Pre-op Health Status Evaluation

Question 1

What does Primum Non Nocere mean?

Answer 1

Do no harm

Question 2

What three questions should you ask when a pt comes in?

Answer 2

What, why, how?

What medications?

Why are they taking these medications?

How will this impact you?

Question 3

What questions should you ask an asthmatic pt?

Answer 3

Have you been hospitalized?

What medications do you take?

What sets it off?

When was your last attack?

Question 4

What is the most common cause of COPD?

Answer 4

Smoking

Question 5

True or false.. reclining a pt with COPD may be a problem

Answer 5

True

Question 6

What happens when you give a COPD pt halcion?

Answer 6

It will cause their drive to breath to go down.

The pulse oximetry can go down to 85-70

Question 7

Where is penicillin metabolized?

Answer 7

Kidneys

Penicillin can be toxic if they have renal problems.

Question 8

If a pt is a yellowish/brownish color, they could be ____. What are some complications associated with that?

Answer 8

Uremic

May have healing issues and halitosis

Question 9

Explain how dialysis works

Answer 9

Someone with renal failure may be on dialysis in which their blood gets filtered in a dialysis machine (takes about 6 hours). They must go in every other day. They have a fistula in their arm that is used for dialysis. Pts are on anticoagulants such as heparin on the days of dialysis

Question 10

What should you be careful about when taking the BP of a pt who is on dialysis?

Answer 10

Don’t put the blood pressure cuff on the arm with the fistula (used for dialysis)

Question 11

True or false.. anticoagulants such as heparin affect INR

Answer 11

False

Question 12

True or false… BP plummets in pts who are on dialysis

Answer 12

False, it goes up

Question 13

What are some complications with renal transplant pts?

Answer 13

The pt is immunocomprimised (drugs are given to them so they dont reject the organ)

You must take extreme caution and give prophylactic antibiotics so bacteria doesn’t get to the transplanted organ

Question 14

True or false… kidney failure is a major cause of HTN

Answer 14

True

Question 15

What are some complications with a dysfunctional liver?

Answer 15

May affect drug metabolism rates

Clotting factors, complement, and albumin arent sufficiently produced

Question 16

What is the most common endocrine disorder? What are some complications associated with this disease

Answer 16

Diabetes. (Make sure to understand how well they are controlled)

Can affect healing (likely to have inflamed gingiva and periodontitis)

HTN

Kidney problems

Make sure to communicate with their physician, especially for sedation

Question 17

Adrenal insufficiency is not a very common problem. Pateints often take supplemental steroids, what problems can this cause?

Answer 17

Bone problems
Renal problems
Poor immune system

Question 18

If a pt has hyperthyroidism, why must you be careful with LA?

Answer 18

Giving them epinephrine may trigger them to go into thyroid storm

Question 19

If a pt has a hereditary coagulopathy, what can happen when you give them a block?

Answer 19

They could get a big hematoma

Make sure to talk to their physician

Question 20

The average hematocrit is around ___

Answer 20

45

Question 21

How long can the anticoagulation effects of aspirin last?

Answer 21

Up to 6 weeks

Question 22

What is the most common anticonvulsant?

Answer 22

Dilantin (phenytoin)

Question 23

What can precipitate a seizure? What do you do if they have a seizure?

Answer 23

Lights, anxiety, lack of sleep

If they have seizure, make them comfortable, keep them from hitting themselves, support an airway, then give them a quiet area to recover after

Question 24

Why shouldnt you do any dental procedures on a mother in the first trimester of pregnancy?

Answer 24

You want to avoid things that may harm the fetus such as NO2 and diazapene. You dont want things to go south and have to give the mom antibiotics or NSAIDs which may not be good for the fetus

Question 25

True or false… you should be conservative when extracting teeth/tissue that are necrosing due to radiation therapy.

Answer 25

False. Take out ALL the necrosis. First priority is to stop the necrosis, then worry about the problems after

Question 26

Radiation doses above ___ can be a huge problem that can cause dry mouth and possibly osteoradionecrosis.

Answer 26

4500

Question 27

If a pt has been on bisphosphonates for less than 3 years or if they have been on it for longer but off of it for 9 months, is it ok to treat them?

Answer 27

Yes. If over 3 years, anything that exposes bone will not heal

Question 28

How do bisphosphonates work?

Answer 28

Kill osteoclasts

Question 29

The maximum benefit of bisphosphonates is at ___ years. Never take longer than ___ years.

Answer 29

3

5