DH theory

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sthomp88
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46927
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DH theory
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2010-12-14 16:09:24
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Modules six through nine
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DH theory
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  1. pneumonic for DH process of Care
    ADPI
  2. What does ADPIE stand for?
    • Assessment
    • Diagnosis
    • Planning
    • Implementation
    • Evaluation
  3. provides a foundation for patient care by collecting both subjective (pt. complaints) and objective (systematic data) data.
    Assessment phase of DH process of care
  4. Patient perception and complaints of pain, symptoms etc.
    subjective data
  5. systematic data collected from exams and radiographs, etc.
    objective data
  6. 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
  7. What are the 3 steps of the diagnosis phase for interpreting information?
    • classification
    • interpretation
    • validation
  8. selection of interventions to be performed by the patient, dental hygienist, or others to help patient attain oral health
    DH care planning
  9. What are the steps in the DH care planning phase?
    • establish priorities
    • set goals
    • interventions
    • expected outcomes (prognosis
    • present the plan
    • informed consent
  10. Activation of the care plan
    implementation phase of DH process of care
  11. 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
  12. continuing care or supportive therapy, scheduled at intervals of 3, 4, or 6 months
    maintenance plan
  13. true or false. Culture affects oral health status and beliefs.
    true
  14. 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
  15. 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
  16. 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
  17. true or false. Always address the patient even if they have an interpreter.
    true
  18. the act of self-determination by persons with the ability to make a choice or decision
    autonomy
  19. doing good for benefit or enhanced welfare
    beneficence
  20. avoidance of harm to others; a core value
    nonmaleficence
  21. a duty to tell the truth when information is disclosed to patients about treatment
    veracity
  22. measures carried out so disease does not occur and is truly prevented
    primary prevention
  23. what is an example of primary prevention?
    use of fluorides
  24. treatment of early disease to prevent further progress of it
    secondary prevention
  25. what is an example of secondary prevention?
    removal of calculus and biofilm
  26. methods to replace lost tissue; for instance replacement of a missing tooth
    tertiary prevention
  27. What are the 7 core values in dental hygiene?
    • individual autonomy and respect
    • societal trust
    • nonmaleficence
    • veracity
    • confidentiality
    • beneficence
    • justice and fairness
  28. What are the vital signs we check in clinic?
    • temperature
    • pulse
    • respiration
    • blood pressure
  29. what is the normal body temperature for adults under age 70?
    98.6 *F (96-99.5 *F)
  30. what is the normal body temperature for adults over age 70?
    96.8 *F
  31. 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
  32. temperature values below 96 *F
    hypothermia
  33. temperature values above 105.8 *F
    hyperthermia - take patient to hospital!
  34. (fever) temperature values over 99.5 *F
    pyrexia
  35. 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
  36. what are 4 causes of decreased body temperature?
    • sleep and early morning
    • starvation
    • hemorrhage
    • physiologic shock
  37. what is the normal pulse rate for adults?
    60-100 bpm
  38. what is the normal pulse rate for 1-2 year old children? 3-4 year old children? 9-10 year old children?
    • 105 bpm
    • 90 bpm
    • 70 bpm
  39. 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
  40. unusually slow heart beat - under 50 bpm - caused by sleep; depressants; fasting; quiet emotions; low vitality from prolonged illness
    bradycardia
  41. name 3 sites for taking pulse
    • radial - wrist
    • carotid - cardiopulmonary resuscitation
    • brachial - on infants
  42. what is the normal respiration rate range for adults?
    14 - 20 breaths per minute (slightly higher for women)
  43. what is the normal respiration rate for 1 year old children? 2 year old children? 8 year old children? 15 year old children?
    • 30
    • 25
    • 20
    • 18
  44. what is the normal blood pressure measurement for systolic, diastolic, and pulse pressure"
    • less than 120
    • less than 80
    • less than 40
  45. the lowest pressure, and effect of ventricular relaxation
    diastolic
  46. peak or highest pressure, caused by ventricular contraction
    systolic
  47. used to measure blood pressure and consists of; a cuff, mercury manometer, and a stethoscope is used with it
    sphygmomanometer
  48. What blood pressure rate indicates prehypertension? stage 1 hypertension? stage 2 hypertension?
    • 120-139 / 80-89
    • 140-159 / 90-99
    • greater than 160/100
  49. 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
  50. series of sounds that are heard as the pressure in the sphygmomanometer cuff is released during the measurement of arterial blood pressure
    korotkoff sounds
  51. in some patients, the korotkoff sounds disappear altogether
    auscultation gap
  52. 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
  53. 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
  54. name 6 causes for increased blood pressure
    • exercise
    • eating
    • stimulants
    • emotional disturbances
    • use of oral contraceptives
    • increases with age and length of use
  55. 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
  56. 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
  57. red area of variable shape and size; reaction to radiation or injury
    erythema
  58. appraisal characteristics to observe about a patient include:
    • posture
    • gait
    • general health status
    • hair
    • breathing
    • voice
  59. What 3 characteristics of the face are observed?
    • expression - scared or stressed
    • shape - symmetry
    • jaw movement - normal and comfortable
  60. what characteristics are observed about the face?
    • color, texture, blemishes
    • traumatic lesions, bruises
    • eruptions, swelling, growths
  61. what characteristics are observed about the eyes?
    • sclera - whites of eyes
    • pupils
    • eyelids
    • eye glasses - offer them safety glasses instead
    • eye balls
  62. what could yellow sclera indicate? red sclera?
    • jaundice
    • drug use
  63. what could dilated pupils in light areas indicate?
    lack of oxygen due to drugs or medications
  64. What are the lateral and medial canthus's checked for?
    scabbing
  65. what are the eyelids checked for?
    droop
  66. what might protruding eye balls indicate?
    hyperthyroidism
  67. What characteristics of the ears are examined?
    • palpate ear lobes
    • entrance to ear canals
    • tragus
    • helix
    • antihelic
  68. What are 5 things that might cause lymphadenopathy?
    • enlarged
    • infection
    • viral infection
    • bacterial infection
    • cancer
  69. name 3 salivary glands examined in extra and intraoral exams
    • parotid
    • submandibular
    • sublingual
  70. What are we looking for in checking salivary glands?
    • obstruction of flow
    • inflammation
    • infection
    • tumors
  71. a bow tie shaped endocrine gland
    thyroid gland
  72. enlarged thyroid gland
    hyperthyroidism
  73. hard to detect; slow metabolism
    hypothyroidism
  74. use of a single finger
    digital
  75. use of finger and thumb of same hand
    bidigital
  76. use of fingers and thumb from each hand applied simultaneously in coordination
    bimanual
  77. 2 hands at the same time to examine corresponding structures on opposite sides of the body
    bilateral
  78. how many lymph nodes are in the entire body? how many of those are in the neck?
    • 400-700
    • 170-200
  79. containing fluid with translucent appearance and a soft consistency
    blisterform lesion
  80. blisterform lesion that is 1 cm or less in diameter, contains serum
    vesicle
  81. contains pus, yellowish in color, can be any size
    pustule
  82. greater than 1 cm in diameter, contains serum, and usually blood
    bulla
  83. solid lesion containing no fluid and a firm consistency
    non-blisterform
  84. slightly raised with a broad flat top and a pasted on appearance
    plaque
  85. solid, less than 5 mm in diameter, smooth or corrugated
    papule
  86. smaller than 1 cm in diameter, solid tissue
    nodule
  87. 2 cm or more in diameter, solid tissue
    tumor
  88. 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
  89. below the normal plane of mucosa, ulcer or erosion, can be single or multiple, regular or irregular outline, smooth or raised margin
    depressed lesion
  90. depressed lesion less than 3 mm deep
    superficial
  91. depressed lesion more than 3 mm deep
    deep
  92. lesion limited to a small focal point
    localized
  93. involves most of an area or segment
    generalized
  94. what are the most common sites for neoplasms?
    • tongue
    • floor of mouth
    • lateral portions of tongue
    • lower lip
    • soft palate
  95. What are 4 warning signs of oral cancer?
    • white areas
    • red areas
    • ulcers
    • pigmentation - black or brown in irregular places
  96. red lesion that is less likely, but when it is there is more likely for cancer
    erythroplakia
  97. white lesion that can't be scrapped off; more common, but less common for cancer
    leukoplakia
  98. class 1 lesion indicates:
    normal
  99. class II lesion indicates:
    atypical; but not suggestive of malignant cells
  100. class III lesion indicates:
    uncertain - possible for cancer
  101. class IV lesion indicates:
    probable for cancer
  102. class V cancer indicates:
    positive for cancer
  103. 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
  104. for which class of lesion is a biopsy usually indicated?
    class III
  105. for what class of lesions are biopsy's always indicated?
    class IV and V
  106. true or false. false negatives are possible, malignancy may still exist, so it is imperative to follow up with them.
    true
  107. 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
  108. 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
  109. how long can a person go with out oxygen before irreversible brain damage occurs?
    4-6 minutes
  110. lack of perfusion of oxygenated blood to all cells of the brain and body, cells cease to provide respiratory and circulatory function
    shock
  111. What are signs of airway obstruction if a pt is unconscious?
    if you give them a rescue breath and their chest doesn't rise
  112. what are signs of mild airway obstruction?
    • good air exchange
    • coughing and irregular breathing
  113. what are signs of sever airway obstruction?
    • poor air exchange
    • breathing difficulty or inability to speak or breathe
    • silent cough
    • cyonosis
  114. When is supplemental oxygen used?
    if patient is still breathing
  115. 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
  116. 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
  117. when is positive pressure of oxygen administration used?
    if patient is not breathing at all
  118. diabetic coma - emergency
    hypoglycemic emergency
  119. 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
  120. 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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