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36 Cards in this Set

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congenital heart defect:
frequency
questions to ask physician (3)
- .8%. fairly common

-cardiac status
-SBE prophylaxis recommendations
-precautions w/ meds
congenital heart defects -
acyanotic defects w/ shunts:
def
possible manifestations
types (3)
-undesirable connection btw systemic and pulmonary circulation
-heart murmurs, cardiac enlargement or congestive heart failure
-Atrial Septal Defect (ASD), VSD, Patent Ductus Arteriosus (PDA)
congenital heart defects-
cyanotic defects:
def
types (3)
-right to left shunting, messing up oxygenation levels
-transposition of Great Vessels, Tetrology of Fallot, Truncus Arteriosus
congenital heart defects-
obstruction of blood flow
types (3)
-aortic stenosis
-pulmonary stenosis
-coarction of aorta
CHD:
symptoms (5)
-cyanosis (hypoxemia)
-delayed dev't
-finger clubbing
-less tolerant of exercise
-pathologic murmur
medical management of CHD (2)
-surgical repair
-cardiac medications
SBE prophylaxis is advised for (4)
-synthetic materials in heart
-previous infective endocarditis
-unrepaired/incompletely repaired CHD
-6 months after CHD repair procedure
-cardiac transplant w/ problem in valve
#1 cause of pediatric ER visits

def
-asthma

-reactive lower airway disease
Asthma:
classification, management
1)mild intermittent:
- <2days/week or 2 nights/month
-brochodilator, no daily meds
2)mild persistent:
- >2 days/week or 2 nights/month
-daily low dose anti-inflammatory inhaler (corticosteroid), bronchodilator
3) moderate persistent
- daily or > 1 night/week
-daily meds (low-medium dose), long acting bronchodilator, leukotriene inhibitors
4) severe persistent
-continual and frequent
-daily high dose meds, long acting bronchodilator, leukotriene, oral steroids
bronchodilator
-short or long acting beta agonist inhalers
asthma:
rescue meds
-are what
-names
controller meds
-are what
-short acting beta agonists
-albuterol, levalbuterol

-anti-inflammatory.
asthma controller meds:
types (6) w/ cautions
1. 1st line: inhaled corticosteroids
-caution: adrenal insufficiency, stunted growth, oral candiasis (tell pt to rinse after use)
2. 2nd line: leukotriene receptor antagonists
-not common in kids
3. oral corticosteroids
-poorly tolerated
4. combination corticosteroid/long-acting beta agonist
5. long-acting beta agonist
6. anticholinergics bronchodilator
asthma:
quesions to ask (5)
-currently active, active upon stimulus, or inactive?
-meds? inhaler?
-triggers?
-last attack? severity?
-history of hospitalizations, ER visits, use of Nebulizer
asthma:
dental triggers (4)
-prolonged supine position
-dental instruments (suction, cotton rolls, trays, etc)
-aerosolized materials: acrylic
-stress
asthma:
NO2?
-okay for mild/moderate pts

-if sever, may make asthma worse
tell pts with inhalers to ______.
why? (2)
-rinse after

can cause:
-xerostomia
-candidiasis
seizures:
cause
frequency
-abnormal neuronal hyperactivity

-0.5% of children
partial seizures:
Simple
-type
-manifestations
-conscious?
-causes

Complex
-type
-manifestations
-consciousness?
-sensory or motor
-one limb or both limbs on 1 side
-pts remain conscious, my verbalize
-focal damage (tumor, etc)

-frequent aura
-lip smacking, chewing, salivation, picking at clothes
-loss of consciousness, amnesia
Generalized seizures:
tonic-clonic seizures
-another name
-involves
-consciousness?
-post-seizure phase?
-Grand Mal
-all extremities
-loss of consciousness
-yes. confusion, sleep, etc
Generalized seizures:
absence seizures
-another name
-manifestations
-consciousness?
-post-seizure phase?
-Petit Mal
-no aura, <30s, bland facial expression, flickering eyelids
-conscious
-none
seizures:
effect of lidocaine
-lowers seizure threshold
febrile seizures:
incidence
permanent?
ages
influencing factors
risks
seizure duration
-most common. 3% of kids
-no. rarely continues to adulthood
- 9months-5yo.
-possibly genetic
-when core temp > 39C
-short
status epilepticus:
def
action
potential risk
-seizure > 30min
-call 911! Emergency.
-if not treated w/in 1 hr, consciousness may not be regained
cerebral Palsy:
def
caused by
-grp of conditions that involve loss of movement/nerve function
-damage to brain around birth
cerebral Palsy:
distinguished by (2)
-location
-extent of impairment
cerebral palsy:
dental considerations (3)
-sensitive gag reflex
-prone to trauma, bruxism, tongue thrusting, generalized spacing btw teeth
-may want to use restraints, or general anesthesia
cerebral palsy:
NO2?
-might help HIGH functioning CP pts.
Diabetes Type 1:
cause
frequency
-from destruction of beta-cells in pancreas. No insulin.
-70% of pediatric diabetes
Diabetes Type 2:
cause
frequency
insulin secretion levels?
-tissue resistance to insulin
-30% of pediatric diabetes
-can be low, normal or high
diabetes:
possible complications (3)
-blood vessel diseases
-impaired wound healing
-higher infection risk
diabetes:
diagnosis (2)
-fasting blood sugar level > 126mg/dL on 2 different occasions
OR
-glucose level > 200mg/dL anytime
diabetes:
hyperglycemia
hypoglycemia
- > 126mg/dL
- < 60 mg/dL BUT must also have symptoms (hunger, thirst, sweating, lethargy, trembling, etc), AND symptoms must reverse when glucose is administered
diabetes:
dental management of hypoglycemic pt
-stop dental treatment
-feed sugar (if conscious)
-retest blood sugar
-repeat in 15 min if symptoms don't improve
Down's syndrome:
aka, incidence

risks
-Trisomy 21, 1/600-800 births

-risk of CHD is up 50-70%
-intestinal atresia
Down's syndrome:
dental management
-med consult as needed. Ask about antibiotic prophylaxis (might be necessary due to cardiac involvement).
Autism:
dental considerations
-know meds, interactions
-short visits
-know pt's sensory hyper-/hypo-reactivity