Pickett Ch. 1 Using Medical History To Prevent Emergenices: Risk Assessment Flashcards
Functional capacity
The ability to complete various physical activities a measurement used in cardiac risk assessment
Functional capacity questions
“Can you walk on the treadmill at 4 mph? Can you climb a flight of stairs carrying groceries? Can you run a short distance?”
If the answers are “yes”, one can conclude that the client meets the minimum 4 MET level of endurance
If not, at risk for cardiac problems during oral procedures
ASA I
Treatment modification not required
Under 120/80 bp
ASA II
Mild disease but doesn’t interfere with daily activity. Overweight, oral contraceptives, smoking. Healthy with risk- controlled.
Very fearful or anxious of procedures.
BP 120-140/80-90
Proceed with caution.
ASA III
Severe disease that limits but not incapacitating. Proceed with great caution b/c risk is increased.
Ex: pt with recent heart attack may need shorter appointment, anxiety med, etc to prevent excessive cardiac stress
ASA IV
Condition that is threat to their lives. Cannot meet met level 4. Postpone treatment until back to Asa 3. Stress even when rested.
Ex: heart attack in last 4 wks or stroke in last 6 months
Above 140/90 bp
(Clinic cut off 160/100)
When “yes” responses on medical history…
Circle in red and ask follow up questions. What when why?
“Why do you think your gums bleed”
Follow up questions help determine
Pathophysiology of disease
Potential risks for med emergencies
Clinical management
Strategies for resolving risk
Prehypertension
Hypertension
120/80 to 139/89
Stage 1
140/90 to 159/99
Stage 2
equal or greater than 160/100
Hypertension is a risk factor for
Stroke
Myocardial infarction
Heart failure or congestive heart failure
Kidney disfunction
Hyperthyroidism
Diabetes
Pulse rate
Radial artery
Normal adults 60-80 bpm
Children <120 bpm
Respiration rate
Adults 14-20 breaths per minute
Children <5 years <22 breaths
