms helps to keep the fingers slightly separated and prevents skin-on-skin contact, which can lead to moisture buildup, maceration, and skin breakdown within the tightly fisted hand. This also allows for easier cleaning.
Why the other options are wrong
- A. Soaking hands for extended periods can cause skin maceration, especially if they are already prone to breakdown, and doesn't address the skin-on-skin contact issue.
- B. Applying tight bandages is dangerous; it can impair circulation and worsen contractures, and is not a CNA intervention.
- C. While PROM is important for maintaining joint mobility, it may not be sufficient on its own to prevent skin breakdown in already severely contracted hands, and might be painful if forced. The question asks for the most effective intervention for 'hygiene and preventing skin breakdown' in existing contractures.
Hand Contracture Care
Interventions for hand contractures focus on preventing skin breakdown and maintaining hygiene in fisted hands, often by utilizing hand rolls or cones.
- Prevents skin-on-skin irritation and maceration.
- Facilitates cleaning of palms.
- Hand rolls/cones provide gentle separation.
Memory trick: Contractures cause skin strife, hand rolls give hands new life.