provides a foundation for patient care by collecting both subjective (pt. complaints) and objective (systematic data) data.
Assessment phase of DH process of care
Patient perception and complaints of pain, symptoms etc.
subjective data
systematic data collected from exams and radiographs, etc.
objective data
identifies the health behaviors of individuals, as well as actual or potential oral health problems that DH is licensed to treat; provides a basis for which the DH care plan is designed
DH diagnosis
What are the 3 steps of the diagnosis phase for interpreting information?
classification
interpretation
validation
selection of interventions to be performed by the patient, dental hygienist, or others to help patient attain oral health
DH care planning
What are the steps in the DH care planning phase?
establish priorities
set goals
interventions
expected outcomes (prognosis
present the plan
informed consent
Activation of the care plan
implementation phase of DH process of care
determine if the patient needs to be retreated, referred, or placed on maintenance; determines change or modification to the plan; observes if the patient is progressing towards their goal
evaluation phase of the DH process of care
continuing care or supportive therapy, scheduled at intervals of 3, 4, or 6 months
maintenance plan
true or false. Culture affects oral health status and beliefs.
true
Why is it important to have an understanding and general knowledge of certain principles concerning different cultures?
to meet each individual patients oral health care needs, and to include each patients health beliefs, practices, values, customs, and traditions in the plan for dental hygiene care
In nonverbal communication, it is important to be aware of personal space, take caution in showing and interpreting_____________, _______________, and ____________________.
hand gestures
facial expressions
eye contact
true or false. When speaking to patients whose dominant language is not of the one you speak, you should simplify your language, and avoid professional jargon.
true
true or false. Always address the patient even if they have an interpreter.
true
the act of self-determination by persons with the ability to make a choice or decision
autonomy
doing good for benefit or enhanced welfare
beneficence
avoidance of harm to others; a core value
nonmaleficence
a duty to tell the truth when information is disclosed to patients about treatment
veracity
measures carried out so disease does not occur and is truly prevented
primary prevention
what is an example of primary prevention?
use of fluorides
treatment of early disease to prevent further progress of it
secondary prevention
what is an example of secondary prevention?
removal of calculus and biofilm
methods to replace lost tissue; for instance replacement of a missing tooth
tertiary prevention
What are the 7 core values in dental hygiene?
individual autonomy and respect
societal trust
nonmaleficence
veracity
confidentiality
beneficence
justice and fairness
What are the vital signs we check in clinic?
temperature
pulse
respiration
blood pressure
what is the normal body temperature for adults under age 70?
98.6 *F (96-99.5 *F)
what is the normal body temperature for adults over age 70?
96.8 *F
what is the normal body temperature for 1 year old children? 4 year old children? 5 year old children? 12 year old children?
99.1 *F
99.4 *F
98.6 *F
98 *F
temperature values below 96 *F
hypothermia
temperature values above 105.8 *F
hyperthermia - take patient to hospital!
(fever) temperature values over 99.5 *F
pyrexia
What are 10 causes of increased body temperature?
late afternoon and early evening
exercise
hot drinks
smoking
application of external heat
infection
dehydration
hyperthyroidism
myocardial infarction
tissue injury
what are 4 causes of decreased body temperature?
sleep and early morning
starvation
hemorrhage
physiologic shock
what is the normal pulse rate for adults?
60-100 bpm
what is the normal pulse rate for 1-2 year old children? 3-4 year old children? 9-10 year old children?
105 bpm
90 bpm
70 bpm
unusually fast heart beat - over 100 bpm - caused by exercise; stimulants; eating; strong emotions; extremes of heat and cold; some forms of heart disease
tachycardia
unusually slow heart beat - under 50 bpm - caused by sleep; depressants; fasting; quiet emotions; low vitality from prolonged illness
bradycardia
name 3 sites for taking pulse
radial - wrist
carotid - cardiopulmonary resuscitation
brachial - on infants
what is the normal respiration rate range for adults?
14 - 20 breaths per minute (slightly higher for women)
what is the normal respiration rate for 1 year old children? 2 year old children? 8 year old children? 15 year old children?
30
25
20
18
what is the normal blood pressure measurement for systolic, diastolic, and pulse pressure"
less than 120
less than 80
less than 40
the lowest pressure, and effect of ventricular relaxation
diastolic
peak or highest pressure, caused by ventricular contraction
systolic
used to measure blood pressure and consists of; a cuff, mercury manometer, and a stethoscope is used with it
the act of listening for sounds within the body to evaluate the condition of the heart, blood vessels, lungs, or other organs, stethoscope is used to hear the sound created by blood as it passes through the brachial artery
auscultation
series of sounds that are heard as the pressure in the sphygmomanometer cuff is released during the measurement of arterial blood pressure
korotkoff sounds
in some patients, the korotkoff sounds disappear altogether
auscultation gap
hollow or depressed area in the underside of the arm at the bend of the elbow; used as a landmark to locate radial pulse and is a reference point for cuff placement
antecubital fossa
where is the cuff placed in relation to the antecubital fossa? what level is the antecubital fossa kept at?
1 inch above it
level with the heart
name 6 causes for increased blood pressure
exercise
eating
stimulants
emotional disturbances
use of oral contraceptives
increases with age and length of use
What are 8 objectives of extra and intra oral exams?
observe the overall patient
screening
communicable diseases
initial lesions
identify deviations from normal
means of comparison
documentation
cancer detection
what are 3 advantages of keeping a routine order for extra and intraoral exams?
minimal possibility for overlooking something and missing something
increased efficiency
maintains a professional atmosphere and increases patients confidence
red area of variable shape and size; reaction to radiation or injury
erythema
appraisal characteristics to observe about a patient include:
posture
gait
general health status
hair
breathing
voice
What 3 characteristics of the face are observed?
expression - scared or stressed
shape - symmetry
jaw movement - normal and comfortable
what characteristics are observed about the face?
color, texture, blemishes
traumatic lesions, bruises
eruptions, swelling, growths
what characteristics are observed about the eyes?
sclera - whites of eyes
pupils
eyelids
eye glasses - offer them safety glasses instead
eye balls
what could yellow sclera indicate? red sclera?
jaundice
drug use
what could dilated pupils in light areas indicate?
lack of oxygen due to drugs or medications
What are the lateral and medial canthus's checked for?
scabbing
what are the eyelids checked for?
droop
what might protruding eye balls indicate?
hyperthyroidism
What characteristics of the ears are examined?
palpate ear lobes
entrance to ear canals
tragus
helix
antihelic
What are 5 things that might cause lymphadenopathy?
enlarged
infection
viral infection
bacterial infection
cancer
name 3 salivary glands examined in extra and intraoral exams
parotid
submandibular
sublingual
What are we looking for in checking salivary glands?
obstruction of flow
inflammation
infection
tumors
a bow tie shaped endocrine gland
thyroid gland
enlarged thyroid gland
hyperthyroidism
hard to detect; slow metabolism
hypothyroidism
use of a single finger
digital
use of finger and thumb of same hand
bidigital
use of fingers and thumb from each hand applied simultaneously in coordination
bimanual
2 hands at the same time to examine corresponding structures on opposite sides of the body
bilateral
how many lymph nodes are in the entire body? how many of those are in the neck?
400-700
170-200
containing fluid with translucent appearance and a soft consistency
blisterform lesion
blisterform lesion that is 1 cm or less in diameter, contains serum
vesicle
contains pus, yellowish in color, can be any size
pustule
greater than 1 cm in diameter, contains serum, and usually blood
bulla
solid lesion containing no fluid and a firm consistency
non-blisterform
slightly raised with a broad flat top and a pasted on appearance
plaque
solid, less than 5 mm in diameter, smooth or corrugated
papule
smaller than 1 cm in diameter, solid tissue
nodule
2 cm or more in diameter, solid tissue
tumor
surface on the same plane as normal mucosa, can be a single macule, or multiple macules, and have a regular or irregular outline
flat lesion
below the normal plane of mucosa, ulcer or erosion, can be single or multiple, regular or irregular outline, smooth or raised margin
depressed lesion
depressed lesion less than 3 mm deep
superficial
depressed lesion more than 3 mm deep
deep
lesion limited to a small focal point
localized
involves most of an area or segment
generalized
what are the most common sites for neoplasms?
tongue
floor of mouth
lateral portions of tongue
lower lip
soft palate
What are 4 warning signs of oral cancer?
white areas
red areas
ulcers
pigmentation - black or brown in irregular places
red lesion that is less likely, but when it is there is more likely for cancer
erythroplakia
white lesion that can't be scrapped off; more common, but less common for cancer
leukoplakia
class 1 lesion indicates:
normal
class II lesion indicates:
atypical; but not suggestive of malignant cells
class III lesion indicates:
uncertain - possible for cancer
class IV lesion indicates:
probable for cancer
class V cancer indicates:
positive for cancer
what classes of lesions is the pt dismissed only after the lesion heals, and if it persists the dentist may refer them out for a biopsy
class I and II
for which class of lesion is a biopsy usually indicated?
class III
for what class of lesions are biopsy's always indicated?
class IV and V
true or false. false negatives are possible, malignancy may still exist, so it is imperative to follow up with them.
true
Where is the pulse rate taken during life support for adults? children ages 1-8? infants younger than 1?
carotid pulse
carotid pulse
brachial pulse
What are 3 steps in airway establishment to prevent oxygen deprivation to brain?
look, listen, and feel for breath,
use head tilt with chin lift or jaw thrust to open airway unless they've injured spinal cord, or had a stroke, DO NOT move their head
administor 2 normal breaths, each one lasting 1 second
how long can a person go with out oxygen before irreversible brain damage occurs?
4-6 minutes
lack of perfusion of oxygenated blood to all cells of the brain and body, cells cease to provide respiratory and circulatory function
shock
What are signs of airway obstruction if a pt is unconscious?
if you give them a rescue breath and their chest doesn't rise
what are signs of mild airway obstruction?
good air exchange
coughing and irregular breathing
what are signs of sever airway obstruction?
poor air exchange
breathing difficulty or inability to speak or breathe
silent cough
cyonosis
When is supplemental oxygen used?
if patient is still breathing
what are 4 steps in oxygen tank operation?
attach the oxygen delivery system
turn key counter clockwise
increase oxygen flow as needed
attach oxygen to patient
what are 4 steps in administering supplemental oxygen?
full face mask, or nasal cannula
start at 4-6 L/min
monitor breathing
use positive pressure if breathing stops
when is positive pressure of oxygen administration used?
if patient is not breathing at all
diabetic coma - emergency
hypoglycemic emergency
What are some symptoms of a hyperglycemic emergency?
slow onset
flushed and dry skin
fruity odor on breath
dry mouth - thirst
low BP
weak or rapid pulse
exaggerated respirations
what is the procedure in the case of a hypoglycemic emergency?
call EMS; keep pt warm; administer oxygen by nasal cannula; basic life support in suppine position
