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Dental Hygiene II > Module 13 Exam 2 > Flashcards

Module 13 Exam 2 Flashcards

1
Q

In utero when do irregularities in heart develop happen

A

during the first 9 weeks

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2
Q

what is the most common heart defects

A

-ventricular septal defect
-patent ductus arteriosus
atrial septal defect
transposition of the great vessels

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3
Q

what is a patent ductus arteriosus

A

passageway is open between two great arteries, aorta and pulmonary artery

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4
Q

what are preventions for heart defects

A
  • rubella vaccine
  • no meds used during pregnancy
  • appropriate use of x-ray equipment
  • control of tobacco, drug and alcohol addictions
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5
Q

what are signs and symptoms of a congenital heart disease

A
  • easy fatigue
  • extertional dyspnea
  • cyanosis of lips and nail bed
  • poor growth and dev
  • heart murmur
  • congestive heart failure
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6
Q

What are dental hygiene concerns for heart defects

A
  • prevention of infective endocardidits

- elimination of oral disease

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7
Q

what is the etiology of rheumatic fever

A

group A streptococcual pharyngeal infection

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8
Q

what valve is most commonly effected in rheumatic fever

A

mitral valve

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9
Q

What is a mitral valve prolapse

A

imperfect closure of the mitral valve between the left atrium and the left ventricle which causes backflow or regurgitation of blood

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10
Q

Does mitral valve prolapse have symptoms

A

no

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11
Q

is a premed needed for mitral valve prolapse

A

no

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12
Q

What is infective endocardidits

A

microbial infection of the heart valves or endocardium that is of concern in the dental and dental hygiene care of high risk patients

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13
Q

what is a bacteremia

A

-presence of microorganisms in the blood stream

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14
Q

What is infective endocarditis characterized by

A

formation of vegetations composed of masses of bacteria and blood clots on heart valves

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15
Q

what bacteria are responsible in most cases for IE

A

streptococci and staphylcocci, alpha-hemolytic strep most prevalent

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16
Q

What are risk factors for IE

A
  • cardiac abnormalities
  • prosthetic heart valves
  • history of previous endocarditis
  • IV drug abuse
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17
Q

What are precipiatating factors of IE

A
  • self induced bacteremia
  • infection at portals of entry
  • trauma to tissues by instrumentation
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18
Q

what is a self induced bacteremia

A

activity that can force bacteria through the wall of a diseased sulcus or pocket

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19
Q

how do you prevent rheumatic heart disease

A

early diagnosis and tx

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20
Q

what are symptoms of rheumatic heart disease

A
  • arthritis
  • carditis
  • low grade fever over several months
  • joints, heart muscle, skin, CNS sub q tissues become involved
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21
Q

what are practice applications of rheumatic heart disease for the DH

A

-maintenance of high levels of oral health to prevent a need for tx of an advanced disease or caries

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22
Q

Rheumatic heart disease is almost always associated with

A

a significant murmur of insufficency

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23
Q

what are the symptoms of Mitral Valve prolapse

A
  • ususally no symptoms

- palpations, fatigue, atypical chest pain, late systolic murmer

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24
Q

How can we prevent IE in the dental setting

A
  • review the patient history (consult)
  • prophylactic antibiotic premed
  • dental hygiene care
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25
Q

What can we do with dental hygiene care with a patient who is at risk for IE

A
  • mainetence of high degree of oral health
  • instruction of brushing and flossing when under premed
  • sequence of tx- bring tissue to healthiest state as possible before instrumentation
  • reduce microbial pop around teeth before instrumentation
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26
Q

what is hypertension

A

abnormal elevation of aterial blood pressure

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27
Q

what is the etiology of primary hypertension

A 
-tobacco use
heredity
overweight
race
salt
sex
age
environment
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28
Q

what percentage of HTN is primary

A

95%

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29
Q

what is elevated in secondary hypertension

A

both diastolic and systolic pressures

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30
Q

WHat is the etiology of secondary HTN

A

-oral contraceptive
renal disease
endocrine disorders
medications

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31
Q

what is the diastolic bp

A

pressure exerted by blood within the arteries during resting resistance after contraction of the left ventricle

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32
Q

what is systolic bp

A

pressure exhorted against the aterial walls during ventricular contraction

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33
Q

what is normal bp

A

<80

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34
Q

what is prehypertension

A

120-139 80-89

35
Q

what is stage 1 hypertension

A

140-159- 90-99

36
Q

what is stage 2 hypertension

A

> 160 >100

37
Q

what are symptoms of hypertension

A
  • high blood pressure
  • long standing severe elevation of blood pressure
  • major sequela
  • malignant hypertension
38
Q

what are symptoms of high blood pressure

A 
occipital headaches
dizziness
visual disturbances
weakness
ringing in ears
tingling of hands and feet
39
Q

hypertensive crisis is a

A

life threatening disorder

40
Q

what are results of long standing severe elevation of blood pressure

A
  • mental confusion
  • blurring of vision
  • severe dyspnea
  • chest pains
41
Q

what are symptoms of a major sequela

A

hypertensive heart disease, enlarged heart with eventual cardiac failure
-hypertensive renal disease
ischemic heart disease
cerebrovascular accident

42
Q

what is treatment goals in primary hypertension

A
  • diastolic below 80

- lower risk of serious complications, death

43
Q

what are treatment goals in secondary hypertension

A

-surgical or other correction of cause is needed

44
Q

what are lifestyle changes that must happen in treatment of hypertension

A

-weight and exercise
diet
tobacco use
other risk factors

45
Q

what is hypertensive heart disease

A

results from the increased load on the heart because of elevated blood pressure
-to cope with increased work load from the peripherial arterial resistance to the increased flow of blood, muscle fibers are stretched and heart enlarges

46
Q

what is the first effect of hypertension on the heart

A

thickening of the left ventricle, later the entire heart is enlarged

47
Q

what is ischemic heart disease

A

the cardiac disability, acute and chronic, that arises from reduction or arrest of blood supply in the myocardium

48
Q

what is the myocardium blood supplied by

A

coronary artery

49
Q

what does ischemia mean

A

oxygen deprivation in a local area from a reduced passage of fluid into the area

50
Q

what is ischemic heart disease a result of

A

an imbalance of the oxygen supply and demand of the myocardium which in turn results from a narrowing or blocking of the lumen of the coronary arteries

51
Q

what is the etiology of ischemic heart diesease

A

-the principle cause is atherosclerosis of the vessel walls

52
Q

what are risk factors for ischemic heart disease

A
  • inflammation-role in formation of atheromas
  • perio microorganisms can cause atheromas
  • elevated blood lipids
  • increased cholesterol,sat. fat, carbs, alchohol and calories
  • tobacco use, diabetes, obesity, sedentary, stress and fam history may all be sig
53
Q

what are manifestations of ischemic heart disease

A

-angina pectoris
myocardial infarction
congestive heart failure

54
Q

What is angina pectoris

A

chest pain, the most common symptom of coronary arthrosclerotic heart disease

55
Q

what are the symptoms of angina pectoris

A
  • heavy, squeezing pressure or tightness in mid chest
  • pale, faintness, sweating, anxiety, fear difficulty breathing
  • pain may radiate down left or right arm, neck
56
Q

what are precipitating factors of angina pectoris

A
  • stable angina

- unstable angina

57
Q

what is treatment for angina pectoris

A

-use vasodilator, nitro, supplemental oxygen

58
Q

What are the steps in the procedure during an angina pectoris attack

A
  • terminate tx (call for assistance
  • position patient
  • administer vasodilator
  • check patient response
  • call for medical assistance
  • record vital signs
  • observe recovery
59
Q

What is a myocardial infarction

A

most extreme manifestation of ishcemic heart disease from a sudden arrest of coronary blood flow

60
Q

what is the etiology of a myocardial infarction

A
  • immediate:thrombosis that blocks an artery narrowed by athrosclerosis
  • blockage creates an area of infarction, which leads to necrosis of the area
61
Q

What are the symptoms of an MI

A

pain, cold sweat, weakness faintness, shortness of breath, nausea, vomiting, BP below baseline

62
Q

Do women always present with symptoms in an MI

A

no, they pay be nausiated, agitated, diphoretic

63
Q

What is the location and onset of pain in a myocardial infarction

A
  • location; under the sternum, may feel like indigestion, severe pain gives a pressing crushing or heavy sensation
  • onset- may be sudden, during sleep or after exercise, pain may be radial
64
Q

How do you manage a MI attack

A
  • terminate tx- sit pt up, give nitro

- summon medical assistance- when nitro doesnt reduce angina in 3 min prep for BLS

65
Q

What is congestive heart failure

A

syndrome in which an abnormality of cardiac function is responsible for the inability or failure of the heart to pump blood at a rate necessary to meet the needs of the body tissues

66
Q

what is the etiology of underlying causes of congestive heart failure

A
  • heart valve damage

- myocardial failure as an abnormality of heart muscle or secondary to ischemia

67
Q

what is the etiology of precipitating causes of congestive heart failure

A
  • acute hypertensive crisis (headache, mental confusion, dizziness, SOB, chest pain)
  • massive pulmonary embolism
  • aarhythmia
68
Q

what are clinical manifestations of left sided heart failure

A
  • subjective- weakness, fatigue, dyspnea, cough, expectortation, nocturia
  • objective-pallor, sweating, cold skin, breathing difficult, heart rate rapid, anxiety fear, diastolic BP increased
69
Q

How should a patient rest in the chair with left sided heart failure

A

sitting or semi-sitting position

70
Q

what are symptoms of right sided heart failure

A

-subjective- weakness, fatigue, swelling of feet or ankles, cold hands and feet
objective symptoms- cyanosis of mucous membranes, prominent jug. veins, congestion with edema in organs, anxiety, fear

71
Q

What kind of tx is used in congestive heart failure

A

-drug therapy, dietary control, limitation of activity

72
Q

what is good to know for the dh in congestive heart failure

A

-know they may be recieving multiple medical tx

73
Q

What is are basic noninvasive treatments

A
  • counseling
  • lifestyle changes
  • medications
74
Q

What kinds of surgical treatments may be done?

A
  • coronary dilation
  • coronary bypass
  • cardiac pacemaker
75
Q

What are the 2 kinds of coronary dilation

A
  • percutaneous transluminal coronary angioplasty (balloon widens lumen)
  • coronary stent
76
Q

What is a coronary bypass

A

-vein graft to jump pass over arteries that have been narrowed

77
Q

What is the natural pacemaker of the heart

A

SA node in the right atrium

78
Q

what are the two types of cardiac pace makers

A

demand or fixed rate

79
Q

what can interfere with a cardiac pacemaker

A

electromagnetic interferences

80
Q

what is important with a cardiac pacemaker in DH care

A
  • be aware of dental devices that have an electric current
81
Q

what are clinical procedures in anticoagulant therapy

A
  • consultation- info about prothrombin time
  • treatment planning-pretest within 24 hours for prothombin time, in quadrant scaling and root planing treat the heather quadrant first, least bleeding will occur

Local hemostatic factors (pressure, suture, perio dressing)

82
Q

what are post procedural instructions for anticoagulant therapy

A
  • extraoral icepacks

- soft diet, cool, gen. moderation of activity

83
Q

What should happen before elective cardiac surgery

A

pt should be brought to optimum oral health, with all infection removed, all restorations completed

84
Q

what should you do with a patient who is post cardiac surgery

A

-frequent appointments for maintenance
-prophylactic antibiotic coverage
pts will be on immunosuppressive therapy

Dental Hygiene II (19 decks)

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