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45 Cards in this Set
- Front
- Back
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
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Case Study A - Alfred Bridgewater presents with a history of thrombophlebitis that occurred 6 months ago. He reports using Coumadin daily, and a recent Doppler study was negative for recurring deep vein thrombosis. His vital signs are Pulse - 70 bpm, Resp. - 14 rpm, BP - 130/70 mm Hg, left arm, sitting.
What is the function of Coumadin? |
Coumadin inhibits the formation of vitamin K-related coagulation factors; it reduces the formation of blood clots within blood vessels |
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Case Study A - Alfred Bridgewater presents with a history of thrombophlebitis that occurred 6 months ago. He reports using Coumadin daily, and a recent Doppler study was negative for recurring deep vein thrombosis. His vital signs are Pulse - 70 bpm, Resp. - 14 rpm, BP - 130/70 mm Hg, left arm, sitting.
List 4 other conditions for which Coumadin is prescribed. |
* Myocardial Infarction * Cerebriovascular Accident ( Stroke) * Artificial Heart Valves * Total Joint Replacement |
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Case Study A - Alfred Bridgewater presents with a history of thrombophlebitis that occurred 6 months ago. He reports using Coumadin daily, and a recent Doppler study was negative for recurring deep vein thrombosis. His vital signs are Pulse - 70 bpm, Resp. - 14 rpm, BP - 130/70 mm Hg, left arm, sitting.
Which blood test are used to measure anticoagulation in clients taking Coumadin? |
* PT (Prothrombin Test) * INR (International Normalized Ratio) |
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Case Study A - Alfred Bridgewater presents with a history of thrombophlebitis that occurred 6 months ago. He reports using Coumadin daily, and a recent Doppler study was negative for recurring deep vein thrombosis. His vital signs are Pulse - 70 bpm, Resp. - 14 rpm, BP - 130/70 mm Hg, left arm, sitting.
If the client required a tooth extraction, what preventative measures should be taken to avoid a medical emergency? |
* Consult with the client's physician or hematologist * PT/INR laboratory tests prior to treatment * continued use of therapeutic levels of Coumadin OR change of therapy as recommended by physician |
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Case Study A - Alfred Bridgewater presents with a history of thrombophlebitis that occurred 6 months ago. He reports using Coumadin daily, and a recent Doppler study was negative for recurring deep vein thrombosis. His vital signs are Pulse - 70 bpm, Resp. - 14 rpm, BP - 130/70 mm Hg, left arm, sitting.
After extraction, the client appears to have excessive bleeding. What strategies can be used to manage this event? |
* Rinse with tranexamic acid or or use another antifibrinolytic medication * Local application of an absorbable gelatin sponge or other hemostatic agent * Application of digital pressure * Dismiss client once bleeding is stopped or controlled * Offer postoperative instructions (i.e. rinse w/ cold water or apply moist tea bag to affected site.) |
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
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Case Study B - Beyonce Jordan, a 19-year-old African-American client, presents for an oral prophylaxis. She reports a history of SCA. The client has been under the care of her family practitioner and states that her condition is stable. Her vital signs are Pulse - 65 bpm, Resp. - 15 rpm, BP - 100/60 mm Hg right arm, sitting.
What type of Preliminary questions would you ask this client before offering treatment? |
* What treatment is being used for the sickle cell anemia? * How long have you been in control? * What problems do you have with healing? * Are you having any symptoms now? |
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Case Study B - Beyonce Jordan, a 19-year-old African-American client, presents for an oral prophylaxis. She reports a history of SCA. The client has been under the care of her family practitioner and states that her condition is stable. Her vital signs are Pulse - 65 bpm, Resp. - 15 rpm, BP - 100/60 mm Hg right arm, sitting.
What symptoms would you expect to see in this client if she had uncontrolled anemia? |
* facial palor * fatigue * muscle weakness * shortness of breath * sore painful tongue * bald tongue * loss of taste sensation |
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Case Study B - Beyonce Jordan, a 19-year-old African-American client, presents for an oral prophylaxis. She reports a history of SCA. The client has been under the care of her family practitioner and states that her condition is stable. Her vital signs are Pulse - 65 bpm, Resp. - 15 rpm, BP - 100/60 mm Hg right arm, sitting.
List 6 strategies that the clinician should use in treating this client. |
* Short appointments * stress plaque control * use low Epi. local anesthetic, * prophylactic antibiotics if oral surgery is planned * use of acetaminophen or opioid APAP for oral pain * use if diazepam or nitrous oxide with >50% oxygen if sedation is needed. |
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
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Case Study C - Mrs. Cathy Swanson is a 55-year-old client who presents for oral health evaluation. She reports a recent diagnosis of squamous cell carcinoma of the mandible and is scheduled for surgery and radiation therapy. the Oncologist recommended that she undergo a comprehensive oral health evaluation before initial cancer therapy. She is not undergoing any orthodontia and does not wear removable or fixed appliances. Vital Signs include Pulse - 74 bpm, Resp. - 18 rpm, BP - 130/60 mm Hg right arm, sitting.
What 4 steps should the dentist and dental hygienist take to perform a comprehensive oral health evaluation for this client? |
* Identify and treat existing infections,k problem teeth and tissue injury or trauma * Stabilize or eliminate potential sites of infection * Extract teeth that may pose a future problem * Instruct client on oral hygiene, use of fluoride gel, nutrition, and the need to avoid tobacco and alcohol. |
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Case Study C - Mrs. Cathy Swanson is a 55-year-old client who presents for oral health evaluation. She reports a recent diagnosis of squamous cell carcinoma of the mandible and is scheduled for surgery and radiation therapy. the Oncologist recommended that she undergo a comprehensive oral health evaluation before initial cancer therapy. She is not undergoing any orthodontia and does not wear removable or fixed appliances. Vital Signs include Pulse - 74 bpm, Resp. - 18 rpm, BP - 130/60 mm Hg right arm, sitting.
List at least 4 of the 8 benefits of providing oral care as part of a cancer pretreatment regimen? |
* Reduces the risk and severity of oral complications * Improves the likelihood that the individual will tolerate optimal dose of treatment * Prevents oral infection that could lead to potentially fatal systemic infections * Prevents or minimizes complications that can compromise nutrition * Prevents, eliminates, or controls pain * Prevents or reduces the incidence of bone necrosis in radiation clients * Prevents or improves oral health * Improves quality of life |
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Case Study C - Mrs. Cathy Swanson is a 55-year-old client who presents for oral health evaluation. She reports a recent diagnosis of squamous cell carcinoma of the mandible and is scheduled for surgery and radiation therapy. the Oncologist recommended that she undergo a comprehensive oral health evaluation before initial cancer therapy. She is not undergoing any orthodontia and does not wear removable or fixed appliances. Vital Signs include Pulse - 74 bpm, Resp. - 18 rpm, BP - 130/60 mm Hg right arm, sitting.
What 6 suggestions would you recommend if the client develops xerostomia associated with radiation therapy? |
* Frequent sips of water * Use of liquids that soften or thin foods * Use of sugarless gum or sugar-free candies to help stimulate saliva production * Use of a commercial oral lubricant * Use of a prescribed saliva stimulant drug * Daily fluoride therapy |
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Case Study C - Mrs. Cathy Swanson is a 55-year-old client who presents for oral health evaluation. She reports a recent diagnosis of squamous cell carcinoma of the mandible and is scheduled for surgery and radiation therapy. the Oncologist recommended that she undergo a comprehensive oral health evaluation before initial cancer therapy. She is not undergoing any orthodontia and does not wear removable or fixed appliances. Vital Signs include Pulse - 74 bpm, Resp. - 18 rpm, BP - 130/60 mm Hg right arm, sitting.
What 4 questions would you ask the oncologist to prevent adverse emergency situations? |
* What is the client's complete blood count, including absolute neutrophil and platelet counts? * If an invasive oral health procedure needs to be done, are there adequate clotting factors? * Does the individual have a central venous catheter? * What is the scheduled sequence of treatment so that the safe oral health treatment can be planned? |
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Case Study C - Mrs. Cathy Swanson is a 55-year-old client who presents for oral health evaluation. She reports a recent diagnosis of squamous cell carcinoma of the mandible and is scheduled for surgery and radiation therapy. the Oncologist recommended that she undergo a comprehensive oral health evaluation before initial cancer therapy. She is not undergoing any orthodontia and does not wear removable or fixed appliances. Vital Signs include Pulse - 74 bpm, Resp. - 18 rpm, BP - 130/60 mm Hg right arm, sitting.
If the client presents for a follow-up appointment during cancer therapy and reports a platelet count of 40,000 platelets/mm3, should treatment be postponed? Why or why not? |
* Yes, treatment should be postponed as client is at risk of hemorrhage and infection. |
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Case Study C - Mrs. Cathy Swanson is a 55-year-old client who presents for oral health evaluation. She reports a recent diagnosis of squamous cell carcinoma of the mandible and is scheduled for surgery and radiation therapy. the Oncologist recommended that she undergo a comprehensive oral health evaluation before initial cancer therapy. She is not undergoing any orthodontia and does not wear removable or fixed appliances. Vital Signs include Pulse - 74 bpm, Resp. - 18 rpm, BP - 130/60 mm Hg right arm, sitting.
If the client develops oral mucositis, should chlorhexidine be used for treatment? |
* No. Research does not support the use of chlorhexidine as an effective prevention or treatment of oral mucositis. |
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
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Case Study D - Mr. Daron Peterson, age 38, presents for a dental hygiene appointment. He reports a recent diagnosis of type 2 DM. He has been a client of the practice for 10 years, and dental records indicate that his oral health status is excellent. The client states that he is presently taking Glucotrol daily, has modified his diet, and exercises 3-4 days per week. He indicates he is concerned about his oral health and is trying to adhere to his physician's recommendations. His blood glucose level taken just prior to coming to the appointment was 70 mm/dl. Vital signs include Pusle - 62 bpm, Resp. 12 rpm, BP - 118/64 mm Hg left arm, sitting.
What 5 follow-up questions would you ask based on the client's report of a recent diagnosis of DM? |
* What have your recent blood sugar levels been? * How often do you test for control of diabetes? * Have you experienced hypoglycemia recently? * Have you had any problems during dental treatment? * When was your last appointment with your physician? |
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Case Study D - Mr. Daron Peterson, age 38, presents for a dental hygiene appointment. He reports a recent diagnosis of type 2 DM. He has been a client of the practice for 10 years, and dental records indicate that his oral health status is excellent. The client states that he is presently taking Glucotrol daily, has modified his diet, and exercises 3-4 days per week. He indicates he is concerned about his oral health and is trying to adhere to his physician's recommendations. His blood glucose level taken just prior to coming to the appointment was 70 mm/dl. Vital signs include Pusle - 62 bpm, Resp. 12 rpm, BP - 118/64 mm Hg left arm, sitting.
During the course of the appointment, the client begins to experience perspiration, confusion, and lethargy. These signs represent what condition? |
* Hypoglycemia |
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Case Study D - Mr. Daron Peterson, age 38, presents for a dental hygiene appointment. He reports a recent diagnosis of type 2 DM. He has been a client of the practice for 10 years, and dental records indicate that his oral health status is excellent. The client states that he is presently taking Glucotrol daily, has modified his diet, and exercises 3-4 days per week. He indicates he is concerned about his oral health and is trying to adhere to his physician's recommendations. His blood glucose level taken just prior to coming to the appointment was 70 mm/dl. Vital signs include Pusle - 62 bpm, Resp. 12 rpm, BP - 118/64 mm Hg left arm, sitting.
What 3 management steps would you provide for the client who experiences perspiration, confusion, and lethargy? |
* Provide a sugar source such as candy, juice, or glucose tablet * If the client is uncooperative or loses consciousness, activate EMS/911 system and provide basic life support * Administer 50% dextrose intravenously or intramuscular glucagon |
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Case Study D - Mr. Daron Peterson, age 38, presents for a dental hygiene appointment. He reports a recent diagnosis of type 2 DM. He has been a client of the practice for 10 years, and dental records indicate that his oral health status is excellent. The client states that he is presently taking Glucotrol daily, has modified his diet, and exercises 3-4 days per week. He indicates he is concerned about his oral health and is trying to adhere to his physician's recommendations. His blood glucose level taken just prior to coming to the appointment was 70 mm/dl. Vital signs include Pusle - 62 bpm, Resp. 12 rpm, BP - 118/64 mm Hg left arm, sitting.
What 4 strategies would be used to prevent a hypoglycemia emergency? |
* Ensure that the client has eaten a meal after taking antidiabetic medication * Observe for signs of hypoglycemia * Avoid scheduling appointments around the peak affect of taking diabetic medications * Avoid lengthy appointments that extend into the client's snack or meal time |
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
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Case Study E - Major Easton presents to the practice for an amalgam restoration on tooth #30. He is 45 with a history of hypertension and elevated cholesterol, which is being treated with Novasc and Lipitor. He is overweight, but proudly reports that he is on a weight management program and has lost 14 lbs. in the past 3 months. Vital signs include Pulse - 70 bpm, Resp. - 14 rpm, BP - 160/80mm Hg, right arm, sitting.
During the course of treatment, the client places his hand over his chest and complains of a crushing pain and difficulty breathing. What two cardiac conditions might be causing these symptoms? |
* MI and Angina pectoris |
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Case Study E - Major Easton presents to the practice for an amalgam restoration on tooth #30. He is 45 with a history of hypertension and elevated cholesterol, which is being treated with Novasc and Lipitor. He is overweight, but proudly reports that he is on a weight management program and has lost 14 lbs. in the past 3 months. Vital signs include Pulse - 70 bpm, Resp. - 14 rpm, BP - 160/80mm Hg, right arm, sitting.
The client is placed in an upright position. If angina is suspected, what 7 steps would you take to treat this client? |
* Reassure client * Measure and record vital signs * Place nitroglycerin sublingually if systolic pressure is >100mm Hg * Provide 100% oxygen * Readminister nitroglycerin up to 3 tablets in 10 minutes * If pain is not relieved, activate EMS/911 system * Record events in dental record. |
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Case Study E - Major Easton presents to the practice for an amalgam restoration on tooth #30. He is 45 with a history of hypertension and elevated cholesterol, which is being treated with Novasc and Lipitor. He is overweight, but proudly reports that he is on a weight management program and has lost 14 lbs. in the past 3 months. Vital signs include Pulse - 70 bpm, Resp. - 14 rpm, BP - 160/80mm Hg, right arm, sitting.
If the client does not respond to steps used if angina were suspected, and looses consciousness, and a pulse cannot be felt, what intervention would you do to manage this emergency? |
* Activate EMS/911 system and perform CPR until EMS arrive. |
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Case Study E - Major Easton presents to the practice for an amalgam restoration on tooth #30. He is 45 with a history of hypertension and elevated cholesterol, which is being treated with Novasc and Lipitor. He is overweight, but proudly reports that he is on a weight management program and has lost 14 lbs. in the past 3 months. Vital signs include Pulse - 70 bpm, Resp. - 14 rpm, BP - 160/80mm Hg, right arm, sitting.
If the client returns for a dental examination 6 months later, what 4 follow-up questions would you ask concerning his coronary condition? |
* How long has it been since your last heart attack? * How is your health now? * Can you walk up a flight of stairs without having to stop and rest? * What medications are you taking? |
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Case Study E - Major Easton presents to the practice for an amalgam restoration on tooth #30. He is 45 with a history of hypertension and elevated cholesterol, which is being treated with Novasc and Lipitor. He is overweight, but proudly reports that he is on a weight management program and has lost 14 lbs. in the past 3 months. Vital signs include Pulse - 70 bpm, Resp. - 14 rpm, BP - 160/80mm Hg, right arm, sitting.
If the client reports a coronary artery bypass graft was performed, is antibiotic prophylaxis required for oral prophylaxis and restorative care? Why or why not? |
* No. This is considered a low risk for infectious endocarditis |
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
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Case Study F - Frank Finley, age 78, presents for an oral prophylaxis. He reports a recent onset of TIAs (Transient Ischemic Attacks). He is taking 325mg aspirin daily in the morning. The client states that other medications were prescribed but he cannot afford them. vital signs include Pulse - 78 bpm, Resp. - 18 rpm, BP - 150/86mm Hg, right arm, sitting
What is the most likely medical emergency that could occur during oral health treatment? |
CVA (Cardiovascular incident) |
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Case Study F - Frank Finley, age 78, presents for an oral prophylaxis. He reoprts a recent onset of TIAs (Transient Ischemic Attacks). He is taking 325mg aspirin daily in the morning. The client states that other medications were prescribed but he cannot afford them. vital signs include Pulse - 78 bpm, Resp. - 18 rpm, BP - 150/86mm Hg, right arm, sitting
What other type of medication could have been prescribed for an individual with a recent history of TIA? |
*Anticoagulant medications |
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Case Study F - Frank Finley, age 78, presents for an oral prophylaxis. He reports a recent onset of TIAs (Transient Ischemic Attacks). He is taking 325mg aspirin daily in the morning. The client states that other medications were prescribed but he cannot afford them. vital signs include Pulse - 78 bpm, Resp. - 18 rpm, BP - 150/86mm Hg, right arm, sitting
During the course of treatment, the client develops slurred speech, difficulty swallowing, and severe headache. What other 5 signs and symptoms characterize a CVA (Cerebrovascular Incident)? |
* visual abnormalities * confusion * inability to speak * loss of feeling on once side of the body * unequal pupil size |
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Case Study F - Frank Finley, age 78, presents for an oral prophylaxis. He reports a recent onset of TIAs (Transient Ischemic Attacks). He is taking 325mg aspirin daily in the morning. The client states that other medications were prescribed but he cannot afford them. vital signs include Pulse - 78 bpm, Resp. - 18 rpm, BP - 150/86mm Hg, right arm, sitting
What 7 emergency management steps would you take if the client developed symptoms that characterize a CVA? |
* Stop the procedure, * Place the client in a supine position with the head elivated * Activate EMS/911 system * Provide basic life support * Administer 100% oxygen if respiratory distress occurs * Monitor vital signs * Record emergency in the dental record. |
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Case Study F - Frank Finley, age 78, presents for an oral prophylaxis. He reports a recent onset of TIAs (Transient Ischemic Attacks). He is taking 325mg aspirin daily in the morning. The client states that other medications were prescribed but he cannot afford them. vital signs include Pulse - 78 bpm, Resp. - 18 rpm, BP - 150/86mm Hg, right arm, sitting
Should aspirin be administered to this client as part of the emergency care? |
Aspirin now can be part of the emergency care; however, the client already took the medication. A physician consult is needed to determine if additional aspirin therapy can be provided. |
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
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Case Study G - Gail Blakely, age 27, is a hairstylist that presents for a restorative dental appointment. She reports that she is in good health and does not take any medications. She reports a prior history of seizure disorder as an early teenager, but has been seizure-free for 10 years. During the course of restorative therapy, the client becomes stiff and her jaw muscles begin to spasm. Her arms and legs thrash about and the client loses consciousness.
What type of seizure is described in this case scenario? |
* Generalized convulsive seizure |
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Case Study G - Gail Blakely, age 27, is a hairstylist that presents for a restorative dental appointment. She reports that she is in good health and does not take any medications. She reports a prior history of seizure disorder as an early teenager, but has been seizure-free for 10 years. During the course of restorative therapy, the client becomes stiff and her jaw muscles begin to spasm. Her arms and legs thrash about and the client loses consciousness.
if the client were to experience an aura, what type of experience would occur? |
* An aura may include headache, drowsiness, yawning, and tingling sensations. |
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Case Study G - Gail Blakely, age 27, is a hairstylist that presents for a restorative dental appointment. She reports that she is in good health and does not take any medications. She reports a prior history of seizure disorder as an early teenager, but has been seizure-free for 10 years. During the course of restorative therapy, the client becomes stiff and her jaw muscles begin to spasm. Her arms and legs thrash about and the client loses consciousness.
What 5 steps would you take to manage this condition? |
* Prevent the client from being injured by moving the patient to the floor or by moving materials out of the way * Allow the client to have the seizure * Place a pillow under the client's head * Place the client in a position such that vomitus cannot be inhaled following seizure. * Move the client to a recovery room to sleep while calling someone to transport the client home. |
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Case Study G - Gail Blakely, age 27, is a hairstylist that presents for a restorative dental appointment. She reports that she is in good health and does not take any medications. She reports a prior history of seizure disorder as an early teenager, but has been seizure-free for 10 years. During the course of restorative therapy, the client becomes stiff and her jaw muscles begin to spasm. Her arms and legs thrash about and the client loses consciousness.
If continuous seizures were to occur, how would you treat this emergency? |
* Activate EMS/911 system and administer Valium intravenously or intramuscularly. |
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Case Study G - Gail Blakely, age 27, is a hairstylist that presents for a restorative dental appointment. She reports that she is in good health and does not take any medications. She reports a prior history of seizure disorder as an early teenager, but has been seizure-free for 10 years. During the course of restorative therapy, the client becomes stiff and her jaw muscles begin to spasm. Her arms and legs thrash about and the client loses consciousness.
What seizure conditions that require activation of EMS/911 systems? |
* Seizures that continue more than 5 minutes without regaining consciousness between attacks (status epilepticus) * Breathing difficulties after a seizure * Persistent confusion and unconsciousness for more than 5 minutes * Injury sustained during a seizure * A first seizure and no history of prior seizures * Seizure during pregnancy or in a person with diabetes |
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
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Case Study H - Heather Feldman, a 62 year old house wife, presents for her dental hygiene appointment. She reports a history of mild hypertension, but is not taking any medications. She has reduced the salt in her diet instead. the client completes the dental hygiene appointment without incident. She leaves the office and returns 10 minutes later crying saying her car was stolen, and accuses the dental hygienist of taking her car. She also says she can not find her pocketbook, but is actually holding her purse in her left arm.
What condition does this client most likely demonstrate? |
* Alsheimer disease |
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Case Study H - Heather Feldman, a 62 year old house wife, presents for her dental hygiene appointment. She reports a history of mild hypertension, but is not taking any medications. She has reduced the salt in her diet instead. the client completes the dental hygiene appointment without incident. She leaves the office and returns 10 minutes later crying saying her car was stolen, and accuses the dental hygienist of taking her car. She also says she can not find her pocketbook, but is actually holding her purse in her left arm.
Is this client at risk for a medical emergency? |
* If the client becomes significantly stressed, she is at risk of syncope or a cardiovascular event. |
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Case Study H - Heather Feldman, a 62 year old house wife, presents for her dental hygiene appointment. She reports a history of mild hypertension, but is not taking any medications. She has reduced the salt in her diet instead. the client completes the dental hygiene appointment without incident. She leaves the office and returns 10 minutes later crying saying her car was stolen, and accuses the dental hygienist of taking her car. She also says she can not find her pocketbook, but is actually holding her purse in her left arm.
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* Use patients, understanding and a calm approach * Provide reassurance and reduce fear * Call a family member or caregiver for assistance * Monitor client's vital signs if concern that this stress could cause a medical emergency |
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What are the 8 Steps to Treat a Patient if Angina is Suspected? |
1. Reposition to upright position 2. Reassure client, maintain composure 3. Measure BP and pulse, record values and qualities of pulse 4. If systolic BP is >100mm Hg, place nitroglycerin sublingually 5. Provide 100% oxygen 6. Re-administer sublingual nitroglycerin every 5 min. as needed (max. 3 tablets in 10 min.) 7. If pain is not relieved in 10 min., activate EMS/911 system (call immediately in client with no history of angina) 8. Record events of emergency in dental record. |
