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Oral Surgery > Managing Cardiac Pts > Flashcards

Managing Cardiac Pts Flashcards

1
Q

What classifies mild-moderate hypertension?

A

systolic

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2
Q

What classifies mild-moderate hypertension?

A

systolic

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3
Q

What classifies severe hypertension?

A

systolic >200, diastolic >110

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4
Q

If the Pt has bp of 205/115 but no symptoms, what would that be classified as?

A

Severe HTN

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5
Q

If the Pt has bp of 205/115 and is symptomatic (sob, fatigue, etc) what would that be classified as?

A

Hypertensive emergency

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6
Q

Cardiac patients and even ones with HTN cannot exceed what dose of epinephrine?

A

0.04 mg in a single visit

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7
Q

What two demographics have the highest prevalence of angina?

A

Men over 40, and post-menopausal women

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8
Q

What is angina?

A

A mismatch in myocardial oxygen demand and oxygen supply (symptom of ischemic heart disease)

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9
Q

If your patient experiences angina, what five general things should you ask questions about?

A

frequency, duration, severity, response to medications, and if it’s stable

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10
Q

Can you treat someone with stable angina?

A

Yes, but have precautions set in place in case they have an episode in the chair

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11
Q

How do we measure cardiac functional status?

A

Metabolic Equivalents (MET)

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12
Q
A

They have poor cardiac functional capacity

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13
Q

How long do you have to defer surgeries after a Pt has an MI?

A

at least 6 months

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14
Q

If the Pt has bp of 205/115 but no symptoms, what would that be classified as?

A

Severe HTN

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15
Q

If the Pt has bp of 205/115 and is symptomatic (sob, fatigue, etc) what would that be classified as?

A

Hypertensive emergency

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16
Q

Cardiac patients and even ones with HTN cannot exceed what dose of epinephrine?

A

0.04 mg in a single visit

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17
Q

What two demographics have the highest prevalence of angina?

A

Men over 40, and post-menopausal women

18
Q

Do you need to provide antibiotic prophylaxis to Pts with cardiac dysrhythmias?

19
Q

If your patient experiences angina, what five general things should you ask questions about?

A

frequency, duration, severity, response to medications, and if it’s stable

20
Q

Can you treat someone with stable angina?

A

Yes, but have precautions set in place in case they have an episode in the chair

21
Q

How do we measure cardiac functional status?

A

Metabolic Equivalents (MET)

22
Q
A

They have poor cardiac functional capacity

23
Q

What are two things on the EKG that signal the Pt is having an MI?

A

Inversion of QRS interval, and ST segment elevates

24
Q

How long do you have to defer surgeries after a Pt has an MI?

A

at least 6 months

25
What steps do you take with a Pt with a history of MI?
Consult Pt's PCP; Determine if dental tx is needed before 6 month mark; Is Pt on anticoagulants; Use anxiety reduction protocol;
26
What steps should you follow if the Pt has chest pain or an MI in the chair?
M - morphine O - oxygen (10 L) N - nitroglycerine (sublingual) A - aspirin (325 mg)
27
How long do Pts have to be on dual anti platelet therapy following PCI or stent placement?
12 months | *risk for re-thrombosis in this 12 months is very high*
28
What four drugs are given for DAPT (dual anti platelet therapy)?
aspirin, plavix, coumadin, and xabans
29
Do you need to provide antibiotic prophylaxis to Pts with cardiac dysrhythmias?
Nope
30
What are some common symptoms of congestive heart failure (CHF)?
coughing, tiredness, SOB, weak heart beat, abdominal swelling, ankle/leg edema
31
What is the most common cause of IE?
Streptococcus viridans
32
You should provide antibiotic prophylaxis in what four situations?
If pt has prosthetic cardiac valve, Had previous IE, Has congenital heart disease, or is a transplant recipient with cardiac valvulopathy
33
What are some orally administered prescription options for antibiotic prophylaxis?
All 30-60 min prior to procedure: Amoxicillin (2g), Clindamycin (600mg), Cephalexin (2g), AZT (500mg)
34
What should you prescribe kids if they need antibiotic prophylaxis?
Amoxicillin (50mg/kg), Clindamycin (20mg/kg)
35
How should you treat a Pt with a BP of 205/120?
Defer dental treatment and send them to their PCP immediately
36
What two ways can you measure if the Pt's MET is under 4?
If they cannot walk a city block or up a flight of stairs without SOB
37
What is INR?
international normalized ratio *used to measure coagulability of the blood*
38
What is a normal INR?
1. 0 | * higher than that means they have thinner blood*
39
What is bridged therapy?
Where you ween the patient off of one drug while simultaneously giving them another for the same effect. i.e. heparin bridge for coumadin Pts
40
What INR should the patient be under before extracting a tooth?
2.0
41
When does the INR of a Pt need to be measured to go through with treatment?
within 24-hours prior to appointment
42
How long does coumadin have an effect in the body?
3-5 days

Oral Surgery (8 decks)

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