Flashcards in Fundamentals Objectives Exam 1 Deck (39)
Discuss the dental health care provider’s responsibilities in assessing vital signs and the rationale for obtaining accurate vital sign readings prior to providing dental hygiene treatment.
The only way to know if you have high blood pressure (HBP, or
hypertension) is to have your blood pressure tested. Understanding your
results is key to controlling high blood pressure.
Identify each part of the stethoscope and blood
pressure cuff and explain its purpose.
Stethoscope: Amplify sound
- 2 earpeices
- Binaurals- isolate ans transfer sounds
- Plastic or rubber tubing -transfers frequency
- Chest piece (2 sides bell and diaphragm)- bell picks up lower freq. sounds diaphragm wide freq.)
Sounds created from patient body are picked up through the diaphragm or bell end. Sound travels through rubber tubing into binaurals to earpiece
Blood Pressure Cuff:
Discuss the normal range of temperature
Average 98.6 degree F
Range 96.8-100.4 degrees F
Discuss the normal range of a pulse and respiration
Discuss the importance of knowing the patient’s A1C and glucose levels prior to dental treatment
Students will perform a glucose test for all patients reporting diabetes. Glucose testing may be performed as a screening if a patient reports a family history or answers yes to pertinent diabetes related questions.
• A1C: patients should maintain 7% or less HbA1C with well controlled diabetes or 7.5% in elderly patients with well controlled diabetes.
• Blood glucose limit up to 250 mg/dl if the patient has a current A1C at 7% or below
• If the patient has not been diagnosed with diabetes and the blood glucose is at or above 200 mg/dl treatment will be delayed and a referral to the physician will be given.
• Any patient with a blood glucose of 300 mg/dl or higher receives an immediate referral to a physician and all treatment is delayed until a medical clearance is received.
Based on the Guidelines within the PU DHS clinic manual, identify which medical conditions require a prophylactic antibiotic prior to dental treatment
Joint Replacement Prophylaxis Recommendation
• All joint replacements DO NOT require premedication, unless otherwise directed by their surgeon and written documentation is received stating premedication is necessary.
• If the surgeon recommends the patient to be on premedication the premedication will be prescribed by the surgeon.
• A verbal statement from the surgeon is acceptable to proceed on with treatment for the initial appointment if NO premedication is indicated. Written documentation from the surgeon that NO premedication is necessary and must be on file prior to the patient’s second appointment.
• The student clinician and/or overseeing faculty will fill out the Medical Consult Consent form within axiUm for all individuals disclosing a joint replacement. Notification through messenger in axiUm is required to be sent to the front office personnel in order for the form to be faxed to the intended recipient.
Endocarditis Prophylaxis Recommendation
Only recommended for the highest risk of IE including those who have:
• Artificial heart valve or who have had a heart valve repaired with artificial material.
• A history of endocarditis
• A heart transplant with abnormal heart valve function
• Certain congenital heart defects including:
o Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), that has not been fully repaired, including children who have had a surgical shunt and conduit.
o A congenital heart defect that’s been completely repaired with artificial material or a device for the first six months after the repair procedure.
o Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.
History of Appetite Suppressant Drugs such as Fenluramine and Phentermine (fenphen)
Referral to the physician for a complete physical examination and echocardiogram is necessary prior to dental treatment due to the increased risk of significant bleeding.
Endocarditis Prophylaxis NOT Recommended
Negligible Risk Category (no greater than the general population)
• Surgical repair of atrial septal defect, ventricular septal defect or patent ductusarteriosus (without residues beyond 6 mos)
• Previous coronary artery bypass graft
• Mitral valve prolapse with or without regurgitation
• Physiologic, functional, or innocent heart murmurs
• Previous rheumatic fever without valvular dysfunction
• Cardiac pacemakers
• Implanted defibrillators
Patient is aware of risks and tx and gives written consent
Given ½ to 1 hour before treatment to limit chance of inflammatory endocarditis
The act of listening/Stethescope
Rapid heart rate above 100 bpm
Slow heart rate below 80
Rapid breathing above 20 breaths per min
Slow breathing below 15 respirations per minute
High blood pressure above 120/80
After standing for 3 minutes a drop in blood pressure
Discuss the rationale for performing a thorough head, neck and oral examination and accurately documenting findings.
Screening for Oral Cancer. Patient typically sees hygienist more than doctor so we make sure to screen.
Intra Oral Exam:
-Note early signs of disease
- Detect abnormalities and potentially life threatening oral malignancies
Extra Oral Exam:
A physical examination technique consisting of:
A systematic visual inspection of the skin of the head and neck
Palpation of the lymph nodes, salivary glands, thyroid, and TMJ
Thorough and accurate documentation of findings.
Identify conditions requiring referral to a physician or dental specialist.
Cancer does not show signs of healing and resolution within a 2 week (14 days) window of time.
Leukoplakia- white lesions
Erythroplakia- red lesions; greater potential for becoming cancer than leukoplakia
-Feeling as if something is caught in throat
-difficulty chewing or swalling
Discuss findings of the head, neck and oral examination that have implications in planning dental hygiene treatment.
Herpatic Lesions must be dismissed while active
work related musculoskeletal disorder
Force+Repetition+Position+No Rest= Musculoskeletal Injury
The science of adjusting the design of tools, equipment, tasks, and environments for safe, comfortable and effective human use
The position of the patient during dental treatment, with the patient lying on his or her back in a horizontal position and the chair back nearly parallel to the floor
A task that involves the same fundamental movement for more than 50 % of the work cycle
The ideal positioning of the body while preforming work activiites that is associated with decreased risk of musculosceletal injury. It is generally believed that the more a joint deviates from the neatral position, the greater is the risk of injury
carpal tunnel syndrome
Painful disorder of the wrist and hand caused by compression of the median nerve within the carpal tunnel
Poor posture (why?)
Repetitive bending wrist up and down or side to side
Gripping instruments without frequent rest periods
Numbness, pain and/or tingling
in the thumb, index, middle and ring fingers
ulnar nerve entrapment
Painful disorder of the wrist and hand caused by compression of the ulnar nerve as it
passes through Guyon’s canal
Bending up/down or side to side at wrist
Holding the little finger a full span away from the hand
Numbness/Tingling in pinky and ring fingers
Loss of (grip) strength
in the hand
rotator cuff tendinitis
Painful inflammation of the tendons in the shoulder region
Holding the upper arm away from the body (elbows pointed outward
Sharp pain near top of shoulder and impaired function of the shoulder joint
Painful inflammation of the tendons of the wrist and hand
Repeatedly extending up or down at the wrist
Pain in the wrist, especially on the outer edges of the hand
Painful disorder of the hand caused by compression of the median nerve between the two heads of the pronator teres muscle
Repetitive grasping, especially with the forearm rotated downward
Similar to carpal tunnel syndrome
Numbness, pain and tingling in the thumb, index and middle, and ring fingers (can be in the palm)
Discomfort in the anterior forearm near the elbow
Painful inflammation of the tendons on the radial side of the wrist and at the base of the thumb
Maintaining an extended thumb for prolonged periods
Pain of the thumb side of the wrist and near the base of the thumb
Discomfort with thumb opposition toward pinch and wrist deviation to same side