Patient Eval and Risk Assesment Flashcards
What are the 5 As we must look for after patient eval?
Antibiotics Analgesics Anesthesia Allergies Anxiety
What’s the 3 Bs we must look for after patient eval?
Breathing
BP
Bleeding
What’s is the C we must look for after patient eval?
Chair position
What’s the 3 Ds we must look for after patient eval?
Drugs
Devices
What’s the 2 Es we must look for after patient eval?
Equipment
Emergencies
What is the 1 Fs we must look for after patient eval?
Follow up
• Must be taken for every patient who is to receive dental treatment
• Two basic techniques used to obtain
➢ Interview the patient
➢ Ask patient questions, record the patient’s verbal responses (axiUM at UMKC)
➢ A printed questionnaire the patient fills out
medical history
_________= patient has already been diagnosed or,
patient presents with information needing a diagnosis
• MED history
The point of a ____ is to screen for potential new diseases • Screening through signs and symptoms with a systems-based approach
• Findings may be consistent with a particular systemic disease, but you will not diagnose
• Physician’s role →further examine, request labs, diagnose
• Referral consultation letter →express findings, concerns and a basis for ROS
ROS (Review of Systems)
➢ Ability to perform common daily tasks can be expressed in _________
metabolic equivalent levels (METs)
If the MET is ______; = better physical condition
Higher
➢ They are important because their use can result in adrenal
insufficiency and the patient is unable to mount a normal response to
the stress of an infection or invasive dental procedure, e.g., extractions
or periodontal surgery.
Steriods
- Risk factor for many cancers and other diseases
- May lead to liver cirrhosis, many complications
- Ask how many standard drinks /week
Alcohol consumption
If the cuff is too small taking bp, will the values be lower or higher than expected?
Falsely elevated
If the cuff is too large taking bp, will the values be lower or higher than expected?
Falsely low
At what bp is dental care not allowed at the school?
> 180/110
If arm is too low, how is bp affected?
Falsely elevated bp
If arm is too high, how is bp affected?
Falsely low
What is the bpm where the pulse is tachycardic?
> 100 bpm
What is the bpm where pulse is bradycardic?
<60 bpm
What is the normal respiratory rate?
12-16 breaths/min
_____ can indicate cardiac or pulmonary insufficiency
Cyanosis
Yellowing or jaundice may be due to ____ disease
liver disease
Petechiae or ecchymoses can be sign of ________ or _________
blood dyscrasia or bleeding
disorder
Clubbing of digits are signs of ____ and/or ______ problems
CV or pulmonary problems
ASA \_\_ A normal healthy patient ▪ Pt is able to walk up one flight of stairs or 2 level city blocks without distress ▪ Little or no anxiety ▪ Little or no risk during treatment
ASA PS 1
ASA \_\_\_\_ ▪ ASA 1 w/ respiratory condition, allergies, phobic, pregnant ▪ Diet or hypoglycemic agent-controlled diabetic ▪ Well-controlled asthmatic ▪ Well-controlled epileptic ▪ Well-controlled hypertensive, not on medication ▪ Pt has mild systemic disease ▪ ASA PS1 with extreme anxiety/fear ▪ Pt walk one flight of stairs or 2 level city blocks, but has to stop after exercise because of distress ▪ Minimal risk during treatment
ASA PS 2
ASA \_\_\_\_ ▪ Well-controlled hypertensive on medication ▪ Well-controlled diabetic on insulin ▪ Slight COPD ▪ 30 days or more ago hxof: ➢ Myocardial infarction ➢ Cerebrovascular accident ➢ Congestive heart failure ▪ Severe systemic dz, limits activity but not incapacitated ▪ Can walk up 1 flight of stairs or 2 level city blocks but has to stop on the way b/c of distress ▪ If dental care is needed, stress reduction protocol and other tx modifications are indicated
ASA PS 3
ASA \_\_\_\_\_\_ ▪ Hx unstable angina, MI, CVA in last 30-days ▪ Severe congestive heart failure ▪ Mod to severe COPD ▪ Uncontrolled hypertension ▪ Uncontrolled diabetes ▪ Uncontrolled epilepsy or seizure disorder ▪ Severe systemic dz, limits activity and constant threat to life ▪ Unable to walk up 1 flight of stairs or 2 level city blocks. Distress is present at rest ▪ Pt poses significant risk during treatment ▪ Elective dental care postponed until ASA 3 class ▪ Emergency dental care may be best in a hospital with a consultation with the Pt’s physician team
ASA PS 4
