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4 indications for laboratory tests include the following: (give examples for each)
1. detection of susptected disease
2. screening high risk pts for suspected disease
3. establishing normal baseline values before treatment
4. addressing medicolegal considerations
- 1. diabetes, infection, bleeding disorders
- 2. diabetes, AIDS
- 3. anticoagulant status, white blood cells, platelets
- 4. possible bleeding disorders, hepatitis B infection
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What are 2 methods of physician referral and consultation and their advantages?
- phone consultation: obtain immediate information and ask follow up questions
- letter or fax requests: provides a written statement of the physician's reply
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What items make up the patients health data that you must have before you assess it? (4)
- history
- clinical examination
- laboratory test results
- consultations
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What is a widely used method of expressing medical risk?
ASA physical classification system
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Which ASA class is a normal healthy pt?
ASA I
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Which ASA class is a pt with mild systemic disease that does not interfere with daily activity, or pt with a significant health risk factor (e.g. smoking, alcohol abuse, gross obesity)
ASA II
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Which ASA class is a pt with moderate to sever systemic disease that is not incapacitating but that may alter daily activity?
ASA III
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Which ASA class is a pt with severe systemic disease that is incompacitating and is a constant threat to life?
ASA IV
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List the 4 'A's' of the ABC's of risk assessment
- antibiotics
- anesthesia
- anxiety
- allergy
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What is the 'B' of the ABC's of risk assessment?
bleeding
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What is the 'C' in the ABC's of risk assessment?
chair position
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What are the 2 'D's' of the ABC's of risk assessment?
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What are the 2 'E's' of the ABC's of risk assessment?
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What are the 3 different treatment modifications that may need to be made after risk assessment?
- preoperative
- intraoperative
- postoperative
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prophylactic antibiotics given prior to certain dental procedures in a pt at risk for bacterial endocarditis
determination of the INR prior to surgery in a pt taking coumadin
ensuring food intake prior to treatment in a diabetic pt on insulin
prescribing an anxiolytic drug for an anxious pt with stable angina
Are all examples of what kind of treatment modification?
preoperative
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limiting the amount of vasoconstrictor in a pt who takes a nonselective beta blocker
administering nitrous to an anxious pt with poorly controlled hypertension
using an upright chair position for a pt with heart failure
avoiding the use of electrosurgery in a pt with a pace maker
avoiding elective radiographs in a pregnant pt
Are all examples of what kind of treatment modification?
intraoperative
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use of extra local measures for hemostasis in a pt taking coumadin
prescribing antibiotics for a poorly controlled diabetic following surgery
prescribing adequate post-operative analgesia for a pt on chronic steroids
Are all examples of what kind of treatment modification?
postoperative
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What might stress and anxiety do for a pt who is medically compromised?
reduce the risk of an emergency
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What are 4 stress reduction tactics that can be used prior to treatment?
- establish good rapport and trust
- explain treatment to be administered
- short morning appointments
- oral premed with sedative
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What are 5 stress and anxiety reduction tactics that are used during injections?
- avoid pain
- keep needle and syrince out of sight
- take your time
- allow adequate time for anesthesia to take effect
- use profound anesthesia initially
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What are 3 stress and anxiety reduction tactics that can be used at the end of the appointment?
- prescribe appropriate analgesia
- post op instructions
- post treatment phone call
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** Missed on Quiz. What is a factor in determining the severity of the appointment along with the invasiveness and length of appointment?
blood loss
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**Missed on Quiz. What is a way to prevent patients from coming to appointments and not being aware of medical conditions?
Screening phone calls
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