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Dental Management of the Medically Complex Patient > Medical Consults > Flashcards

Medical Consults Flashcards

1
Q

what are questions designed to identify or hint to medical issues that may affect dental treatment

A
  • anxiety
  • cardiovascular diseases
  • neurologic disorders
  • GI diseases
  • respiratory tract diseases
  • musculoskeletal diseases
  • endocrine diseases
  • STDs
  • cancer and radiation treatment
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2
Q

what is normal BP

A

less than 120/80 mmHgw

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3
Q

what is elevated BP

A

120-129/ less than 80 mmHg

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4
Q

what is stage 1 hypertension

A

130-139/ 80-89 mmHg

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5
Q

what is stage 2 hypertension

A

greater than 140/90 mmHg

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6
Q

what is hypertensive crisis

A

greater than 180/ greater than 120 mmHg

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7
Q

to dx BP you have to have

A

more than 2 readings on more than 2 separate visits

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8
Q

what falls under ischemic heart disease

A

-CAD
- angina
- MI
- CHF

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9
Q

what falls under category of arrhythmias

A
  • supraventricular arrhythmias
  • atrial fibrillation
  • ventricular arrhythmia
  • pacemaker
  • implanted cardioverter defribrillator
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10
Q

what falls under the category of history of surgical cardiac intervention

A
  • valve replacement/repair
  • coronary artery bypass graft
  • cardiac stent placement/angioplasty
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11
Q

requests for information should be made in writing by:

A

letter or fax, however a phone call may be faster

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12
Q

if you call on the phone you must document:

A
  • responding person
  • date
    -time
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13
Q

where do you document communications with the patients physician

A

in the patients cahrt

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14
Q

a _____ record is a legal record

A

written

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15
Q

what should be provided in clinical context in a med consult

A
  • patient reported medical history
  • patient reported medications
  • positive findings on review of systems where applicable
  • vital readings
  • dental treatment to be performed
  • any other relevant intraoral or extraoral findings
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16
Q

what are good practices in a med consult

A
  • provide clinical context
  • avoid dental jargon
  • concisely express concerns but be specific about the input you need
  • take ownership of the risk assessment
  • remember you are asking for a favor
  • check for missing medical information and updated medication list
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17
Q

when there is complex medical history or if patient seems to be a poor historian:

A

ask for last clinical note

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18
Q

what are treatment modifications

A

systematic assessment of risk and identifying potential problems

19
Q

risk is _____ when treating a medically complex patient

A

always increased

20
Q

what are the prudent rules for clinical practic

A
  • dont start something you cannot finish
  • dont start a procedure if you cannot deal with the potential complications
  • know the potential complications
  • apply to the patients clinical context
  • plan around the likelihood of the most severe complication
21
Q

what do you do with a patient with elevated BP with diagnosed HTN

A

proceed with treatment

22
Q

what do you do with a diagnosed HTN with greater than stage 1 HTN

A
  • med consult -> within BP goal -> proceed with dental tx with cardiac measures
  • med consult -> not within BP goal -> no tx until goal is met
23
Q

what do you do with elevated undiagnosed BP

A

proceed with treatment but recommend med eval

24
Q

what do you do with undiagnosed greater than stage 1 BP

A

no dental treatment until medical evaluation

25
Q

any patient with SBP ___ and/or DBP _____ should be referred to the emergency room

A

greater than 180; greater than 120

26
Q

what are the HTN medical consult questions

A
  • what is the patients BP goal (range)
  • what have been patients in office BP readings
  • does the patient have any end organ damage
    current medications prescribed to manage HTN
27
Q

what are the cardiac measures for HTN

A
  • stress reduction protocol
  • Nitrous oxide
  • profound anesthesia
  • cardiac epi dose = max 0.04mg
  • articaine for maxillary block and maxillary or mandibular infiltrations
  • 2% lidocaine 1:100,000 epi for IANB
  • 3% mepivacaine without epi for anesthesia
28
Q

ac (ante cibum) means:

A

before meals

29
Q

bid means:

A

twice a day

30
Q

D means:

A

day

31
Q

disp means

A

dispense

32
Q

hs means

A

at bedtime

33
Q

po means:

A

by mouth

34
Q

pc means:

A

after meals

35
Q

prn means:

A

as needed

36
Q

qd means:

A

every day

37
Q

qid means

A

four times a day

38
Q

rx means

A

to take

39
Q

sig means

A

write directions

40
Q

STAT means

A

immediately

41
Q

tid means

A

three times a day

42
Q

pid means

A

5 times a day

43
Q
A

Dental Management of the Medically Complex Patient (13 decks)

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