Special Needs Flashcards
What is ADPIED
Assess Dental Hygiene Diagnosis Plan Care Implement Evaluate Document
Assess…
from the waiting room to your chair..data collection
Dental hygiene Diagnosis…
Based on your findings.. identify the problems
Plan Care…
What do they need clinically, patient education… select interventions
Implement…
What procedures are needed?…activate the plan
Evaluate…
How did our plan of care work? Feedback on effectiveness
Document…
Comprehensive record keeping
Normal Vital signs
Resp: 12-20
Pulse: 60-100
BP: 120/80
Temp: 98.7
ASA 1
normal, healthy pt, no issue walking up stairs and no anxiety
ASA II
Mild systemic disease
ASA III
severe systemic disease that limits activity but is not incapacitting
ASA IV
a patient with incapacitating systemic disease that is a constant threat to life
ASA V
patient is not expected to survive 24 hours with or without care
What kind of fluoride treatment is suggested for pregnant patient
Daily fluoride rinses NOT systemic supplements
If a pregnant patient is having hypotension, what do you do?
Turn them to the LEFT side, put a pillow under the right hip
What medications can help quit smoking?
Buproprion(zyban)
Chantix
What medication should you avoid when treating an alcoholic
Acetaminophen (to protect the liver)
What are common oral findings of a patient with Fetal Alcohol Syndrome
U-shaped or cleft palate, gingivitis, abnormal tooth eruption pattern, tooth malformation
What is an identification of a heroine addict
pinpoint pupils (opioid)
What is used to treat withdrawl and dependence of heroine
Methadone
What is Narcan
An opiod antagonist, reverses effects
What is used to reverse the effects of heroine/any opiod
Narcan
What is an identification of a cocaine user
Dilated pupils (stimulant)
What should you avoid using if you notice a patient may use cocaine or some sort of stimulant?
Epinephrine
What kind of drug is Methamphetimine
CNS stimulant
If a patient comes in and confesses to using meth what should you do?
Delay treatment for 24 hours after use
Do NOT use epinephrine
What is the most common medication used for asthma
albuterol
What are common side effects of albuterol
Xerostomia, Candida infections, Increased Caries
What to avoid with a patient with asthma?
Air Polisher Ultrasonic Aspirin NSAIDS Epinephrine
What is COPD
Chronic Obstructive Pulmonary Disease… two or more disease processes (Bronchitis, Emphysema)
Signs/Symptoms of COPD
Dyspnea Wheezing CHRONIC cough Chest pain Increased respiration rate CHRONIC airway obstruction
Contraindications for patients with COPD
Air Polisher and Ultrasonic
Rubber Dam use
Avoid Nitrous Oxide/Oxygen Sedation
What is chronic bronchitis
inflammation of lining of bronchial tubes
thick, heavy mucus and phlegm
“smokers’ cough”
(more prevalent in women)
“Blue Bloater” (severe dyspnea, coughing)
What is Emphysema
“Pink puffer” “Barrel chest”
Overinflation of alveoli/air sacs
CHRONIC productive coughing
Seen in older men
What is Cystic Fibrosis
An exocrine gland disorder (genetic)
Glands over secrete- saliva, tears, sweat is thick & sticky
What is Tuberculosis
Bacterial infection of the respiratory tract, DO NOT TREAT THIS PATIENT IF IT IS ACTIVE
How is Tuberculosis transmitted
by droplets, ingestion, coughing, sneezing contaminated dust
Contraindications for patients with Cardia Arrhythmias
NO EPIEPHRINE
avoid ultrasonic if pacemaker
What is Cardiac Arrythmias
irregular heartbeat leading to inadequate blood flow
What is congenital heart disease
anomalies of heart structure that was developed in utero
*consult physician, probaby premed
What is coronary heart disease
plaque builds up in the coronary arteries
AKA Ischemic Heart Disease
*premed
What are common signs/symptoms of congenital heart disease
Cyanosis
Clubbing of toes and fingers
What is Angina Pectoris
Transient and reversible oxygen deficiency-can be stable or untable
Signs/symptoms of angina pectoris
CRUSHING pain or pressure of chest
Squeezing pain radiating to shoulders, arms or mandible
Sweating, anxiety, pallor, difficulty breathing
Dental considerations for angina pectoris***
have nitroglycerin available on tray (relaxes vascular smooth muscles)
What is myocardial infarction
sudden reduction or arrest of blood flow to the heart
Signs/symptoms of myocardial infarction
**nausea, vomiting, palpitations and decreased blood pressure
along with symptoms of angina
Dental considerations for myocardial infarction
Contraindicate treatment if has had a recent attack, wait 3-6 months
What is congestive heart failure
Heart is unable to pump adequately in delivering oxygen rich blood to the body
Dental considerations for congestive heart failure
patient may not be able to lay supine
Use epinephrine with caution if client is on digitalis
Pt generally exhibits shortness of breath, fatigue, swollen ankles
What is the silent killer
Hypertension
What is Prehypertension
120-129/<80
What is Stage 1 hypertension
130-139/80-89
What is Stage 2 hypertension
140/90 or higher
What is a hypertensive emergency
180/120 or higher
What are signs/symptoms of hypertension
since it is the “silent killer” it is generally asymptomatic
What are contraindications for those with hypertension
Drugs with vasoconstrictors
Sodium in air polishing
Dental considerations for those with hypertension
monitor vital signs
slowly raise hair
**limit epinephrine
**Nitrous oxide/oxygen recommended
What is Cerebrovascular Disease?
Stroke
What is a primary dental consideration for a pt with a stroke
do not treat for 6 months after the stroke
What ages does parkinson’s disease usually develop
40-60 years, higher incidence in males
What is the most common drug prescribed for ADHD
ritalin
What is Bell’s Palsy
unilateral weakness or paralysis of cranial nerve VII (facial nerve) inability to control facial muscles
What depression meds may have an epinephrine interaction
Tricyclic Antidepressants
What is the maximum dose of epinephrine for an uncontrolled diabetic
.04mg
What is hepatitis
inflammation of the liver
What is the transmission route for type A and E hepatitis
Fecal-oral route (A has a vaccine E does not have a vaccine)
What is the transmission route for type B hepatitis
Blood/body fluids, sexual contact (can get a vaccine)
What is the transmission route for type C hepatitis
Blood/body fluids, sexual contact (NO VACCINE, usually asymptomatic)
What is the transmission route for type D hepatitis
Blood/body fluids, sexual contact (Hep V Vaccine..must have hep B to get hep D)
What is renal failure
Kidney has failed to perform adequately
When is the best time to schedule a patient with renal faiure
After dialysis
What is Addison’s disease
insufficient steroid production by adrenal glands (ADDisons -> ADD-steroids)
what is treatment for hypothyroidism
synthroid-hormone replacement therapy
Possible effects of hyperthyroidism
tachycardia, protruded eyes, accelerated toot DO NOT USE EPINEPHRINE
what is the difference between osteoarthritis and rheumatoid arthritis
Osteoarthritis-age related, progressive cartilage degeneration/loss of joint cushioning
Rheumatoid: Chronic autoimmune condition
What is Raynaud’s Phenomenon
Bluish discoloration of primarily the fingers and toes.. cold temperatures or stress (seen in systemic sclerosis–porcelain doll appearance)
What is Reyes Syndrome?
Neurological disorder affecting the liver and brain, associated with aspirin use in children
What is Myasthenia
Autoimmune-Neromuscular disorder characterized by extreme muscle weakness
