study guide Flashcards
Difference between client and patient
Patient =
Client=
Patient = suggests a SICK and DEPENDENT person
client=describes the contemporary healthcare consumer, connotes wellness, active participant in own oral health, responsible for personal choices and consequences
unit water supply, anti-retraction valves, water lines and traps
Water used for routine dental treatment should meet nationally recognized standards set by the U.S. Environmental Protection Agency (EPA) for drinking water
SCC uses treated distilled water for unit lines w/ sterisil system
Microbial counts <500 CFU/ ml, Clinic goal <200 CFU/ ml
Flush beginning of day for 2 minutes
Flush waterlines between pts for 20 sec
SCC has anti-retraction valves, but still do not have a patient close
Compressed air- how produced, how utilized
Provides compressed air to run the dental units and delivery systems
Utilized to dry teeth to help with visual observation ex view filling/sealants/calculus
and to allow sealants to adhere to dry teeth surface
Opens spring cupboards in sterilization room
Compressed air is produced through the air water syringe.
Know the reasons a complete history is important
Understand patient concerns, attitudes, and goals for the dental visit
Document baseline information
Assess overall physical and emotional health and nutritional status
Establish patient rapport
Identify risk factors that require precautions
Facilitates the medical and dental diagnosis of various conditions
Identify conditions that require referral
Maintain legal documentation
Health history helps us assess
Physical
Personal
Societal
Connive - (conniving)
Emotional
Spiritual
Comprehensive health history will include
Demographic information
Chief complaint
Dental history
Medical history
Social history - life events/habits
how to handle changes made in health history
Monitor changes of health history at the beginning of every dental appointment
Error should be lined out, initialed, and dated
New screening form annually / every year
and the relevance of chief complaint
A lot of information can be gathered
The chief complaint is the reason why the patient is here
steps in the HH interview
First step health history interview - establishes patient rapport and trust
Establish a private setting
Elicit the patient’s chief concerns and setting agenda for appointment
Use open-ended questions
Use active listening (“I see”, nodding when listening)
Briefly summarize interview
Once health history is reviewed
Input medical history into eagle soft once client is seated and have them sign with signature pad
types of questions asked
Why are patients taking medications?
What are the adverse effects of this drug? - Lexi comp
Are there potential drug interactions? - Lexi comp
Do these findings suggest a problem with drug dosage?
How is the patient managing medications?
Will any oral side effects of this medication require intervention?
EX Xerostomia - dry mouth - risk of cavities , more plaque buildup
Are symptoms reported during patient’s health history interview caused by medical condition or are they drug side effects?
Given the pharmacologic history and other assessment data, what are the risks of treating this patient?
ASA (American society of anesthesiologist) classifications & significance to patient/client treatment
A patient classified as ASA IV or greater should not receive elective dental treatment
Only palliative care is recommended for a patient with an ASA V status
MET pg 135 classify clients based on
ASA I - healthy can walk up flight of stairs no problems, no alcohol or smoke
ASA II - pt. With mild systemic disease ex, pregnancy, obesity, current smoker, mild respiratory (ex. Jazzy has asthma, ASA 2 🙂)
ASA III - pt. With severe systemic disease, substantial functional limitations ex- COPD chronic obstructive pulmonary disease,active Hepatitis, poorly controlled diabetes (able to walk up a flight of stairs or 2 city blocks, but must rest after, pacemaker)
ASA IV -severe systemic disease that is a constant threat to life (do not work on them - cannot climb a flight of stairs, regularly scheduled dialysis, CVA or TIA less that 3 months ago (baby stroke)
ASA V- moribund pt that is not expected to survive without operation; only palliative (hospital setting) care is recommended
ASA VI - braindead
Why do we look up drugs?Lexicomp
Many medications interact with drugs used in dentistry or produce side effects
Pharmacologic history provides information regarding past and present medications use and offers clues about patient’s health status and health behaviors
Enables dental hygienist to assess risks associated with treating patients who are taking medications
EX: I see you are taking ____ why are you taking it
1st step in pharmacologic history is compiling a list of all medications that the patient is currently taking
Alternative antibiotics when allergies exist
Depending on what the allergy is, you can use an alternative antibiotic that does not contain the allergen. For example, if allergic to amoxicillin.. Clindamycin is an alternative drug that could be used
Why pre-med?
Routine dental procedures can introduce bacteremia into blood stream; can allow microorganisms to lodge on damaged or abnormal areas of heat valves
AHA recommends prophylactic antibiotic premedication before:
Pros ethic cardiac calves or prosthetic material used for cardiac valve repair
History of infective endocarditis (IE)
Unprepared cyanotic congenital heart disease
Total joint replacement only when have risk factors of diabetes mellitus or immunocompromised
Preventive measure are taken to avoid bacteremia and possible infection by administering premed 1/2 to 1 hour before dental procedures (where blood can be introduced into the blood stream)
Importance of patient education needs to be a conscious effort on part of patient and clinician
Know normal vital signs and how to obtain- BP, respirations and pulse
Inspection, palpation, and auscultation
Systematic approach for each procedure
Minimize risk factors
Body Temperature normal range = 98.6 to 100.4
Pulse indicator of tech integrity of the cardiovascular system
Bradycardia = below 60 beats per minute (B before T)
Tachycardia = above 100 beats per minute (Tachy-Rapid)
Pulse measurement sites = radial pulse
60-100bpm
Respiration rate = by counting the rise and fall of patients chest
Normal adult range = 12-20 RPM
Children’s range = 20-30 RPM
Tachypnea = rapid breathing (>20 RPM)
Bradypnea = slow breathing
Blood pressure = force exerted by the blood against the arterial walls when the heart contracts
Blood pressure cuff and stethoscope - listening for korotkoff sounds
Normal blood pressure >119 and >79
Elevated 120-129 and less than 80
High blood pressure stage 130-139 or 80-89
High blood pressure stage 2 140 or higher or 90 or higher
Know indicators of heart disease and High BP
Age and race
Certain diseases
Weight and diet
Gender
Stress
Pain
Oral contraceptives and medication
Exercise
Time of day
Tobacco, caffeine, and alcohol use
HYPERTENSION = major cause of stroke
140/90 associated with cardiovascular disease, stroke, kidney failure, premature death
AT SCC if >210 or >120 = DO NOT TREAT
Know how to chart BP readings
Recorded in a fraction, which arm seated
Top number = systolic = maximum pressure occurring in blood vessels during cardiac ventricular contraction
Lower number = diastolic = minimum pressure occurring against the arterial wall as a result of cardia ventricular relaxation
Know causes of repetitive stress injuries (RSIs)
Forceful or awkward movements
Poor posture
Repetitive movements
Task involved 50% of work cycle
risk factors for Carpal Tunnel Syndrome (CTS)
A painful disorder of the wrist and hand caused by compression of the median nerve in the wrist
Repeatedly bending the hand up, down, or from sided to side at the wrist
And pinch gripping with out resting the muscles
* repetitive forceful pinching of an instrument can be a risk factor for _______
Pinch force = force use to grasp the handle during instrumentation
More pinch force = more muscle cramping
Know patient chair positions: Supine, semi-supine etc. - when and why utilized
Supine patient position = maxillary treatment areas
Neutral patients feet even with or slightly higher than their nose, chair back nearly parallel, top of patients head even with upper edge of headrest
Mandibular = raise chair back slightly
Semi-Supine = semi-upright, slightly leaned back
Reasons for use of loupe magnification
Help see treatment area better
Improves visual sharpness
Reduces strain to clinicians back and shoulder
Decrease eye strain
Types of grasps and types of strokes for both exploratory and calculus removal purposes
Modified pen grasp = any periodontal instrument - facilitates precise control of instrument - facilities good tactile conduction - allows detection of rough areas on tooth surface - lessens musculoskeletal stress
Neutral hand position for periodontal instrumentation = wrist aligned with long axis of lower arm, palm is relaxed, thus, middle and index fingers held in a neutral position, light finger pressure against the instrument handle, ring finger advanced ahead of other fingers in the grasp held straight in a neutral joint position and not hyperextended
Vertical stroke = on anterior teeth - used on facial, lingual and proximal surfaces
On posterior teeth - used on mesial and distal surfaces
Oblique stroke = used on facial and lingual surfaces on posterior teeth
Horizontal stroke = used at line angles of posterior teeth, furcation areas, in deep, narrow pockets - used on narrow root surfaces of anterior teeth
Short biting
Multidirectional stroke = combination of all overlapping strokes
Vertical
Oblique
horizontal
Assessment stroke = used to evaluate the tooth surface
used with explorers to locate calculus deposits
“exploratory” stroke
used to reevaluate tooth surface after calculus removal
Relaxed modified pen grasp, flowing, feather-light stroke
Calculus removal stroke = used to remove calculus deposits off of the tooth surfaces
used with curette and sickle scalers
Short, controlled, biting stroke
Firm later pressure of cutting edge applied against the tooth
Root debridement stroke = used to remove residual calculus deposits, bacterial plaque, and byproducts from 1) root surface that are exposed in the mouth because of gingival recession and 2) root surfaces within deep periodical pockets
Lighter, “shaving stroke”, used with curettes
