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pneumonic for DH process of Care
ADPI
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What does ADPIE stand for?
- Assessment
- Diagnosis
- Planning
- Implementation
- Evaluation
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provides a foundation for patient care by collecting both subjective (pt. complaints) and objective (systematic data) data.
Assessment phase of DH process of care
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Patient perception and complaints of pain, symptoms etc.
subjective data
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systematic data collected from exams and radiographs, etc.
objective data
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identifies the health behaviors of individuals, as well as actual or potential oral health problems that DH is licensed to treat; provides a basis for which the DH care plan is designed
DH diagnosis
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What are the 3 steps of the diagnosis phase for interpreting information?
- classification
- interpretation
- validation
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selection of interventions to be performed by the patient, dental hygienist, or others to help patient attain oral health
DH care planning
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What are the steps in the DH care planning phase?
- establish priorities
- set goals
- interventions
- expected outcomes (prognosis
- present the plan
- informed consent
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Activation of the care plan
implementation phase of DH process of care
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determine if the patient needs to be retreated, referred, or placed on maintenance; determines change or modification to the plan; observes if the patient is progressing towards their goal
evaluation phase of the DH process of care
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continuing care or supportive therapy, scheduled at intervals of 3, 4, or 6 months
maintenance plan
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true or false. Culture affects oral health status and beliefs.
true
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Why is it important to have an understanding and general knowledge of certain principles concerning different cultures?
to meet each individual patients oral health care needs, and to include each patients health beliefs, practices, values, customs, and traditions in the plan for dental hygiene care
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In nonverbal communication, it is important to be aware of personal space, take caution in showing and interpreting_____________, _______________, and ____________________.
- hand gestures
- facial expressions
- eye contact
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true or false. When speaking to patients whose dominant language is not of the one you speak, you should simplify your language, and avoid professional jargon.
true
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true or false. Always address the patient even if they have an interpreter.
true
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the act of self-determination by persons with the ability to make a choice or decision
autonomy
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doing good for benefit or enhanced welfare
beneficence
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avoidance of harm to others; a core value
nonmaleficence
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a duty to tell the truth when information is disclosed to patients about treatment
veracity
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measures carried out so disease does not occur and is truly prevented
primary prevention
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what is an example of primary prevention?
use of fluorides
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treatment of early disease to prevent further progress of it
secondary prevention
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what is an example of secondary prevention?
removal of calculus and biofilm
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methods to replace lost tissue; for instance replacement of a missing tooth
tertiary prevention
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What are the 7 core values in dental hygiene?
- individual autonomy and respect
- societal trust
- nonmaleficence
- veracity
- confidentiality
- beneficence
- justice and fairness
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What are the vital signs we check in clinic?
- temperature
- pulse
- respiration
- blood pressure
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what is the normal body temperature for adults under age 70?
98.6 *F (96-99.5 *F)
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what is the normal body temperature for adults over age 70?
96.8 *F
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what is the normal body temperature for 1 year old children? 4 year old children? 5 year old children? 12 year old children?
- 99.1 *F
- 99.4 *F
- 98.6 *F
- 98 *F
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temperature values below 96 *F
hypothermia
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temperature values above 105.8 *F
hyperthermia - take patient to hospital!
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(fever) temperature values over 99.5 *F
pyrexia
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What are 10 causes of increased body temperature?
- late afternoon and early evening
- exercise
- hot drinks
- smoking
- application of external heat
- infection
- dehydration
- hyperthyroidism
- myocardial infarction
- tissue injury
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what are 4 causes of decreased body temperature?
- sleep and early morning
- starvation
- hemorrhage
- physiologic shock
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what is the normal pulse rate for adults?
60-100 bpm
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what is the normal pulse rate for 1-2 year old children? 3-4 year old children? 9-10 year old children?
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unusually fast heart beat - over 100 bpm - caused by exercise; stimulants; eating; strong emotions; extremes of heat and cold; some forms of heart disease
tachycardia
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unusually slow heart beat - under 50 bpm - caused by sleep; depressants; fasting; quiet emotions; low vitality from prolonged illness
bradycardia
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name 3 sites for taking pulse
- radial - wrist
- carotid - cardiopulmonary resuscitation
- brachial - on infants
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what is the normal respiration rate range for adults?
14 - 20 breaths per minute (slightly higher for women)
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what is the normal respiration rate for 1 year old children? 2 year old children? 8 year old children? 15 year old children?
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what is the normal blood pressure measurement for systolic, diastolic, and pulse pressure"
- less than 120
- less than 80
- less than 40
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the lowest pressure, and effect of ventricular relaxation
diastolic
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peak or highest pressure, caused by ventricular contraction
systolic
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used to measure blood pressure and consists of; a cuff, mercury manometer, and a stethoscope is used with it
sphygmomanometer
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What blood pressure rate indicates prehypertension? stage 1 hypertension? stage 2 hypertension?
- 120-139 / 80-89
- 140-159 / 90-99
- greater than 160/100
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the act of listening for sounds within the body to evaluate the condition of the heart, blood vessels, lungs, or other organs, stethoscope is used to hear the sound created by blood as it passes through the brachial artery
auscultation
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series of sounds that are heard as the pressure in the sphygmomanometer cuff is released during the measurement of arterial blood pressure
korotkoff sounds
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in some patients, the korotkoff sounds disappear altogether
auscultation gap
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hollow or depressed area in the underside of the arm at the bend of the elbow; used as a landmark to locate radial pulse and is a reference point for cuff placement
antecubital fossa
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where is the cuff placed in relation to the antecubital fossa? what level is the antecubital fossa kept at?
- 1 inch above it
- level with the heart
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name 6 causes for increased blood pressure
- exercise
- eating
- stimulants
- emotional disturbances
- use of oral contraceptives
- increases with age and length of use
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What are 8 objectives of extra and intra oral exams?
- observe the overall patient
- screening
- communicable diseases
- initial lesions
- identify deviations from normal
- means of comparison
- documentation
- cancer detection
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what are 3 advantages of keeping a routine order for extra and intraoral exams?
- minimal possibility for overlooking something and missing something
- increased efficiency
- maintains a professional atmosphere and increases patients confidence
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red area of variable shape and size; reaction to radiation or injury
erythema
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appraisal characteristics to observe about a patient include:
- posture
- gait
- general health status
- hair
- breathing
- voice
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What 3 characteristics of the face are observed?
- expression - scared or stressed
- shape - symmetry
- jaw movement - normal and comfortable
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what characteristics are observed about the face?
- color, texture, blemishes
- traumatic lesions, bruises
- eruptions, swelling, growths
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what characteristics are observed about the eyes?
- sclera - whites of eyes
- pupils
- eyelids
- eye glasses - offer them safety glasses instead
- eye balls
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what could yellow sclera indicate? red sclera?
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what could dilated pupils in light areas indicate?
lack of oxygen due to drugs or medications
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What are the lateral and medial canthus's checked for?
scabbing
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what are the eyelids checked for?
droop
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what might protruding eye balls indicate?
hyperthyroidism
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What characteristics of the ears are examined?
- palpate ear lobes
- entrance to ear canals
- tragus
- helix
- antihelic
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What are 5 things that might cause lymphadenopathy?
- enlarged
- infection
- viral infection
- bacterial infection
- cancer
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name 3 salivary glands examined in extra and intraoral exams
- parotid
- submandibular
- sublingual
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What are we looking for in checking salivary glands?
- obstruction of flow
- inflammation
- infection
- tumors
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a bow tie shaped endocrine gland
thyroid gland
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enlarged thyroid gland
hyperthyroidism
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hard to detect; slow metabolism
hypothyroidism
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use of a single finger
digital
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use of finger and thumb of same hand
bidigital
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use of fingers and thumb from each hand applied simultaneously in coordination
bimanual
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2 hands at the same time to examine corresponding structures on opposite sides of the body
bilateral
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how many lymph nodes are in the entire body? how many of those are in the neck?
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containing fluid with translucent appearance and a soft consistency
blisterform lesion
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blisterform lesion that is 1 cm or less in diameter, contains serum
vesicle
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contains pus, yellowish in color, can be any size
pustule
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greater than 1 cm in diameter, contains serum, and usually blood
bulla
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solid lesion containing no fluid and a firm consistency
non-blisterform
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slightly raised with a broad flat top and a pasted on appearance
plaque
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solid, less than 5 mm in diameter, smooth or corrugated
papule
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smaller than 1 cm in diameter, solid tissue
nodule
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2 cm or more in diameter, solid tissue
tumor
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surface on the same plane as normal mucosa, can be a single macule, or multiple macules, and have a regular or irregular outline
flat lesion
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below the normal plane of mucosa, ulcer or erosion, can be single or multiple, regular or irregular outline, smooth or raised margin
depressed lesion
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depressed lesion less than 3 mm deep
superficial
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depressed lesion more than 3 mm deep
deep
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lesion limited to a small focal point
localized
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involves most of an area or segment
generalized
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what are the most common sites for neoplasms?
- tongue
- floor of mouth
- lateral portions of tongue
- lower lip
- soft palate
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What are 4 warning signs of oral cancer?
- white areas
- red areas
- ulcers
- pigmentation - black or brown in irregular places
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red lesion that is less likely, but when it is there is more likely for cancer
erythroplakia
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white lesion that can't be scrapped off; more common, but less common for cancer
leukoplakia
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class 1 lesion indicates:
normal
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class II lesion indicates:
atypical; but not suggestive of malignant cells
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class III lesion indicates:
uncertain - possible for cancer
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class IV lesion indicates:
probable for cancer
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class V cancer indicates:
positive for cancer
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what classes of lesions is the pt dismissed only after the lesion heals, and if it persists the dentist may refer them out for a biopsy
class I and II
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for which class of lesion is a biopsy usually indicated?
class III
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for what class of lesions are biopsy's always indicated?
class IV and V
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true or false. false negatives are possible, malignancy may still exist, so it is imperative to follow up with them.
true
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Where is the pulse rate taken during life support for adults? children ages 1-8? infants younger than 1?
- carotid pulse
- carotid pulse
- brachial pulse
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What are 3 steps in airway establishment to prevent oxygen deprivation to brain?
- look, listen, and feel for breath,
- use head tilt with chin lift or jaw thrust to open airway unless they've injured spinal cord, or had a stroke, DO NOT move their head
- administor 2 normal breaths, each one lasting 1 second
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how long can a person go with out oxygen before irreversible brain damage occurs?
4-6 minutes
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lack of perfusion of oxygenated blood to all cells of the brain and body, cells cease to provide respiratory and circulatory function
shock
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What are signs of airway obstruction if a pt is unconscious?
if you give them a rescue breath and their chest doesn't rise
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what are signs of mild airway obstruction?
- good air exchange
- coughing and irregular breathing
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what are signs of sever airway obstruction?
- poor air exchange
- breathing difficulty or inability to speak or breathe
- silent cough
- cyonosis
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When is supplemental oxygen used?
if patient is still breathing
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what are 4 steps in oxygen tank operation?
- attach the oxygen delivery system
- turn key counter clockwise
- increase oxygen flow as needed
- attach oxygen to patient
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what are 4 steps in administering supplemental oxygen?
- full face mask, or nasal cannula
- start at 4-6 L/min
- monitor breathing
- use positive pressure if breathing stops
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when is positive pressure of oxygen administration used?
if patient is not breathing at all
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diabetic coma - emergency
hypoglycemic emergency
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What are some symptoms of a hyperglycemic emergency?
- slow onset
- flushed and dry skin
- fruity odor on breath
- dry mouth - thirst
- low BP
- weak or rapid pulse
- exaggerated respirations
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what is the procedure in the case of a hypoglycemic emergency?
call EMS; keep pt warm; administer oxygen by nasal cannula; basic life support in suppine position
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