Clinic Theory Week 10 Flashcards
Temperature assessment
Measurement of the degree of heat in a body measured with a thermometer
When should an oral temp not be taken
Pt recently had oral surgery
Pt is under 5 (might bite)
Pt is confused or sedated
Anything hot or cold to drink within the last 30 minutes affects
Pts temperature
Placing thermometer intraorally
Ask client to open and raise tongue
Place bulb of thermometer on heat pocket
Rest stem on anterior teeth in opposing arch
Average normal oral temperature
37°
Pyrexia aka
Fever
Any reading above ___ is considered a fever (pyrexia)
37.6°
Variables affecting temperature
Time of day (lowest in am)
Exercise
Age (if 70+ avg temp 36°)
Environment
Stress
Smoking
Hot/cold liquids
Hormones
Infection
A temperature above 101F or 38.3C usually indicates
Active disease process
A temperature above 105.8F or 41C is considered a
Medical emergency
Pulse rate is an indication of
An individuals heart rate
Normal adult pulse rate is between
60 and 100 beats per minute
Ages 2-6 have a higher approximate range of pulse than adults
True (2-6 yrs=75-120)
Who tend to have a slower pulses at rest
Athletes
Increased pulse rate can be a normal response to
Stress
Exercise
Pain
Factors affecting pulse rate
Age
Medication
Stress
Exercise
Most common pulse point used in dental assessments is over the
Radial artery in the wrist
Brachial artery
Main artery of upper arm
(Divides into the radial and ulnar arteries at the elbow)
Radial artery
Begins below the elbow and extends down the forearm on the thumb side of the wrist onto the hand
Normal amplitude refers to
Full, strong pulse that is easily felt
Regularly irregular refers to
Regular pattern overall with “skipped” beats
Irregularly irregular refers to
No real patter, difficult to measure accurately
To assess amplitude of pulse use a numerical scale to characterize its strength
0- absent no pulse
1- weak/thready pulse hard to feel
2- normal pulse easily felt
3 bounding, forceful that is readily felt
Palpating for pulse
Use finger pads of your first 3 index fingers
Apply only enough pressure so that the radial artery can be felt
What finger should not be used due to having its own pulse
Thumb
You should not tell patient when you are taking this vital
Respiration
(They may change breathing pattern if they are aware it is being assessed)
Normal breathing allows a person to inhale and exhale how much air (ml)
500mL of air
Children use their diaphragms when breathing so watch their
Abdomen (as opposed to chest)
Normal respiration for an adult is between
12-20 breaths per minute
Some Variables that contribute to respiratory rate
Excitement
Exercise
Pain
Fever
Age
Medication
Gender
Body position
Stress
Breathing is an unconscious function; can be brought under bolstering control by
Holding breath
Panting
Singing
Sighing
Ages 3-6 years take more breaths per minute than adults
True (22-34 breaths per minute)
Evaluation of respiration
Rhythm (regularity)
Ease (laboured painful?)
Depth (deep/shallow)
Noise (wheezing/gurgling)
Abnormal odor (fruity/alcohol)
Systolic pressure refers to
Top reading of blood pressure (first sound)
Pressure created against the vessel walls when the heart beats
Diastolic pressure refers to
Bottom reading, second sound
Pressure between heart beats when the heart relaxes
Systolic pressure should be less than
130mm Hg
Diastolic pressure should be less than
85mm Hg
Hypertension is what?
Abnormally high blood pressure
Does high blood pressure have symptoms?
High blood pressure reading is above
No- referred to as silent killer
Above 135/85
Hypotension is
Abnormally low blood pressure
Dangers/risks of high blood pressure
Stroke, heart attack, seizure, heart failure, kidney failure
Recommended lifestyle changes for high blood pressure
Reduce salt
Prescribed medication
Exercise
Stress reduction
Lose weight
Blood pressure equipment
Sphygmomanometer
Consists of a cuff, bulb and manometer
Need a stethoscope
Kortokoff sounds refers to
Series of sounds heard as the pressure in BP cuff is released
Ausculation is the act of
Listening for sounds in the body with a stethoscope
Influences of blood pressure
Age, race, body position, respiration, emotion, temperature, anxiety, exercise, alcohol, tobacco
White coat hypertension
Dental or medical anxiety causes blood pressure to rise
If patient experiences white coat hypertension, in order to obtain accurate readings have the pt
Relax in a quiet room for a short time before assessing blood pressure
Normal bp if the client has no history of other risk factors is
130/85
Normal bp if the client has history of other risk factors is less that
130/80
Four of the most critical technique elements for accurate blood pressure determination
Cuff size
Cuff placement
Position of clients arm
Obtaining a palpating estimate of the blood pressure
Bladder length in reference to blood pressure cuff: too short causes
Falsely high readings
Cuff placement landmark
Antecubital fossa
Lower edge should be 1-2 inches above the fossa
Fossa should be at the clients heart level
Arm position in reference to blood pressure: antecubital fossa too low causes
False high readings
Blood glucose levels for diabetic client
3.9mmol/L-11.1mmol/L
If blood glucose reading is lower than 3.9mmol/L pt is
Hypoglycemic (blood sugar too low)
If BGL higher than 11.1mmol/L your pt is
Hyperglycaemic
Purpose of health history
Document/obtain baseline info
Identify risk factors
Health status is
Dynamic
Health history form is
Confidential and protected by law
What are the vital signs
Temperature
Pulse rate
Respiration rate
Blood pressure
Tachycardia
Above 100 beats per minute
Abnormally elevated heart rate
Bradycardia
Below 60 beats per minute
Abnormally slow heart rate
PVC’s- premature ventricular contractions are common and can be caused by
Smoking fatigue alcohol caffeine stress and certain medications
Pulsus alter and may indicate
(Hint alternating strong and weak pulses)
Ventricular failure
Tachypnea
Rapid breathing (over 20RPM)
Bradypnea
Slow breathing
Can occur with diabetic coma
Chronic hypertension causes thickening
And loss of elasticity in arterial wall
At TCDHA what pages have the medical condition written on the sticker
Personal info page
Medical update page
Record of care page
4 step treatment approach- RAME
R- recognition of disease
A- assessment of risk
M-management for safety
E-emergency care
Unresponsiveness (unconsciousness) requires
Immediate basic life saving support steps to be implemented
CPR: what does CAB stand for
Compressions
Airway
Breathing
Partial airway obstruction: pt is
Making noises or coughing noises
Anaphylaxis is generalized most threatening allergic reaction; affects can be seen
Skin, smooth muscle, respiratory and cardiovascular system
Anaphylactic shock occurs when consciousness is lost as a result of
Hypotension from anaphylactic reaction
Chest pain caused by temporary myocardial schemas without damage to heart muscle
Angina pectoris
Cerebrovascular accident is known as
Stroke
Syncope
Fainting