Fundamentals Objectives Exam 1 Flashcards
Discuss the dental health care provider’s responsibilities in assessing vital signs and the rationale for obtaining accurate vital sign readings prior to providing dental hygiene treatment.
The only way to know if you have high blood pressure (HBP, or
hypertension) is to have your blood pressure tested. Understanding your
results is key to controlling high blood pressure.
Identify each part of the stethoscope and blood
pressure cuff and explain its purpose.
Stethoscope: Amplify sound
- 2 earpeices
- Binaurals- isolate ans transfer sounds
- Plastic or rubber tubing -transfers frequency
- Chest piece (2 sides bell and diaphragm)- bell picks up lower freq. sounds diaphragm wide freq.)
Sounds created from patient body are picked up through the diaphragm or bell end. Sound travels through rubber tubing into binaurals to earpiece
Blood Pressure Cuff:
Discuss the normal range of temperature
Average 98.6 degree F
Range 96.8-100.4 degrees F
Discuss the normal range of a pulse and respiration
Pulse 60-100
Respiration: 12-20
Discuss the importance of knowing the patient’s A1C and glucose levels prior to dental treatment
Students will perform a glucose test for all patients reporting diabetes. Glucose testing may be performed as a screening if a patient reports a family history or answers yes to pertinent diabetes related questions.
• A1C: patients should maintain 7% or less HbA1C with well controlled diabetes or 7.5% in elderly patients with well controlled diabetes.
• Blood glucose limit up to 250 mg/dl if the patient has a current A1C at 7% or below
• If the patient has not been diagnosed with diabetes and the blood glucose is at or above 200 mg/dl treatment will be delayed and a referral to the physician will be given.
• Any patient with a blood glucose of 300 mg/dl or higher receives an immediate referral to a physician and all treatment is delayed until a medical clearance is received.
Based on the Guidelines within the PU DHS clinic manual, identify which medical conditions require a prophylactic antibiotic prior to dental treatment
Joint Replacement Prophylaxis Recommendation
• All joint replacements DO NOT require premedication, unless otherwise directed by their surgeon and written documentation is received stating premedication is necessary.
• If the surgeon recommends the patient to be on premedication the premedication will be prescribed by the surgeon.
• A verbal statement from the surgeon is acceptable to proceed on with treatment for the initial appointment if NO premedication is indicated. Written documentation from the surgeon that NO premedication is necessary and must be on file prior to the patient’s second appointment.
• The student clinician and/or overseeing faculty will fill out the Medical Consult Consent form within axiUm for all individuals disclosing a joint replacement. Notification through messenger in axiUm is required to be sent to the front office personnel in order for the form to be faxed to the intended recipient.
Endocarditis Prophylaxis Recommendation
Only recommended for the highest risk of IE including those who have:
• Artificial heart valve or who have had a heart valve repaired with artificial material.
• A history of endocarditis
• A heart transplant with abnormal heart valve function
• Certain congenital heart defects including:
o Cyanotic congenital heart disease (birth defects with oxygen levels lower than normal), that has not been fully repaired, including children who have had a surgical shunt and conduit.
o A congenital heart defect that’s been completely repaired with artificial material or a device for the first six months after the repair procedure.
o Repaired congenital heart disease with residual defects, such as persisting leaks or abnormal flow at or adjacent to a prosthetic patch or prosthetic device.
History of Appetite Suppressant Drugs such as Fenluramine and Phentermine (fenphen)
Referral to the physician for a complete physical examination and echocardiogram is necessary prior to dental treatment due to the increased risk of significant bleeding.
Endocarditis Prophylaxis NOT Recommended
Negligible Risk Category (no greater than the general population)
• Surgical repair of atrial septal defect, ventricular septal defect or patent ductusarteriosus (without residues beyond 6 mos)
• Previous coronary artery bypass graft
• Mitral valve prolapse with or without regurgitation
• Physiologic, functional, or innocent heart murmurs
• Previous rheumatic fever without valvular dysfunction
• Cardiac pacemakers
• Implanted defibrillators
informed consent
Patient is aware of risks and tx and gives written consent
prophylactic antibiotic
Given ½ to 1 hour before treatment to limit chance of inflammatory endocarditis
auscultation
The act of listening/Stethescope
tachycardia
Rapid heart rate above 100 bpm
bradycardia
Slow heart rate below 80
tachypnea
Rapid breathing above 20 breaths per min
bradypnea
Slow breathing below 15 respirations per minute
hypertension
High blood pressure above 120/80
orthostatic hypotension
After standing for 3 minutes a drop in blood pressure
