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pneumonic for DH process of Care
What does ADPIE stand for?
provides a foundation for patient care by collecting both subjective (pt. complaints) and objective (systematic data) data.
Assessment phase of DH process of care
Patient perception and complaints of pain, symptoms etc.
systematic data collected from exams and radiographs, etc.
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
What are the 3 steps of the diagnosis phase for interpreting information?
selection of interventions to be performed by the patient, dental hygienist, or others to help patient attain oral health
DH care planning
What are the steps in the DH care planning phase?
- establish priorities
- set goals
- expected outcomes (prognosis
- present the plan
- informed consent
Activation of the care plan
implementation phase of DH process of care
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
continuing care or supportive therapy, scheduled at intervals of 3, 4, or 6 months
true or false. Culture affects oral health status and beliefs.
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
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
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 or false. Always address the patient even if they have an interpreter.
the act of self-determination by persons with the ability to make a choice or decision
doing good for benefit or enhanced welfare
avoidance of harm to others; a core value
a duty to tell the truth when information is disclosed to patients about treatment
measures carried out so disease does not occur and is truly prevented
what is an example of primary prevention?
use of fluorides
treatment of early disease to prevent further progress of it
what is an example of secondary prevention?
removal of calculus and biofilm
methods to replace lost tissue; for instance replacement of a missing tooth
What are the 7 core values in dental hygiene?
- individual autonomy and respect
- societal trust
- justice and fairness
What are the vital signs we check in clinic?
- blood pressure
what is the normal body temperature for adults under age 70?
98.6 *F (96-99.5 *F)
what is the normal body temperature for adults over age 70?
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
temperature values below 96 *F
temperature values above 105.8 *F
hyperthermia - take patient to hospital!
(fever) temperature values over 99.5 *F
What are 10 causes of increased body temperature?
- late afternoon and early evening
- hot drinks
- application of external heat
- myocardial infarction
- tissue injury
what are 4 causes of decreased body temperature?
- sleep and early morning
- physiologic shock
what is the normal pulse rate for adults?
what is the normal pulse rate for 1-2 year old children? 3-4 year old children? 9-10 year old children?
unusually fast heart beat - over 100 bpm - caused by exercise; stimulants; eating; strong emotions; extremes of heat and cold; some forms of heart disease
unusually slow heart beat - under 50 bpm - caused by sleep; depressants; fasting; quiet emotions; low vitality from prolonged illness
name 3 sites for taking pulse
- radial - wrist
- carotid - cardiopulmonary resuscitation
- brachial - on infants
what is the normal respiration rate range for adults?
14 - 20 breaths per minute (slightly higher for women)
what is the normal respiration rate for 1 year old children? 2 year old children? 8 year old children? 15 year old children?
what is the normal blood pressure measurement for systolic, diastolic, and pulse pressure"
- less than 120
- less than 80
- less than 40
the lowest pressure, and effect of ventricular relaxation
peak or highest pressure, caused by ventricular contraction
used to measure blood pressure and consists of; a cuff, mercury manometer, and a stethoscope is used with it
What blood pressure rate indicates prehypertension? stage 1 hypertension? stage 2 hypertension?
- 120-139 / 80-89
- 140-159 / 90-99
- greater than 160/100
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
series of sounds that are heard as the pressure in the sphygmomanometer cuff is released during the measurement of arterial blood pressure
in some patients, the korotkoff sounds disappear altogether
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
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
name 6 causes for increased blood pressure
- emotional disturbances
- use of oral contraceptives
- increases with age and length of use
What are 8 objectives of extra and intra oral exams?
- observe the overall patient
- communicable diseases
- initial lesions
- identify deviations from normal
- means of comparison
- cancer detection
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
red area of variable shape and size; reaction to radiation or injury
appraisal characteristics to observe about a patient include:
- general health status
What 3 characteristics of the face are observed?
- expression - scared or stressed
- shape - symmetry
- jaw movement - normal and comfortable
what characteristics are observed about the face?
- color, texture, blemishes
- traumatic lesions, bruises
- eruptions, swelling, growths
what characteristics are observed about the eyes?
- sclera - whites of eyes
- eye glasses - offer them safety glasses instead
- eye balls
what could yellow sclera indicate? red sclera?
what could dilated pupils in light areas indicate?
lack of oxygen due to drugs or medications
What are the lateral and medial canthus's checked for?
what are the eyelids checked for?
what might protruding eye balls indicate?
What characteristics of the ears are examined?
- palpate ear lobes
- entrance to ear canals
What are 5 things that might cause lymphadenopathy?
- viral infection
- bacterial infection
name 3 salivary glands examined in extra and intraoral exams
What are we looking for in checking salivary glands?
- obstruction of flow
a bow tie shaped endocrine gland
enlarged thyroid gland
hard to detect; slow metabolism
use of a single finger
use of finger and thumb of same hand
use of fingers and thumb from each hand applied simultaneously in coordination
2 hands at the same time to examine corresponding structures on opposite sides of the body
how many lymph nodes are in the entire body? how many of those are in the neck?
containing fluid with translucent appearance and a soft consistency
blisterform lesion that is 1 cm or less in diameter, contains serum
contains pus, yellowish in color, can be any size
greater than 1 cm in diameter, contains serum, and usually blood
solid lesion containing no fluid and a firm consistency
slightly raised with a broad flat top and a pasted on appearance
solid, less than 5 mm in diameter, smooth or corrugated
smaller than 1 cm in diameter, solid tissue
2 cm or more in diameter, solid tissue
surface on the same plane as normal mucosa, can be a single macule, or multiple macules, and have a regular or irregular outline
below the normal plane of mucosa, ulcer or erosion, can be single or multiple, regular or irregular outline, smooth or raised margin
depressed lesion less than 3 mm deep
depressed lesion more than 3 mm deep
lesion limited to a small focal point
involves most of an area or segment
what are the most common sites for neoplasms?
- floor of mouth
- lateral portions of tongue
- lower lip
- soft palate
What are 4 warning signs of oral cancer?
- white areas
- red areas
- pigmentation - black or brown in irregular places
red lesion that is less likely, but when it is there is more likely for cancer
white lesion that can't be scrapped off; more common, but less common for cancer
class 1 lesion indicates:
class II lesion indicates:
atypical; but not suggestive of malignant cells
class III lesion indicates:
uncertain - possible for cancer
class IV lesion indicates:
probable for cancer
class V cancer indicates:
positive for cancer
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
for which class of lesion is a biopsy usually indicated?
for what class of lesions are biopsy's always indicated?
class IV and V
true or false. false negatives are possible, malignancy may still exist, so it is imperative to follow up with them.
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
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
how long can a person go with out oxygen before irreversible brain damage occurs?
lack of perfusion of oxygenated blood to all cells of the brain and body, cells cease to provide respiratory and circulatory function
What are signs of airway obstruction if a pt is unconscious?
if you give them a rescue breath and their chest doesn't rise
what are signs of mild airway obstruction?
- good air exchange
- coughing and irregular breathing
what are signs of sever airway obstruction?
- poor air exchange
- breathing difficulty or inability to speak or breathe
- silent cough
When is supplemental oxygen used?
if patient is still breathing
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
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
when is positive pressure of oxygen administration used?
if patient is not breathing at all
diabetic coma - emergency
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
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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