1. dental management of the medically complex pt

Question 1

organized risk assessment

Answer 1

P= patient evaluation 
A= allergies, analgesics, anesthetics, antibiotics, anxiety 
B= BP, bleeding and breathing 
C= Chair Positioning
D= Drugs and Devices 
E= Equipment and Emergencies
F= Follow up

Question 2

METs

Answer 2

= metabolic equivalent levels

• a unit of oxygen consumption
• higher MET = better physical condition.

Question 3

true allergy signs. (9)

Answer 3

• anaphylaxis
• itching
• urticaria (hives)
• Rash
• swelling
• wheezing
• angioedema
• runny nose
• tearing eyes

Question 4

signs of intolerance or adverse side effects

Answer 4

• nausea
• vomiting
• diarrhea
• heart palpitations
• fainting

Question 5

what trimester is the safest to provide dental tx

Answer 5

second trimester

Question 6

pts with a hx of IV drug use are at a high risk for:

Answer 6

infectious ds like hep b, c, HIV/AIDS and infective endocarditis

Question 7

when assessing the pulse rate what can you palpate and what should you NOT use

Answer 7

• carotid (more reliable) or palpate radial artery (on the thumb side of wrist)
• do NOT use the thumb for pulse detection

Question 8

normal pulse rate

Answer 8

60-100 bpm

Question 9

tachycardia pulse rate

Answer 9

more than 100 bpm

Question 10

bradycardia pulse rate

Answer 10

less than 60 bpm

Question 11

normal respiration rate

Answer 11

12-16 breaths/min

Higher in small children than in adults.

Question 12

an earlobe crease MAY be associated with

Answer 12

coronary artery disease

but it is non-specific for heart ds

Question 13

CBC

Answer 13

complete blood count with platelets and WBC differential

it has RBC, WB.

Question 14

platelet count is what

Answer 14

150,000 to 400,000

Question 15

PT-INR

Answer 15

prothrombin time - international normalized ratio

it helps determine bleeding risk, measures extrinsic and normal coagulation cascade pathways

higher INR is a higher bleeding risk

Question 16

normal INR

Answer 16

=1

Question 17

INR in a pt on coumadin

Answer 17

INR = 2 to 3

Question 18

P.T.T.

Answer 18

purpose: to balance the risk of bleeding vs the risk of thrombosis

partial thromboplastin time (IV heparin)

normal range is 25 to 38 seconds

uses the intrinsic pathway

aPTT is used for pradaxa (activated PTT)

Question 19

arm below heart level for bp

Answer 19

it over-estimates systolic and diastolic pressures

Question 20

if the cuff is too small how does that change the bp

Answer 20

gives you a falsely elevated value

Question 21

if the cuff is too large how does that change the bp

Answer 21

a falsely low value

Question 22

if the arm is above heart level for bp

Answer 22

it under-estimates systolic and diastolic pressures.