Pre-op Health Status Evaluation Flashcards
What does Primum Non Nocere mean?
Do no harm
What three questions should you ask when a pt comes in?
What, why, how?
What medications?
Why are they taking these medications?
How will this impact you?
What questions should you ask an asthmatic pt?
Have you been hospitalized?
What medications do you take?
What sets it off?
When was your last attack?
What is the most common cause of COPD?
Smoking
True or false.. reclining a pt with COPD may be a problem
True
What happens when you give a COPD pt halcion?
It will cause their drive to breath to go down.
The pulse oximetry can go down to 85-70
Where is penicillin metabolized?
Kidneys
Penicillin can be toxic if they have renal problems.
If a pt is a yellowish/brownish color, they could be ____. What are some complications associated with that?
Uremic
May have healing issues and halitosis
Explain how dialysis works
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
What should you be careful about when taking the BP of a pt who is on dialysis?
Don’t put the blood pressure cuff on the arm with the fistula (used for dialysis)
True or false.. anticoagulants such as heparin affect INR
False
True or false… BP plummets in pts who are on dialysis
False, it goes up
What are some complications with renal transplant pts?
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
True or false… kidney failure is a major cause of HTN
True
What are some complications with a dysfunctional liver?
May affect drug metabolism rates
Clotting factors, complement, and albumin arent sufficiently produced
What is the most common endocrine disorder? What are some complications associated with this disease
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
Adrenal insufficiency is not a very common problem. Pateints often take supplemental steroids, what problems can this cause?
Bone problems
Renal problems
Poor immune system
If a pt has hyperthyroidism, why must you be careful with LA?
Giving them epinephrine may trigger them to go into thyroid storm
If a pt has a hereditary coagulopathy, what can happen when you give them a block?
They could get a big hematoma
Make sure to talk to their physician
The average hematocrit is around ___
45
How long can the anticoagulation effects of aspirin last?
Up to 6 weeks
What is the most common anticonvulsant?
Dilantin (phenytoin)
What can precipitate a seizure? What do you do if they have a seizure?
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
Why shouldnt you do any dental procedures on a mother in the first trimester of pregnancy?
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
True or false… you should be conservative when extracting teeth/tissue that are necrosing due to radiation therapy.
False. Take out ALL the necrosis. First priority is to stop the necrosis, then worry about the problems after
Radiation doses above ___ can be a huge problem that can cause dry mouth and possibly osteoradionecrosis.
4500
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?
Yes. If over 3 years, anything that exposes bone will not heal
How do bisphosphonates work?
Kill osteoclasts
The maximum benefit of bisphosphonates is at ___ years. Never take longer than ___ years.
3
5
