-
what is the strange smell noticed by patient before a seizure?
aura
-
what medication causes gingival hyperplasia?
phenytoin
-
what is gingival hyperplasia associated with phenytoin meds caused by?
fibroblasts and osteoblasts depositing excessive extracellular matrix
-
what determines the severity of phenytoin induced gingival enlargement?
amount of biofilm
-
a pt has an acetone, fruity smelling breath, what is this a symptom of?
ketoacidosis
-
what is classic symptom of ketoacidosis?
acetone, fruity smelling breath
-
what are 3 symptoms of hypoglycemia?
-
what is contraindicated during emergency management for epileptic seizure
place tongue depressor between teeth
-
what are 3 things that will trigger a seizure
- alcohol or withdrawal
- lack of sleep
- stress
-
name 3 possible complications of diabetes
- increased susceptibility to infection
- increased risk of cardiovascular disease
- increased risk for kidney dysfunction
-
what is the first step to addressing insulin shock?
give pt sucrose-juice or cake frosting
-
what is the most common type of dental emergency associated with a person having diabetes?
hypoglycemia
-
what is the type of asthma called that is triggered by an increase in pollen and seasonal allergens?
allergic, atopic
-
what type of local anesthetics should be avoided with asthma pts
epinephrine and levonordefrin
-
what orally inhaled drug is used to treat acute asthma attacks?
albuterol
-
what is a side effect of albuterol?
dry mouth
-
what is the first action to take with syncope
supine position
-
t/f dizziness is not an early presyncope sign?
true
-
what are 3 early presyncope sings?
- heavy perspiration
- nausea
- tachycardia
-
t/f placing a patient in the supine position is the #1 most important action to take for a patient who has fainted
true
-
t/f the possibility of a second syncopal episode is greatest during the post syncope phase
true
-
neurologic damage can occur in as little as ___-___ min if a patient remains upright during a syncopal episode
2-3 minutes
-
name 2 alterations and adaptations to treatment to prevent or limit syncope
- determine precipitating factors
- eliminate factors
-
what is the most likely cause of a seizure in the dental office?
local anesthesia overdose
-
name 4 actions involved in managing a seizure
- lower chair
- place pt in supine
- time seizure
- let seizure run its course
-
t/f it is important to use long acting anesthesia on patients with diabetes to keep them out of pain longer
false
-
t/f a diabetic patient should eat breakfast prior to their appointment
true
-
name 3 treatment contraindications in an asthma attack
- aspirin
- nitrous oxide if claustrophobic
- anesthetic containing bisulfites, epinephrine or levonodefrin
-
what can happen if you give a pt local anesthesia with epienphrine that is an asthmatic patient and also diabetic or has high blood pressure?
hyperglycemia
-
if a pt's asthma attack is not resolving itself after they have used their inhaler and you have administered O2 what should be done next?
call 911
-
what is the most common medical emergency in the dental office?
syncope (Fainting)
-
name three actions to take for a hyperventilating pt
- cease treatment
- place in upright position
- breathe into cupped hands
-
name 2 symptoms of hyperventilation
- rapid deep breathing
- lightheadedness
- rapid pulse
-
name 5 oral health problems associated with a kidney pt on hemodialysis
- dry mouth
- halitosis due to excess urea
- perio disease
- bone loss/tooth loss
- mucositis
-
t/f kidney disease pt often take blood thinners which may cause more bleeding during dental treatment
true
-
t/f systemic fluorides should be prescribed for pt with kidney disease
false
-
t/f when giving a kidney pt local anesthesia it s best to give them the highest dose possible
false-lowest dose possible
-
t/f congestive heart failure is a principal complication of virtually all forms of heart disease
true
-
t/f hear failure is more prevalent in women than men
false
-
t/f the purpose of the kidneys is to cleanse the urine of toxins
false
-
t/f a kindy hemodialysis pt should have dental treament the same day as their dialysis
false
-
t/f during a medical emergency involving a cardiac patient the patient should be placed in supine position
false
-
t/f the patient's vitals of a cardiac arrest should be monitored every 5 minutes
true
-
name 3 treatment adaptations/considerations with a cardiac patient?
- short appointments
- morning appointments
- ensure optimum vital signs
-
when using local anesthetics with a cardiac patient what should be avoided?
epinephrine
-
what is the best anesthesia of choice for a cardiac patient
carbocaine
-
what is the ASA classification for a pt that can climb a flight of stairs without distress?
ASA I normal
-
what is the ASA classification for a pt that can climb a flight of stairs without distress but must stop once the task is completed due to distress
ASA II
-
what is the ASA class for a patient that can climb a flight of stairs but must stop and rest before completing the task
ASA III
-
what is the ASA class for a pt that cannot negotiate a flight of stairs because of shortness of breath or undue fatigue
ASA IV
-
what is the ASA class of a pt that is not expected to survive?
ASA V
-
what is the most dangerous type of stroke?
hemorrhagic
-
it is imperative to always check the blood pressure of a pt with a heart condition why?
hypertention is the cause of 75% of all cases of heart failure
-
if your pt exhibits a spike in systolic blood pressure they are at risk for which type of strok?
hemorrhagic
-
in a pt with a history of stroke for every ____ mm HG over ____ that blood pressure increases the chances for a _____ stroke go up ____%
-
if your pt reports they have recently had a stroke, how long must you wait before doing dental treatment?
6 months
-
name three ethnic groups that show higher risk of stroke
- african americans
- hispanics
- native americans
-
t/f using low dosages of nitrous is acceptable for a pt with a history of stroke
true
-
t/f epinephrine and certain anti-anxiety agents shoudl be avoided when treating a pt with a history of stroke
true
-
in an emergency a conscious stroke pt is placed in what position? unconscious?
-
name a common dental allergen
latex
-
name the 4 progressive symptoms of an allergic reaction
- flushing of skin
- rhinitis
- hives
- loss of consciousness/anaphylatic shock
-
what are the two most important therapeutic agents used in the treatment of anaphylatic shock?
epinephrine and oxygen
-
if your hypertensive pt has an allergic reaction, what therapeutic agent is contraindicated? what is an alternative treatment for the pt
- epinephrine
- antihistamine or corticosteroids prior to appt
-
which type of angina emergency would you most likely see in the dental office
unstable
-
symptoms of angina attack may last ___ to ___ minutes
1 to 15 minutes
-
t/f if your pt is known to have a pacemaker ultrasonic scaling is contraindicated
false
-
t/f a magnetically attached headrest should be removed when working with a cardiac patient with a pacemaker
true
-
what is a common medication used for angina pectoris pt
nitroglycerin
-
in the SLCC clinic where is the AED located?
in the 6 pack on the north wall
-
cardiac arrest may be mistaken for what?
syncope
-
what is the organism that causes tuberculosis
mycobacterium tuberculosis
-
what is the type of TB where the organism lays dormant within the body and shows no symptoms called?
latent TB
-
how do health care workers determine if latent TB is present
positive tuberculin skin test (TST)
-
what are 4 modes of transmission of active TB?
- coughing
- sneezing
- singing
- speaking
-
what are three major symptoms of active TB?
- cough lasting more than 3-4 weeks
- cough producing blood/sputum
- chest pain with breathing/coughing
-
a myocardial infarction is commonly known as?
heart attack
-
what is heart attack a common name for?
myocardial infarction
-
name 4 uncontrollable risk factors for an MI
-
name 3 emergencies in which you should place the pt in supine position
- syncope
- seizure
- unconsciousness
-
how are the symptoms of heart attack in women different than men?
women tend to have chest pain along with sob, nausea, vomiting, neck back and jaw pain
-
in an event of a heart attack what would help to reduce the patients pain?
nitroglycerin or aspirin
-
how long should dental treatment be avoided after a heart attack?
6 months
-
name 3 things that will minimize the risk of heart attack during dental treatment
- nitrous oxide
- supplemental oxygen
- pain control
- stress reduction
-
name 4 controllable risk factors of hypertension
- weight
- activity level
- diet
- stress
-
name 4 possible consequences of a hypertensive crisis (9)
- stroke
- heart attack
- kidney damage
- memory loss
- loss of consciousness
- eye damage
- blood vessel damage
- angina
- fluid in lungs
-
what type of local anesthesia is indicated for pt with hypertension?
carbocaine
-
name 4 contraindications to treatment with hypertensive pt?
- vasoconstrictors in local anesthesia
- salt water rinses
- jet polisher
- sodium bicarbonate rinses or brushing
-
what is the most common inherited bleeding disorder?
von willebrand's disease
-
which common over the counter med can cause thinning of the blood
aspirin
-
before treating a pt with hemophilia what should you do?
have a Dr note confirming treatment can go forward
-
what does COPD stand for?
chronic obstructive pulmonary disease
-
what are two primary diseases that cause COPD
- emphysema
- chronic bronchitis
-
if you pt with COPD is having trouble breathing what can you do to help?
- sit in comfortable position (upright)
- have them breath through pursed lips
- give them low oxygen
- have them lean elbows on knees and breath
-
name 2 environmental causes of COPD
- smoking (1st or 2nd hand)
- air pollution
-
in which chair position should you treat your pt with COPD
semi supine
-
name 3 contraindications when treating a pt with COPD
- rubber dam use (claustrophobic)
- nitrous oxide
- bilateral mandibular or platal anesthetics
- barbiturate
- antihistames
- high levels of O2
-
labored breathing is also known as?
dyspnea
-
what is dyspnea
labored breathing
-
what is a contraindication for a hyperventilating pt
administering oxygen
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