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Patient Care I > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

healthcare associated infections (HAI):

A

an infection acquired during the delivery of healthcare in any setting
*broad term that reflects the uncertainty of where a pathogen may have been acquired

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2
Q

chain of infection requires what 3 things?

A
  1. source or resevoir (sufficient #’s of pathogen)
  2. susceptible host
  3. mode of transmission
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3
Q

aerosols

A

-liquid or solid particles less than 50 micrometers
-small enough to stay airborne for extended period of time

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4
Q

splatter

A

-mixture of air, water, and/or solid substances larger than 50 micrometers
-visible to the naked eye
-airborn briefly –> limited penetration into respiratory system
-travle in bullet-like trajectory

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5
Q

droplets & droplet nuclei

A

-0.5-1 micrometers
-can settle in pulmonary alveoli
-high level of risk of infection in dentistry

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6
Q

what are the three modes of transmission?

A
  1. direct
  2. indirect
  3. respiratory
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7
Q

direct transmission

A

pathogens transferred b/w individuals with no intermediate

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8
Q

what percentage of nuclei in dental office is smaller than 5 microns in size?

A

95%

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9
Q

indirect transmission

A

pathogens transferred b/w individuals via an intermediate

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10
Q

respiratory transmission

A

pathogens transferred from droplets or droplet nuclei (inhalation)

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11
Q

virulence

A

ability to cause infection & damage
-easily colonizes
-grows rapidly
-produces harmful substances
-evades/counter body’s defenses

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12
Q

what are the 2 types of resistance?

A
  1. innate
  2. acquired
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13
Q

innate resistance

A

physical (skin, mucous membranes)
mechanical (secretions, cilia)
chemical (stomach acid)

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14
Q

acquired resistance

A

cell-mediated (antibodies)

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15
Q

immunity

A

condition of being able to resist a particular disease; especially through preventing development of a pathogenic microorganism

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16
Q

stages of infection

A
  1. incubation
  2. prodromal
  3. acute or spread of illness
  4. convalescent or decline
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17
Q

incubation stage of infection

A

time b/w exposure & apparent symptoms

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18
Q

prodromal stage of infection

A

time b/w appearance of initial symptoms & full development

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19
Q

acute or period of illness stage of infection

A

signs & symptoms are most obvious; specific & severe

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20
Q

convalescent or decline stage of infection

A

of pathogens decreases and symptoms decrease; host is susceptible to secondary infection

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21
Q

sanitization

A

process of physical cleaning to reduce the quantity of microbes & bioburden
-use of disinfectant & paper towels on surfaces
-use of soap & brush on instruments
-ultrasonic on instruments
should be used before sterilization &/or disinfection

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22
Q

sterilization

A

destruction of all microbial forms (including spores)
-heat (what we use)
-filtration
-radiation
-chemical (used for heat sensitive instruments)

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23
Q

antiseptics

A

substance that stops or slows down the growth of microorganisms; used on living tissue
*30% solution better than 100%

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24
Q

disinfection

A

less lethal than sterilization
*target for cubicle prep

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25
Q

what are the 3 levels of disinfection?

A
  1. high-level
  2. intermediate level (dual quaternaries)
  3. lower-level
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26
Q

high-level disinfectants

A

used for heat-sensitive instruments (endoscopes); kills all pathogens but not all spores; extended contact

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27
Q

intermediate level disinfectants (dual quaternaries)

A

cavicide or caviwipes
*what we use

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28
Q

lower-level disinfectants

A

used for floors & walls

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29
Q

Spaulding’s Classification System

A

categorizes patient care items by their potential risk of infection

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30
Q

Spaulding’s classification rankings

A

critical
semi-critical
non-critical

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31
Q

critical items

A

penetrate soft & hard tissues or the vascular system & confer a high degree of risk for infection if contaminated with pathogens; must be sterilized
-explorers, scalpels, burs, scalers

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32
Q

semi-critical items

A

contact, but do not penetrate; non-sharp items that enter the oral cavity; must be heat-sterilized (if heat-sensitive must minimally undergo high-level disinfection)
-amalgam condensers, mirrors, reusable impression trays

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33
Q

non-critical items

A

items that do not enter the oral cavity but may be touched; require disinfection or plastic barrier
-counter tops, chair controls, light handles, keyboard

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34
Q

standard precautions

A

treat everyone as infectious regardless of suspected or confirmed infection

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35
Q

3 types of controls:

A
  1. administrative
  2. engineering
  3. work-practice
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36
Q

administrative controls

A

policies, procedures & enforcement measures targeted at reducing risk of infection
ex: postponing nonemergent procedures

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37
Q

engineering controls

A

devices that isolate or remove the risk of exposure
ex: sharps containers

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38
Q

work-practice controls

A

procedures that reduce likelihood of exposure by altering the manner in which task is performed
ex: one-handed scoop technique for recapping a needle

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39
Q

regulated waste defined by OSHA

A

blood or other potentially infection material (OPIM) in liquid or semi-liquid state; items caked with blood or OPIM; contaminated sharps

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40
Q

what goes in red biohazard bag @ umkc?

A

solid waste soaked or saturated with blood or saliva; contaminated sharps; anesthetic carpules; scalpel blades; surgically removed tissue

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41
Q

CDC guidelines intended to _____

A

prevent infection transmission

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42
Q

ultrasonic cleaners

A

uses high frequency sound waves & cavitation to loosen and remove debris

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43
Q

autoclave

A

steam under pressure; most dependable & economical; most common; dulls cutting edges & rusts

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44
Q

flash sterilizers

A

steam; not intended to be used solely

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45
Q

dry heat

A

super high heat for long time; does not dull edges or rust; long cycle, poor penetration; handpiece won’t tolerate

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46
Q

chemiclave

A

steam under pressure with chemical vapor; short cycle & less corrosion; chemical vapor hazardous

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47
Q

latex reactions:

A
  1. contact dermatitis
    (irritant or allergic)
  2. latex allergy
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48
Q

irritant contact dermatitis

A

not an allergic rxn; least-threatening type; usually due to repeated exposure; dry, itchy, burning areas

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49
Q

allergic contact dermatitis

A

type IV delayed rxn; may result from allergy to chemical used in manufacturing; more severe than irritant

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50
Q

latex allergy

A

type I (immediate) hypersensitivity rxn; rxn’s may include nose, eye & skin

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51
Q

how to minimize latex reactions?

A

-dry hands before donning gloves
-use latex-free gloves
-use powder-free gloves

52
Q

monitoring sterilization

A

“spore testing”; should be done weekly

53
Q

what do you do if spore test is failed?

A

take machine out of service, review usage protocols & re-test machine
if re-test fails then machine needs to be inspected

54
Q

what is the #1 cause for failed spore test?

A

overloading of machine

55
Q

ergonomics

A

science of fitting jobs to the people who work them

56
Q

3 P’s to fitness in the operatory:

A
  1. posture
  2. positioning
  3. periodic stretching
57
Q

order of donning PPE

A
  1. gown
  2. glasses
  3. mask
  4. gloves
58
Q

order of doffing PPE

A
  1. gloves
  2. glasses
  3. gown
  4. mask
59
Q

how often should you purge water lines?

A

30 sec every morning and b/w each patient

60
Q

vital signs are the best way to prevent what?

A

medical emergencies

61
Q

what are the 4 classical signs of infection?

A
  1. calor (heat)
  2. dolor (pain)
  3. rubor (redness)
  4. tumor (swelling)
62
Q

4 types of infection:

A
  1. viral
  2. bacterial
  3. fungal
  4. parasitic
63
Q

viral infection

A

parasitic & require a host cell
ex: influenza, herpes (HSV), HPV, and HIV

64
Q

bacterial infection

A

single-cell microorganisms
ex: strep throat, E. coli, MRSA, tuberculosis

65
Q

fungal infection

A

yeast & mold
ex: ringworm, thrush, histoplasmosis

66
Q

parasitic infection

A

live on or in host; no oral manifestations
ex: malaria, lice, tapeworm

67
Q

what are the 4 vital signs?

A
  1. temperature
  2. pulse
  3. respirations
  4. blood pressure
68
Q

temperature

A

can take oral, axillary, or rectal; lowest @ 6am and highest between 4-6pm

69
Q

what is the average oral temp?

A

98.6

70
Q

what is the temperature of a fever?

A

100.4 degrees or higher

71
Q

what is the temperature of a low-grade fever?

A

99.6-100.3 degrees

72
Q

pulse

A

heart rate or # of times your heart beats per minute

73
Q

what are the three places you can take a pulse?

A
  1. radial (wrist)
  2. brachial (inside of elbow)
  3. carotid (neck)
74
Q

what is a normal pulse?

A

60-100 bpm

75
Q

tachycardia

A

pulse rate is greater than 100 bpm

76
Q

bradycardia

A

pulse rate is less than 60 bpm

77
Q

what are normal respirations?

A

12-20 breaths per minuteb

78
Q

bradypnea

A

slow breathing; less than 12 breaths/min

79
Q

tachypnea

A

fast breathing; more than 20 breaths/min

80
Q

systolic pressure

A

higher #; refers to the pressure inside the artery when heart contracts

81
Q

diastolic pressure

A

lower #; refers to the pressure inside the artery at rest and filling with blood

82
Q

is systolic or diastolic pressure associated with higher risk of stroke and heart disease?

A

higher systolic pressure

83
Q

pulse pressure

A

difference b/w systolic and diastolic pressure; force that the heart generates each time it contracts

84
Q

normal or safe pulse pressure

A

less than 45 mmHg

85
Q

risk factor pulse pressure

A

greater than 60 mmHg

86
Q

normal blood pressure

A

less than 120/80 mmHg

87
Q

elevated blood pressure

A

120-129/80 mmHg

88
Q

hypertension stage 1

A

130-139/80-89 mmHg

89
Q

hypertension stage 2

A

140 or higher/90 or higher mmHg

90
Q

hypertensive crisis

A

higher than 180/higher than 120 mmHg

91
Q

systolic hypertension

A

systolic pressure higher than 130 but diastolic is under 80
*most common type in people over 65

92
Q

hypertension risk factors

A

race
-non-hispanic blacks (42%)
-non-hispanic whites (28%)
-hispanics (26%)
-non-hispanic asians (25%)
post-menopausal women more likely due to lack of estrogen

93
Q

how to use manual blood pressure cuff

A
  1. place bottom edge of cuff about 1 inch above antecubital fossa
  2. inflate cuff about 20-30 mmHg above normal systolic
  3. pressure release valve turned to allow needle to fall at rate of 2-3 mmHg/sec
  4. systolic recorded at point where beating sounds (Korotkoff sounds) first heard
  5. diastolic recorded at point where Korotkoff sounds completely disappear
94
Q

common mistakes using manual BP cuff

A

cuff too big/loose= low reading
cuff too small/tight= high reading
crossed legs= high reading

95
Q

how many life-threatening emergencies will a dentist experience?

A

1-2
*becoming more likely due to increase in life expectancy

96
Q

categories of emergencies

A
  1. minor
  2. intermediate
  3. major
97
Q

minor emergency

A

simple faint

98
Q

trendelenburg position

A

used to increase blood flow to the head; body is laid supine or flat with 15-30 degree incline with feet elevated above the head
used in minor emergencies

99
Q

intermediate emergency

A

need O2 and repositioning

100
Q

major emergency

A

referral to MD or hospital (ER)

101
Q

ways to determine medical risks

A

medical history questionnaire
physical evaluation
dialogue history
medical consultation (if necessary)
ASA classification

102
Q

goals of physical evaluation

A

evaluate if…
-ability to psychologically and/or physically tolerate stress or procedure
-treatment modification needed
-psychosedation indicated
-which sedation method indicated?
-any contradictions to pre-medications used

103
Q

ASA I classification

A

normal healthy patient, non-smoking, no or minimal alcohol use

104
Q

ASA II classification

A

patient with mild systemic disease, current smoker, pregnancy, obesity, well-controlled DM/HTN, mild lung disease

105
Q

ASA III classification

A

patient with severe systemic disease, poorly controlled DM/HTN, COPD undergoing regularly scheduled dialysis

106
Q

ASA IV classification

A

patient with severe systemic disease that is a constant threat to life, recent (less than 3 months) MI heart attack, TIA (mini stroke)

107
Q

ASA V classification

A

moribund patient who is not expected to survive 24 hours without an operation

108
Q

ASA VI classification

A

declared brain dead patient whose organs are being removed for donor purposes

109
Q

signs of anxiety

A

increased BP & pulse
trembling
diaphoresis
restlessness
hyperventilation
dilated pupils

110
Q

stress reduction protocol

A

oral sedation- pm & am
intraoperative sedation
effective pain control- local anesthesia
am appointment
time factor- short appointments
post-op RX
post-op phone call

111
Q

syncope

A

transient loss of consciousness due to hypoperfusion of the brain & is characterized by rapid onset & spontaneous resolution; usually evoked by emotional stress associated with fear or pain

112
Q

how long does it take to fully recover from syncope?

A

24 hours

113
Q

vasovagal syncope

A

sudden, rapid drop in HR and BP which leads to fainting
*primary cause of syncope

114
Q

orthostatic hypotension

A

decrease in systolic BP of 20mmHg or decrease in diastolic of 10mmHg within 3 minutes of standing

115
Q

early manifestations of syncope

A

warmth
loss of color
sweating
nausea
BP @ baseline
tachycardia

116
Q

late manifestations of syncope

A

yawning
difficulty breathing
pupillary dilation
cold hands & feet
dizziness
loss of consciousness
hypotension
bradycardia

117
Q

hyperventilation

A

to breath at an abnormally rapid rate –> increasing rate of loss of CO2 –> causes respiratory alkalosis due to decreased partial pressure of CO2 in blood

118
Q

signs and symptoms of hyperventilation

A

rapid & shallow breathing
rapid pulse & respirations
confusion
dizziness
cold hands
tightness in chest, pain
carpal-pedal spasms; can lead to seizures
tingling or numbness of hands and lips

119
Q

management of hyperventilation

A

terminate procedure
position comfortably (usually upright)
reassure patient
no oxygen
breathe into paper bag or headrest cover; cupped breaths
count to 10 between breaths
valium 5mg IM or IV in severe cases

120
Q

goals of chairside dental assisting

A

-provide patient comfort and quality care
-reduce chair time
-minimize stress and fatigue during complicated dental procedures

121
Q

right handed operator work area

A

8-12 oclock

122
Q

left handed operator work area

A

12-4 oclock

123
Q

transfer zone

A

in front of mouth @ chin level
parallel transfer
dentist must signal
dentist should not have to move

124
Q

what should you supply at the beginning of every procedure?

A

mirror and explorer

125
Q

oral evacuation

A

keeps mouth free of saliva, debris, and water; retracts tongue and cheek; reduce bacterial aerosol caused by handpiece

126
Q

two grasps of oral evacuation

A
  1. pen grasp
  2. palm-thumb grasp
127
Q

x

A

x

Patient Care I (4 decks)

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