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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?

A

Nope

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
Q

What steps do you take with a Pt with a history of MI?

A

Consult Pt’s PCP; Determine if dental tx is needed before 6 month mark; Is Pt on anticoagulants; Use anxiety reduction protocol;

26
Q

What steps should you follow if the Pt has chest pain or an MI in the chair?

A

M - morphine
O - oxygen (10 L)
N - nitroglycerine (sublingual)
A - aspirin (325 mg)

27
Q

How long do Pts have to be on dual anti platelet therapy following PCI or stent placement?

A

12 months

risk for re-thrombosis in this 12 months is very high

28
Q

What four drugs are given for DAPT (dual anti platelet therapy)?

A

aspirin, plavix, coumadin, and xabans

29
Q

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

A

Nope

30
Q

What are some common symptoms of congestive heart failure (CHF)?

A

coughing, tiredness, SOB, weak heart beat, abdominal swelling, ankle/leg edema

31
Q

What is the most common cause of IE?

A

Streptococcus viridans

32
Q

You should provide antibiotic prophylaxis in what four situations?

A

If pt has prosthetic cardiac valve, Had previous IE, Has congenital heart disease, or is a transplant recipient with cardiac valvulopathy

33
Q

What are some orally administered prescription options for antibiotic prophylaxis?

A

All 30-60 min prior to procedure: Amoxicillin (2g), Clindamycin (600mg), Cephalexin (2g), AZT (500mg)

34
Q

What should you prescribe kids if they need antibiotic prophylaxis?

A

Amoxicillin (50mg/kg), Clindamycin (20mg/kg)

35
Q

How should you treat a Pt with a BP of 205/120?

A

Defer dental treatment and send them to their PCP immediately

36
Q

What two ways can you measure if the Pt’s MET is under 4?

A

If they cannot walk a city block or up a flight of stairs without SOB

37
Q

What is INR?

A

international normalized ratio used to measure coagulability of the blood

38
Q

What is a normal INR?

A
  1. 0

* higher than that means they have thinner blood*

39
Q

What is bridged therapy?

A

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
Q

What INR should the patient be under before extracting a tooth?

A

2.0

41
Q

When does the INR of a Pt need to be measured to go through with treatment?

A

within 24-hours prior to appointment

42
Q

How long does coumadin have an effect in the body?

A

3-5 days

Oral Surgery (8 decks)

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