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Clinical Dental Hygiene II > Chapter 58 > Flashcards

Chapter 58 Flashcards

1
Q

What are some barriers for receiving dental care?

A
  • few dental clinics in nursing homes
  • cost
  • fear
  • no transportation
  • limited mobility
  • patients attitude to their health
  • patients pain
  • medicare does not cover dental servives
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2
Q

These patients can sometimes be limited to one or two activites a day. They are usually dependent on caregivers.

A

Residence bound patients

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3
Q

What are residental facilities?

A

nursing homes
rehab centers
assisted living

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4
Q

There are US federal regulations on dental services requiring these facilities to receive medicare or medicaid funding

A

true

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5
Q

What are community based settings?

A
  • senior centers
  • work/activity centers for disabled
  • medical practices
  • homeless shelters
  • churches
  • elementary schools
  • head start and day care
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6
Q

What are common oral problems for residence bound patience?

A
  • perio
  • lack of daily oral care
  • need for routine check up
  • difficulty biting or chewing
  • weight loss
  • toothache/ pain
  • loose teeth
  • fractured teeth
  • lost filling or crowns
  • caries
  • ill fitting denture
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7
Q

Does oral health affect systemic health?

A

yessss!

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8
Q

What can lead to compromised nutrition?

A

oral pain or discomfort

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9
Q

What can compromise ability of daily oral care?

A

physical limitations

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10
Q

True or False: Oral health and cleanliness can affect pts self-esteem, quality of life, and ability to communicate

A

true

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11
Q

Hygienist providing care in a homebound patient can…?

A
  • traige for pt who need to see dentist
  • assist in preventing further complications
  • educate to prevent caries
  • encourage daily care
  • palliative care
  • contribute to pts general well being and quality of life
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12
Q

Preparation for home visit tx:

A
  • understanding pt
  • instruments and equipment
  • appointment time
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13
Q

How to prepare for understanding the patient before a home visit?

A
  • know before you go
  • review HH and call before you go
  • consider any pt problems
  • determine precautions for this pts care and safety
  • arrange with dentist if premed is required
  • if local anethesia is needed
  • arrange if there are extra items needed during DH care
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14
Q

When should a home visit appointment be?

A

contact the pt to see what time is convenient and the apt should be around a time the pt is awake

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15
Q

Instruments/ Equipment for a home visit?

A
  • Routine DH care can be provided by manual instruments
  • if ultrasonic is needed, they can be transported
  • May need covered plastic tubs and boxes for clean or contaminated materials
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16
Q

How do you approach a home bound visit patient?

A
  • communication
  • personal factors
  • suggestions for general procedures
17
Q

How should you communicate with a home bound patient?

A

Clinician needs to be empathetic and understanding. Gentle approach is best. Clinician should communicate with pt but discuss tx with caregiver

18
Q

Treatment location:

A
  • Some patients may be able to sit in a chair or wheelchair

- Kitchen or bathroom may be the most advantageous bc of access to water and counterspace

19
Q

How should you treat a patient in a bed?

A

Adjust pts head for best height. Use pillows to support or stabalize the patients head

20
Q

How should you treat a pt in a wheelchair?

A

Headrest can be attached. Some wheelchairs can tilt back. A pillow may help also

21
Q

What does the critically ill require?

A

maintenance of oral cleanliness bc of helplessness of pt

22
Q

Role of a hygienist:

A
  • Evaluate pt needs
  • plan and conduct oral health program for nurses
  • include hands on demonstrations
  • motivate caregiver for daily care
23
Q

Role of the hygienist for terminally ill pt:

A
  • provide comfort
  • educate pt and caregiver on oral care
  • emphasis on symptom relief and clean oral cavity
  • terminal illness is no excuse for neglect
  • focus on short term palliative care
24
Q

Oral lesions in terminally ill pt?

A
  • candidiasis
  • xerostomia
  • changes in mucosa
  • denture problems
25
Q

Why may a denture may no longer fit?

A

weight loss

26
Q

common among terminal pts bc of medication, mouth breathing, and dehydration. You should tell caregiver to keep oral cavity moist with water, ice chips, or OTC saliva substitutes

A

xerostomia

27
Q

79% of these pt have this, can be life threatening in immunocompromised pt

A

candidiasis

28
Q

these have the capability of causing extreme discomfort, and a secondary infections

A

active oral lesions

29
Q

About ___ of hospice patients had pathlogenic changes in the oral cavity and ____ reported soreness

A

75%…. 42%

30
Q

What are the general mouth care considerations for terminally ill patients?

A
  • cleanliness

- visual inspections

31
Q

When should a health history be reviewed in preparing to see a homebound patient?

A

before seeing the pt call to confirm responses on HH

32
Q

Should a patient who is terminally ill be treated dentally or should their work be postponed?

A

NO, they should continue with dental work. Just because they are terminally ill does not mean they should be neglected!!!

33
Q

What is the main objective care for a patient who is terminally ill?

A

clinician should focus on short term palliative care rather than long term

34
Q

what are the contrainfications for a homebound pt with xerostomia?

A

avoid rinses with alcohol

35
Q

Why should the tissues be examined daily in terminally ill pts?

A

because active lesions can cause extreme discomfort and secondary infection

36
Q

Why are dentures ill fitting in terminally ill patients?

A

bc of weight loss

37
Q

What techniques can be used for a homebound patient in a wheelchair?

A

-headrest may be attached
-straight chair or wheelchair can be back against the wall as a headrest
-some tilt back
a pillow behind pt head

38
Q

How often should a caregiver clean a terminally ill pts mouth?

A

2x daily

Clinical Dental Hygiene II (14 decks)

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