Pbde Special Needs

Front 1

Definition Special Healthcare Needs SHCN (4)

Back 1

1. Persons with a physical, developmental,mental,sensory,behavioral,cognitive,or emotional impairment or limiting condition that requires medical management,health care intervention,and/or use of specialized services or programs.
2. Developmental or acquired
3. May cause limitations in daily self-maintenance or life activities.
4. Health care for SHCN requires specialized knowledge, increased awareness and attention and accommodation.

Front 2

What three items are necessary as the parent reports of child's medical history?

Back 2

1. Parents must complete and sign health hx form.
2. Oral interview also
3. Inaccuracies include medications, allergies, need for antibiotic premedication for both healthy and medically compromised children.

Front 3

What are four complications that families of children with serious medical problems?

Back 3

1. Diagnosis of serious disease causes changes in family life. ie. distress,Uncertainty,Loss of control,Negative feelings,Anxiety and depression,Loneliness,Financial problems
2. Negative experiences with health care.
3. Competing therapies
4. Lack of understanding/low priority of oral health.

Front 4

What are the eleven ways medications impact the oral health of the SHCN patient?

Back 4

1. Interact with other medications
2. Alter patient behavior
3. Alter plaque composition and pH
4. Affect salivary flow and pH
5. Affect oral mucosa
6. Alter taste
7. Cause angioedema
8. Alter oral tissue pigmentation
9. Cause gingival enlargement
10. Alter hemostasis
11. Affect alveolar bone

Front 5

PRINCIPLES of DRUG INTERACTIONS:

Define:
1. Pharmacokinetic:
2. Pharmocodynamic:

Back 5

1.Change in amount of drug in body due to altered absorption,distribution,metabolism,or elimination.
2. Change in pharmacological effect due to additive,synergistic or antagonistic properties.

Front 6

What valves are responsible for the S1 and S2 heart sounds respectively?

Back 6

S1: Tricuspid and mitral valves.
S2: Pulmonic and aortic valves.

Front 7

What are the six main ideas regarding heart murmurs?

Back 7

1. Due to increase blood flow velocity across normal valve.
2. Very common ~80% of children.
3. 90% are NORMAL
4. Some systolic (contracting) murmurs are innocent
5. All diastolic (resting) and continuous murmurs abnormal.
6. Louder with increased cardiac output, fever, and anemia.

Front 8

What is the incidence of congenital heart disease?

Back 8

8-10/1000 live births

Front 9

What are three principles describing some defects with Increased Pulmonary Blood Flow?

Back 9

1. Left to Right shunt lesions. ie. ASD,VSD,PDA,AV canal.
2. Pulmonary blood flow increase at expense of systemic circulation
3. Sign/symptoms of CHF over time.

Front 10

Describe the three principles of Obstructive Defects?

Back 10

1. Anatomic narrowing impedes flow. ie. Coarctation of aorta,Aortic stenosis,Pulmonic stenosis.
2. Valvular,Subvalvular,or supravalvular
3. Symptoms of CHF unless mild

Front 11

What are three principles describing some defects with Decreased Pulmonary Blood Flow?

Back 11

1. Right to Left shunt lesions. ie. Tetralogy of Fallot,Tricuspid atresia,ASD or VSD + obstructive defect.
2. Patients hypoxemic/cyanotic
3. Highest risk of infective endocarditis.

Front 12

Describe the three principles of Primary Pump Failure.

Back 12

1. Dilated cardiomyopathy: Abnormality of myocardium which limit ability to contract. Etiology is disease or drugs.
2. Hypertrophic cardiomyopathy - IHSS (Dysrhythmias,syncope,sudden death)
3. Abnormal origin CA

Front 13

What is congestive heart failure and how is it managed?

Back 13

1. Inability of the heart to pump an adequate amount of blood to systemic circulation at normal pressure to meet metabolic demands.
2. Managed medically,surgically, or with combinations
3. Goals: improve cardiac function,remove accumulated fluid, decrease demand on heart,improve tissue oxygenation

Front 14

Medications of CHD

Digoxin (Lanoxin)

Back 14

Effect: Increased contractility
Mechanism: Maintains high Intracellular Na
Side effects: Nausea, vomiting, Arrhythmias, Death, Drug interactions

Front 15

Medications of CHD

Diuretics (furosemide,thiazides,spironlactone)

Back 15

Effect: Decrease fluid load
Mechanism: Increase urinary secretion of Na and water.
Side effects: Renal damage, Electrolyte problems,Kidney stones.

Front 16

Medications for CHD

Warfarin (coumadin)

Back 16

Effect: Increase PT
Mechanism: Inactivates vitamin K in the liver.
Side effects: Bleeding, OK for dental tx if INR<3.5 or PT<20 sec.

Front 17

Medications for CHD

ACE Inhibitors (captopril,enalapril)

Back 17

Effect: Decrease Blood Pressure
Mechanism: Vasodilator
Side effects: Hypotension, Renal damage, Increase in vitamin K, Neutropenia