informed consent/day of surgery call/1 week post-op

Question 1

informed consent

Answer 1

1) procedures
2) goals
3) risks
4) benefits
5) alternatives to treatment

Question 2

legal concepts influencing liability

Answer 2

?

Question 3

risk reduction

Answer 3

1) patient information / education
2) office communication
3) records and documentation
- comprehensive records
4) managing complications
- know when to refer
–
we have lots of insurances

Question 4

HIPPA

Answer 4

1) protects confidential health info
2) distribute patient information securely

Question 5

risk analysis and management

Answer 5

1) encrypting electronic messages
2) destroy private documents

Question 6

limited english proficiency and ADA act

Answer 6

1) LEP need to meaningfully access services
2) physically accessible

Question 7

preoperative consultation

Answer 7

1) discuss diagnosis
2) review x-rays
3) discuss postoperative course
- bleeding stop in 30 mins
- swelling 48 hours
- expect sutures to stay for days
4) be positive about surgical outcome and discuss dental treatment plan
- discuss local anesthetic action
- discuss modalities of sedation
—
5) take analgesic meds prior to local anesthetic effect
6) apply pressure on wound with gauze
7) limit strenuous activity

*written and verbal

Question 8

day of surgery call

Answer 8

1) reassure patient regarding outcome of surgery
2) discuss administration of analgesics
- time of onset
- duration of action
- effects
- narcotic pain relievers etc.

Question 9

hemorrhage (postoperative bleeding)

Answer 9

1) can bleed up to 24 hours
2) can alarm patients
3) tea bags can be helpful (tannic acid)
4) NSAIDS interfere with platelet aggregation, other meds

Question 10

biting on gauze

Answer 10

1) should be in the gap and put pressure on bleeding area

Question 11

local measures to control bleeding

Answer 11

1) surgicel and gel foam
2) collaplug with figure 8 suture

Question 12

pain and discomfort

Answer 12

1) NSAIDS and acetaminophen
2) peak pain 12 hours after surgery
3) explaining time of onset and durations of drugs is helpful

Question 13

diet

Answer 13

1) soft and cool food
2) increase fluid intake to promote circulation
3) return to a normal diet once wound healing has been established
4) diabetics must return to a normal insulin and caloric intake asap

Question 14

oral hygiene

Answer 14

1) brush away from the surgical site
2) rinse with salt water, listerine, etc
3) sucking thick liquids can dislodge clot, regular liquid can be take through a straw

Question 15

erythema

Answer 15

1) tissue redness
2) fibroblasts and endothelial cells go to work in the wound healing process and granulation tissue is formed
3) normal for tissues to be red and friable
4) redness prolonged can be sign of delayed healing

Question 16

exudate

Answer 16

1) leakiness

Question 17

ecchymosis

Answer 17

1) bleeding into tissues
2) bruising
2) extremities of age have a compromised lymphatic system

Question 18

infection

Answer 18

1) buccal abscesses
2) submandibular and sublingual abscesses
3) get them early and control the source

Question 19

1 week post op

Answer 19

1) sutures removed
2) plan for subsequent treatment discusses
3) reassured as to post operative care
4) practice builder
- call them afterwards to check on them

Question 20

wound dehiscence loss of suture

Answer 20

1) wound dehiscence generally heals by secondary intention
2) approximation not strangulation as tissues closed under tension causes ischemia (lack of blood supply)
3) can leads to tissue necrosis

Question 21

dry socket

Answer 21

1) not an infection, it is alveolar osteitis due to fibrinolytic activity
2) bacterial biproducts
3) bony surfaces are exposed, foul smell and taste