Module 13 Exam 2 Flashcards Preview

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Flashcards in Module 13 Exam 2 Deck (84):
1

In utero when do irregularities in heart develop happen

during the first 9 weeks

2

what is the most common heart defects

-ventricular septal defect
-patent ductus arteriosus
atrial septal defect
transposition of the great vessels

3

what is a patent ductus arteriosus

passageway is open between two great arteries, aorta and pulmonary artery

4

what are preventions for heart defects

-rubella vaccine
-no meds used during pregnancy
-appropriate use of x-ray equipment
-control of tobacco, drug and alcohol addictions

5

what are signs and symptoms of a congenital heart disease

-easy fatigue
-extertional dyspnea
-cyanosis of lips and nail bed
-poor growth and dev
-heart murmur
-congestive heart failure

6

What are dental hygiene concerns for heart defects

-prevention of infective endocardidits
-elimination of oral disease

7

what is the etiology of rheumatic fever

group A streptococcual pharyngeal infection

8

what valve is most commonly effected in rheumatic fever

mitral valve

9

What is a mitral valve prolapse

imperfect closure of the mitral valve between the left atrium and the left ventricle which causes backflow or regurgitation of blood

10

Does mitral valve prolapse have symptoms

no

11

is a premed needed for mitral valve prolapse

no

12

What is infective endocardidits

microbial infection of the heart valves or endocardium that is of concern in the dental and dental hygiene care of high risk patients

13

what is a bacteremia

-presence of microorganisms in the blood stream

14

What is infective endocarditis characterized by

formation of vegetations composed of masses of bacteria and blood clots on heart valves

15

what bacteria are responsible in most cases for IE

streptococci and staphylcocci, alpha-hemolytic strep most prevalent

16

What are risk factors for IE

-cardiac abnormalities
-prosthetic heart valves
-history of previous endocarditis
-IV drug abuse

17

What are precipiatating factors of IE

-self induced bacteremia
-infection at portals of entry
-trauma to tissues by instrumentation

18

what is a self induced bacteremia

activity that can force bacteria through the wall of a diseased sulcus or pocket

19

how do you prevent rheumatic heart disease

early diagnosis and tx

20

what are symptoms of rheumatic heart disease

-arthritis
-carditis
-low grade fever over several months
-joints, heart muscle, skin, CNS sub q tissues become involved

21

what are practice applications of rheumatic heart disease for the DH

-maintenance of high levels of oral health to prevent a need for tx of an advanced disease or caries

22

Rheumatic heart disease is almost always associated with

a significant murmur of insufficency

23

what are the symptoms of Mitral Valve prolapse

-ususally no symptoms
-palpations, fatigue, atypical chest pain, late systolic murmer

24

How can we prevent IE in the dental setting

-review the patient history (consult)
-prophylactic antibiotic premed
-dental hygiene care

25

What can we do with dental hygiene care with a patient who is at risk for IE

-mainetence of high degree of oral health
-instruction of brushing and flossing when under premed
-sequence of tx- bring tissue to healthiest state as possible before instrumentation
-reduce microbial pop around teeth before instrumentation

26

what is hypertension

abnormal elevation of aterial blood pressure

27

what is the etiology of primary hypertension

-tobacco use
heredity
overweight
race
salt
sex
age
environment

28

what percentage of HTN is primary

95%

29

what is elevated in secondary hypertension

both diastolic and systolic pressures

30

WHat is the etiology of secondary HTN

-oral contraceptive
renal disease
endocrine disorders
medications

31

what is the diastolic bp

pressure exerted by blood within the arteries during resting resistance after contraction of the left ventricle

32

what is systolic bp

pressure exhorted against the aterial walls during ventricular contraction

33

what is normal bp

<80

34

what is prehypertension

120-139 80-89

35

what is stage 1 hypertension

140-159- 90-99

36

what is stage 2 hypertension

>160 >100

37

what are symptoms of hypertension

-high blood pressure
-long standing severe elevation of blood pressure
-major sequela
-malignant hypertension

38

what are symptoms of high blood pressure

occipital headaches
dizziness
visual disturbances
weakness
ringing in ears
tingling of hands and feet

39

hypertensive crisis is a

life threatening disorder

40

what are results of long standing severe elevation of blood pressure

-mental confusion
-blurring of vision
-severe dyspnea
-chest pains

41

what are symptoms of a major sequela

hypertensive heart disease, enlarged heart with eventual cardiac failure
-hypertensive renal disease
ischemic heart disease
cerebrovascular accident

42

what is treatment goals in primary hypertension

-diastolic below 80
-lower risk of serious complications, death

43

what are treatment goals in secondary hypertension

-surgical or other correction of cause is needed

44

what are lifestyle changes that must happen in treatment of hypertension

-weight and exercise
diet
tobacco use
other risk factors

45

what is hypertensive heart disease

results from the increased load on the heart because of elevated blood pressure
-to cope with increased work load from the peripherial arterial resistance to the increased flow of blood, muscle fibers are stretched and heart enlarges

46

what is the first effect of hypertension on the heart

thickening of the left ventricle, later the entire heart is enlarged

47

what is ischemic heart disease

the cardiac disability, acute and chronic, that arises from reduction or arrest of blood supply in the myocardium

48

what is the myocardium blood supplied by

coronary artery

49

what does ischemia mean

oxygen deprivation in a local area from a reduced passage of fluid into the area

50

what is ischemic heart disease a result of

an imbalance of the oxygen supply and demand of the myocardium which in turn results from a narrowing or blocking of the lumen of the coronary arteries

51

what is the etiology of ischemic heart diesease

-the principle cause is atherosclerosis of the vessel walls

52

what are risk factors for ischemic heart disease

-inflammation-role in formation of atheromas
-perio microorganisms can cause atheromas
-elevated blood lipids
-increased cholesterol,sat. fat, carbs, alchohol and calories
-tobacco use, diabetes, obesity, sedentary, stress and fam history may all be sig

53

what are manifestations of ischemic heart disease

-angina pectoris
myocardial infarction
congestive heart failure

54

What is angina pectoris

chest pain, the most common symptom of coronary arthrosclerotic heart disease

55

what are the symptoms of angina pectoris

-heavy, squeezing pressure or tightness in mid chest
-pale, faintness, sweating, anxiety, fear difficulty breathing
-pain may radiate down left or right arm, neck

56

what are precipitating factors of angina pectoris

-stable angina
-unstable angina

57

what is treatment for angina pectoris

-use vasodilator, nitro, supplemental oxygen

58

What are the steps in the procedure during an angina pectoris attack

-terminate tx (call for assistance
-position patient
-administer vasodilator
-check patient response
-call for medical assistance
-record vital signs
-observe recovery

59

What is a myocardial infarction

most extreme manifestation of ishcemic heart disease from a sudden arrest of coronary blood flow

60

what is the etiology of a myocardial infarction

-immediate:thrombosis that blocks an artery narrowed by athrosclerosis
-blockage creates an area of infarction, which leads to necrosis of the area

61

What are the symptoms of an MI

pain, cold sweat, weakness faintness, shortness of breath, nausea, vomiting, BP below baseline

62

Do women always present with symptoms in an MI

no, they pay be nausiated, agitated, diphoretic

63

What is the location and onset of pain in a myocardial infarction

-location; under the sternum, may feel like indigestion, severe pain gives a pressing crushing or heavy sensation
-onset- may be sudden, during sleep or after exercise, pain may be radial

64

How do you manage a MI attack

-terminate tx- sit pt up, give nitro
-summon medical assistance- when nitro doesnt reduce angina in 3 min prep for BLS

65

What is congestive heart failure

syndrome in which an abnormality of cardiac function is responsible for the inability or failure of the heart to pump blood at a rate necessary to meet the needs of the body tissues

66

what is the etiology of underlying causes of congestive heart failure

-heart valve damage
-myocardial failure as an abnormality of heart muscle or secondary to ischemia

67

what is the etiology of precipitating causes of congestive heart failure

-acute hypertensive crisis (headache, mental confusion, dizziness, SOB, chest pain)
-massive pulmonary embolism
-aarhythmia

68

what are clinical manifestations of left sided heart failure

-subjective- weakness, fatigue, dyspnea, cough, expectortation, nocturia
-objective-pallor, sweating, cold skin, breathing difficult, heart rate rapid, anxiety fear, diastolic BP increased

69

How should a patient rest in the chair with left sided heart failure

sitting or semi-sitting position

70

what are symptoms of right sided heart failure

-subjective- weakness, fatigue, swelling of feet or ankles, cold hands and feet
objective symptoms- cyanosis of mucous membranes, prominent jug. veins, congestion with edema in organs, anxiety, fear

71

What kind of tx is used in congestive heart failure

-drug therapy, dietary control, limitation of activity

72

what is good to know for the dh in congestive heart failure

-know they may be recieving multiple medical tx

73

What is are basic noninvasive treatments

-counseling
-lifestyle changes
-medications

74

What kinds of surgical treatments may be done?

-coronary dilation
-coronary bypass
-cardiac pacemaker

75

What are the 2 kinds of coronary dilation

-percutaneous transluminal coronary angioplasty (balloon widens lumen)
-coronary stent

76

What is a coronary bypass

-vein graft to jump pass over arteries that have been narrowed

77

What is the natural pacemaker of the heart

SA node in the right atrium

78

what are the two types of cardiac pace makers

demand or fixed rate

79

what can interfere with a cardiac pacemaker

electromagnetic interferences

80

what is important with a cardiac pacemaker in DH care

- be aware of dental devices that have an electric current

81

what are clinical procedures in anticoagulant therapy

-consultation- info about prothrombin time

-treatment planning-pretest within 24 hours for prothombin time, in quadrant scaling and root planing treat the heather quadrant first, least bleeding will occur

Local hemostatic factors (pressure, suture, perio dressing)

82

what are post procedural instructions for anticoagulant therapy

-extraoral icepacks
-soft diet, cool, gen. moderation of activity

83

What should happen before elective cardiac surgery

pt should be brought to optimum oral health, with all infection removed, all restorations completed

84

what should you do with a patient who is post cardiac surgery

-frequent appointments for maintenance
-prophylactic antibiotic coverage
pts will be on immunosuppressive therapy