Behavior and Ethics Flashcards

1
Q

Patients who are at higher risk for pain?

👦p.a.m

A
  1. Infants and young children 👦

Three Hx

  1. History of PREMATURITY
  2. History of ABUSE (physical, sexual, psycological)
  3. History of frequent MEDICAL procedures

Hx of PAM

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2
Q

What is FLACC?

A

FLACC

OBSERVATIONAL PAIN SCALE

Faces, Legs, Activity, Crying, Consolability

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3
Q

What age and over can the Wong-Baker scale be used for pain?

😃🙂😐🙁 😢😭

A

WONG-BAKER SCALE

“SIX FACES”

😃🙂😐🙁😢😭

Children older than 3, THREE

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4
Q

What age and over can a Visual Analogue Scale (VAS) / Numeric Scale can be used?

A

0 - 10 scale

6, SIX years old

0-6-10

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5
Q

PIAGET

Behavior Theory

🤯⚙️⚙️⚙️⚙️

A

DEVELOPMENTAL STAGE THEORY

🤯⚙️⚙️⚙️⚙️

FOUR different COGNITIVE development stages:

  1. SENSORIMOTOR
  • Birth - 24 months
  • Infants gain knowledge of the world from the physical actions they perform within it.
  1. PRE-OPERATIONAL
  • Ages 2 to 7
  • Thinking in this stage is still egocentric, meaning the child has difficulty seeing the viewpoint of others.
  1. CONCRETE OPERATIONAL
  • Ages 7 to 11
  • characterized by the appropriate use of logic.
  1. FORMAL OPERATIONAL PERIOD
  • Ages 12 to Adult
  • person is capable of hypothetical and deductive reasoning. During this time, people develop the ability to think about abstract concepts.
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6
Q

FREUD

Behavior Theory

🤯🍆🍑

A

PSCYHCOSEXUAL STAGES

🤯🍆🍑

Psychoanalytic:

  • Children progress through predictable psychosexual stages
  • Children’s behavior is orientated towards certain parts of the body
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7
Q

ERICKSON

Behavior Theory

🤯👨‍👩‍👧‍👦

A

PSYCHOSOCIAL CRISIS STEPS

🤯👨‍👩‍👧‍👦

Psychoanalytic

  • Psychosocial development proceeds by critical steps or psychosocial crisis that shape personality.
  • basic trust ➡️ autonomy ➡️…..integrity
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8
Q

SKINNER

Behavior Theory

🤯➡️🤯

A

OPERANT - CONSEQUENCE

🤯➡️🤯

Behaviorism

-Operant - consequence of behavior is in itself stimulus that can affect future behavior

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9
Q

PAVLOV

Behavior Theory

🤯Ex

A

CLASSICAL CONDITIONING

🤯Ex

Behaviorism

  • One stimulus is associated with another through experience
  • (white coat is associated with pain of injection)
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10
Q

What constitutes INFORMED CONSENT?

A

Must inform patient about

  1. NATURE of the PROCEDURE
  2. RISKS
  3. ALTERNATIVE TREATMENT OPTIONS
    Including no treatment

FEES are NOT part of informed consent

Based on the ethical principle of AUTONOMY

FAILURE to do so could result in ASSULT AND BATTERY.

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11
Q

MINORS CONSENT

A

Minors younger than 18 can give IMPLIED CONSENT or ASSENT but not Actual Consent.

EXCEPTIONS

  • Emancipated
  • Emergency situation

ACTUAL CONSENT if

  • Married
  • Parent themselves
  • Pregnant
  • Military
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12
Q

What is the most important in RISK MANAGEMENT?

A

DOCUMENTATION

  • Be Specific With FACTS
  • Be Objective, no personal opinions of pt
  • Be Complete
  • Be Timely
  • Never make or sign an entry for someone else.
  • Never delete or change anything you wrote-instead provide an addendum
  • All writings are discoverable so do not write anything you do not want read in court.
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13
Q

NON-MALEFICENCE

A

Primum non nocere = First Do No Harm

  • Keep Skills and Knowledge up-to-date through continuing education
  • Know your limitations and refer difficult cases to a specialist
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14
Q

BENEFICENCE

A

Professionals have a duty to act for the benefit of others

Provide service to the patient and the public at large

Promote patient’s welfare

The same ethical standard exists no matter the financial arrangement

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15
Q

JUSTICE

A

Be fair in dealings with patients, colleagues, and society

Deal with people justly and deliver dental care without prejudice

Never slander another dental professional

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16
Q

VERACITY

A

TRUTHFULNESS

Be honest and trustworthy in dealings with the public

Respect the position of trust inherent in the dentist-patient relationship

Must not represent care being rendered, fees being charged, or any form of advertising in a false or misleading way

17
Q

STATUTE OF LIMITATIONS

A

Laws that set the MAXIMUM TIME after an event within which legal proceedings may be initiated.

varies state to state

OCCURRENCE RULE = statute of limitations starts to run after the injury or malpractice occurred

DISCOVERY RULE = stature of limitations starts to run after the injury or malpractice is discovered (more lenient)

18
Q

WITNESSES

A

EXPERT TESTIMONY = an expert who has expertise in dentistry and can testify to the existing STANDARD OR CARE and how it was breached by defendant.

Standard of Care = LOWEST ACCEPTABLE level of care among members of the dental professions

FACT WITNESS = Someone who was there

19
Q

GOOD SAMARITAN ACT

A

Offers LEGAL PROTECTION to health professionals and others who provide “REASONABLE ASSISTANCE” to individuals who are

  • Injured
  • Ill
  • In Peril
  • Incapacitated
20
Q

What does Bulimia do to the Salivary Glands?

A

When gastric acid from the stomach is constantly passing through the digestive tract in the wrong direction, it greatly damages tissues lining the esophagus and mouth. When the body is preparing to vomit, the salivary glands increase production of saliva to lubricate the esophagus and mouth in an effort to protect the tissues from the acidity of the vomit. Because patients with bulimia typically induce vomiting multiple times a day, they are FORCED to produce EXCESS amounts of SALIVA which causes their PAROTID salivary glands to become OVER-STIMULATED In order to keep up with the amount of work that is being asked of them, the glands increase in size which is defined as parotid HYPERTROPHY.

  1. SIALADENTIS - Inflammation
  2. SIALLORHEA - Drooling / excess salivation
  3. SIALOLITH - Salivary Stones
21
Q

What is Apraxia?

A

A neurological disorder characterized by the inability to perform learned (familiar) movements on command, even though the command is understood and there is a willingness to perform the movement. Both the desire and the capacity to move are present but the person simply cannot execute the act.

Childhood apraxia of speech (CAS) is an uncommon speech disorder in which a child has difficulty making accurate movements when speaking.

22
Q

What is Articulation?

A

The act of expressing in coherent verbal form

23
Q

What is Dysprosody?

A

Refers to the loss of normal rhythm or melody of SPEECH.

It is usually the result of neurological damage such as brain trauma, severe head injury, stroke, brain vascular damage or brain tumors.

24
Q

Frankl Behavior Rating Scale

A

1 = Definitely Negative (Refusal/Distress)

2 = Negative Resistance (Uncooperative/Reluctant)

3 = Positive Acceptance (Cooperative/Reserved)

4 = Definitely Positive (Interested/Enjoyed)

25
Q

What is Anticipatory Guidance?

A

AGE-APPROPRIATE COUNSELING for patients and their parents focused on PREVENTION.

FIRST DENTAL VISIT should be by 1 YEAR OLD

26
Q

What is Familiarization?

A

NO TREATMENT DENTAL VISIT with an emphasis on introducing the dental setting and common instruments

27
Q

What is Functional Inquiry?

A

Questionnaire or Interview

Allows you to learn chief complaints and estimate behavior

28
Q

What is Behavior SHAPING?

A

SHAPING

Slowly develop behavior by REINFORCING SUCCESSIVE APPROXIMATIONS to a desired goal.

Reinforcement should always be IMMEDIATE AND SPECIFIC to the DESIRABLE BEHAVIOR

Ex: Ask to open wide -> patient only opens a little bit -> instill positive reinforcement

29
Q

What is AVERSIVE CONDITIONING?

A

Punish with the purpose of extinguishing or improving negative behavior.

Not for Timid and Tense-cooperative

Ex:
Voice Control
Hand-Over-Mouth

HOM- gently place hand over mouth to gain attention of uncontrolled

30
Q

ADHD

A

Inattentive (AD) and hyperactive (HD)

More common in BOYS

Most commonly first appears age 3-6

Three most common psychstimulant medications

  • Methyphenidate (Ritalin)
  • Atomoxetine (Strattera)
  • Amphetimine (Adderall)

All three have same side effects:
(Dry mouth, Nausea, Hypertension)

31
Q

AUTISM

A

Condition related to Brain 🧠 Development that impacts how a person perceives and socializes with others

Spectrum refers to WIDE RANGE of symptoms

COMMONLY DEMONSTRATE

  • Repetitive Behavior (body movements, questions)
  • Heightened Sense of light and sound
32
Q

Bruxism

Symptoms?
Nerves Responsible?

A

Oral parafunctional activity.

Excessive teeth grinding or jaw clenching.

Symptoms:
hypersensitive teeth, aching jaw muscles, headaches, tooth wear, and damage to dental restorations.

Nerves:
CN - 5, 9, 10