Exam 1

Fruity Breath, Headache, Thirst, Nausea, Vomiting, Trouble Concentrating, Possible Diabetic Coma

Stop Tx, Activate EMS (if necessary), Initiate BLS (if necessary), Check Blood Sugar, Ask Pt if They have Insulin, Have Pt administer Insulin

Too much food, too little insulin, illness, and stress

Hunger, Headache, Cool, Moist Skin, Nausea, Confusion, Irritation, Dizziness, and Weakness

Stop tx, give pt something sweet, test blood sugar, have pt eat snack, contact physician if symptoms persist. If Pt loses consciousness, activate EMS and Initiate BLS

Too little food, too much insulin, extra exercise

Loss of Awareness, Blank Stare, Muscle Twitches

Up to 90 Seconds

Stop Tx, Lower Chair, Clear Area of Sharps, Observe Closely, Refer to Physician

Abnormal electrical impulses to brain, unknown cause

Loss of consciousness, muscles contract, muscle twitches

10-20 seconds

Rhythmic Muscle Contractions and Convulsions

Less Than 2 Minutes

Stop tx, lower chair, clear area of sharps, do not restrain, protect pt's head, place in recovery position, assess/establish airways, monitor vitals, activate EMS (if necessary), Initiate BLS (if necessary, help make arrangements for pt to get home

Laying on side, top arm supports head, top leg bent at right angle

Epilepsy, low blood sugar, high fever, bright lights, abnormal electrical impulses to the brain

Crushing/Burning Chest Pain, Radiating Pain to Shoulder, Arm, Neck, or Mandible, Long Duration, Cold, CLammy Skin, Nausea, Anxiety, Shortness of Breath, Weakness

Stop tx, activate EMS, make pt comfortable, monitor vitals, administer O2, establish/maintain airways, intiate BLS (if necessary)

Blocked coronary artery, risk increases with stress

Curshing/Burning Chest Pain

Crushingurnings chest pain, radiating pain to the shoulder, arm, neck, or mandible, nausea, anxiety, lightheadedness

Nausea, Anxiety, Lightheadedness

Stop tx, make pt comfortable, monitor vitals, administer O2, administer nitroglycerin tables, activate EMS if pain persists

Lack of oxygenated blood to the mycardium

Hives, angioedema, respiratory distress, wheezing, laryngeal edema, weak pulse, unconsciousness, cardiovascular collapse

Urticaria

Stop Tx, Activate EMS, Establish/Maintain Airways, Monitor Vitals, Initiate BLS (if necessary), have dentist administer epinephrine or benadryl

Severe allergy

Unproductive cough, shortness of breath, rapid breathing, wheezing, anxiety or panic, and cyanosis

A blue/purple tint to lips and/or extremities

Stop tx, have pt administer their bronchodilator, administer O2, monitor vitals, activate EMS (if necessary), Initiate BLS (if necessary)

Bronchospasm, allergens, over-exertion

Sudden weakness on one side, drooping on one side of the face, difficulty speaking, possible loss of vision, change in mental status, nausea, severe headache, and convulsions

stop tx, place pt in trendelenburg position, administer O2, monitor vitals, activate EMS, Initiate BLS as needed

Blood clot in the brain

Loss of consciousness, pale, perspiration, nausea, dizziness, weak pulse, shallow breathing

Stop tx, place in trendelenburg position, maintain airways, monitor vitals, administer O2, ammonia inhalants, place cool, damp cloth on forehead

Laid back, feet up

Heart problems, seizures, hypoglycemia, low BP, anemia, and fear

Cortisol Deficiency

Confusion, weakness, lethargy, respiratory depression, low BP, weakapid pulse, abdominal pain, loss of consciousness

stop treatment, activate EMS, place in trendelenburg position, monitor vitals, administer O2, establish/maintain airways, initiate BLS (if necessary)

Extreme dehydration, physical trauma or extreme stress, damage to adrenal or pituitary gland

Rapid, deep breathing, lightheadedness, dizziness, heart palpitations, tingling extremities

Stop Tx, Reassure Pt, instruct Pt to take slow, deep breaths, have Pt breath into cupped hands

NO

Lung Diseases, Panic Disorder, Over-Exertion

Severe, Unknown Allergies, and Asthma Attacks

Adrenalin

Increases HR, BP, muscle strength, and sugar metabolism

0.3-0.5 mg every 5-10 minutes as needed

Injected intramuscularly

1 mg/1 mL

Adrenalin

Benadryl

A histamine blocker

50 mg/mL

In cases of mild or delayed allergic reactions

Intravenously or intramuscularly

5 mg in 24 hours

10-15 mg in 24 hours

Diphenhydramine

Nonsteroidal anti-inflammatory

Following the MONA protocol when a myocardial infarction is suspected

Manages chest pain

325 mg

Aspirin

Opioid overdoses

4mg every 2-3 min until response or EMS arrival

Sprayed in one nostril

Narcan Nasal Spray

OPA: Oral Pharyngeal Airway

Opens airway by preventing tongue from covering epiglottis

No

Hypoclycemia

24 g (1 tube) every 20 minutes

Orally

Beta 2 Androgenic Agonist

Acute bronchospasms form asthma

Insta-Glucose

Ages 4+

Albuterol Inhaler

Fainting/Syncope

Open and hold under the nose

Ammonia Inhalants

Anaphylaxis from known allergic reactions

Blue

Red

0.15 mg

0.3 mg

Injected into the thigh

Nitrate Vaso-Dialator

Relieving angina pectoris

Epi-Pen

0.4 mg every 5 minutes

Under the tongue or in the cheek

Nitroglycerin Sublingual Tablets

3

Immediately wash area with soap and water

Report the incident to a faculty member

HLC, Concentra Walk-in Clinic, or Flagstaff Medical Center

The Student

How exposure occurred, student's social and medical history, any known info about the antibody status of the source pt regarding hep B,C, and HIV

Blood Draw

Prophylactic medication should be provided and a consent or declination form for tx should be signed and a copy brought to the hygiene department

Until final determination is made regarding the source pt's HIV status

Student should be tested at 6 weeks, 3 months, and 6 months

Student should be tested at 2 weeks, 6 weeks for Hep C RNS and at 3 months and 6 months for Hep C antibody, and at 2 weeks, 6 weeks, 3 months, and 6 months for liver function

Go to HLC (if student) or Lab Corp

Dental Hygiene Department

Hep B, Hep C, and HIV

No Further Testing Is Needed

Mesial and Distal

Labial, Buccal, Facial, then Lingual

Occlusal/Incisal

When connected two unconnected surfaces (e.g., mesial occlusal distal)

Final letters "al" are dropped from the first term and replaced by "o" (e.g., mesiolingual)

The final letters "al" are dropped from the first term and replaced by "o" (e.g., mesiolabioincisal)

A hyphen is added (e.g., mesio-occlusodista)

Mesial

True

Hygienists are devoted to the prevention of disease and the promotion and improvement of the public's health

Partnership, Acceptance, Compassion, and Evocation

Resist Righting, Understanding, Listening, and Empower

Open-Ended Questions, Affirmations, Reflections, Summarizing

Nicotine

Over 7,000

Over 90

Carcinogens, Respiratory Toxicants, Cardiovascular Toxicant, Reproductive or Developmental Intoxicants and Toxicants

Less than 20 seconds

Peaks after 10 minutes and then declines in 20-30 minutes

Remains in the tissues for 8-12 hours and is gone from the blood in 1-3 days

28

Through gingiva and oral mucous membranes and the intestines

3-4x more from smokeless

Peaks in 30 min and declines over 2 hours

Electronic Delivery

True

Unpredictable and Varies

Intensifies the release of dopamine by the brain

0.7-2.0 mg

1.5-4.1 mg

1.9-2.6 mg

0.01-7.8 mg

Equivalent to inhaling 100-200 times the volume of smoke from one cigarette

Environmental Tobacco Smoke

True

Cancer, Lung/Respiratory Effects, Cardiovascular Effects, and Pregnancy Complications

Nicotine Stomatitis, Smoker's melanosis, black hairy tongue, median rhomboid glossitis, Leukodema, Hyperkeratosis, Dry Socket, and Delayed Wound Healing

Decreased inflammation, peridontal destruction, bone and attachment, loss, recession, tooth loss, decreased gingival blood flow and GCF

Impaired neutrophils-decreased chemotaxis and phagocytosis, altered antibody production, decreased IgG, impairment of revascularization, negative effect on bone metabolism

Within 24 hours

In the 1st week

Mood changes, anxiety, nervousness, sleep disturbances, appetite increase, and cravings

Breath deeply, take a walk, know your triggers, get more rest, take a multivitamin, make a list of things to do instead of smoking, avoid places where you commonly used tobacco

Avoid caffeine, drink a class of warm milk, avoid alcohol, take a long walk before bed, avoid naps, take a warm bath, meditate, read a book, listen to soothing music

Eat only when hungry, eat low-fat/calorie snacks, chew sugarless gum, drink extra water, exercise

Delay smoking or dipping by 1 minute at a time, distract yourself, deep breaths, discuss your feelings

In 5-10 minutes

One

Mouth soreness, Dyspepsia, Nausea, Headache, Cough, Hiccups, Hearburn, Flatulence

OTC

Bupropion SR, Varenicline, Nicotine Inhaler, Nicotine Nasal Spray

Insomia and Dry Mouth

Nausea, insomnia, abnormal vivid or strange dreams, contipation, gas, and/or vomiting

Mouth Soreness, Dyspepsia, Headaches

Local irritation of mouth and throat

Nasal and throat irritation and dependence potential

Local skin reaction, insomnia, changes in dreams, headache

History of seizure or eating disorder or using a monoamine oxidase inhibitor

Kidney problems, has not been studied in pregnant or nursing women. Potential for agitation, depressed mood, atypical behavior or suicidal thoughts

Temporomandibular disorder or dentures

Asthma or COPD

Nasal polyps, Rhinitis, Sinusitis, and Asthma

Allergy to patch adhesive, severe eczema or psoriasis. Do not cut patches

1. Ask
2. Advise
3. Assess (5 R's)
4. Assist
5. Arrange Follow-Up

1. Relevance
2. Risks
3. Rewards
4. Roadblocks
5. Repetition

Patient's right to control access to identifiable personal health information

The responsibility of the healthcare provider to protect pt info

Protection against unsecured patient data

Recorded information is not altered after the fact

Only data actually obtained during the pt visit are recorded

Personal opinion or negative socail ovservations not pertinent to the pt treatment are never placed in the pt record

Recommended Dietary Allowance

Estimated Average Requirement

Adequate Level

Tolerable Upper Level

Dietary Reference Intake

Percent Daily Value

Foods that prevent caries and promote remineralization

Foods that do not increase tooth decay

Food that provide many nutrients in relatively few calories

Heart disease, Alzheimer's, Ulcerative Colitis, Crohn's Disease, Rheumatoid Arthritis, Diabetes, and Periodontal Disease

Inflammation

Patients with diabetes are at a 2-4x greater risk

Eat anti-inflammatory foods (fruits and veggies), reduce refined sugars, limit simple carbohydrates, exercise, lose weight, and manage stress

Vitamins A, B2, B3, B6, C, Zinc, and Copper

Vitamins B complex, C, Calcium, Phosphorus, Magnesium, Zinc, and Copper

Vitamin A, Calcium, Phosphorus, Magnesium, Fluoride

Fluoride, Calcium, Phosphorus, and Magnesium

20 minutes

40 minutes

Indifference or lack of opinion or excitement

Engage, Focus, Evoke, Plan

The Assessment Trap, The Expert Trap, The Premature Focus Trap, The Blaming Trap, and the Chat Trap

Undivited attention, eye contact (if pt initiates), facial expressions that show support, decoding what was said for clearer understanding, responding with a statement instead of a question

Simple reflections move the cliet forward slowly, complex reflections ad meaning and emphasis to what was said and can propel a client quickly towards their goal

When one's actions are aligned with their values and goals

When one is not meeting their goals due to a conflict between goals and actions

Orange fruits and vegetables, liver, eggs, whole milk, soybeans

Meat, Dairy, Eggs, green vegetables, and fortified grains

Meats, Fish, Whole grains, Legumes, green peas, acorn squash, bananas, and oranges

Meat, fish, poultry, peanuts, sunflower seads, avacado, brown rice, green leafy vegetables

Fish, organ meats, potatoes, bananas

Citrus, Berries, Kiwi, and other fruits

Meat, seafood, poultry, nuts, seeds, legumes, whole grains, and dairy

Meat, seafood, vegetables, nuts, seeds, and chocolate

Meat, Poultry, fish, eggs, dairy, legumes, nuts

Bananas, seeds, dark chocolate, spinach, tofu, leafy greans

Fruites, Spinach, Carrots, fish, seaweed