Patient Eval and Risk Assesment

Question 1

What are the 5 As we must look for after patient eval?

Answer 1

Antibiotics
Analgesics
Anesthesia
Allergies
Anxiety

Question 2

What’s the 3 Bs we must look for after patient eval?

Answer 2

Breathing
BP
Bleeding

Question 3

What’s is the C we must look for after patient eval?

Answer 3

Chair position

Question 4

What’s the 3 Ds we must look for after patient eval?

Answer 4

Drugs

Devices

Question 5

What’s the 2 Es we must look for after patient eval?

Answer 5

Equipment

Emergencies

Question 6

What is the 1 Fs we must look for after patient eval?

Answer 6

Follow up

Question 7

• Must be taken for every patient who is to receive dental treatment
• Two basic techniques used to obtain
➢ Interview the patient
➢ Ask patient questions, record the patient’s verbal responses (axiUM at UMKC)
➢ A printed questionnaire the patient fills out

Answer 7

medical history

Question 8

_________= patient has already been diagnosed or,

patient presents with information needing a diagnosis

Answer 8

• MED history

Question 9

The point of a ____ is to screen for potential new diseases • Screening through signs and symptoms with a systems-based approach
• Findings may be consistent with a particular systemic disease, but you will not diagnose
• Physician’s role →further examine, request labs, diagnose
• Referral consultation letter →express findings, concerns and a basis for ROS

Answer 9

ROS (Review of Systems)

Question 10

➢ Ability to perform common daily tasks can be expressed in _________

Answer 10

metabolic 
equivalent levels (METs)

Question 11

If the MET is ______; = better physical condition

Answer 11

Higher

Question 12

➢ They are important because their use can result in adrenal
insufficiency and the patient is unable to mount a normal response to
the stress of an infection or invasive dental procedure, e.g., extractions
or periodontal surgery.

Answer 12

Steriods

Question 13

• Risk factor for many cancers and other diseases
• May lead to liver cirrhosis, many complications
• Ask how many standard drinks /week

Answer 13

Alcohol consumption

Question 14

If the cuff is too small taking bp, will the values be lower or higher than expected?

Answer 14

Falsely elevated

Question 15

If the cuff is too large taking bp, will the values be lower or higher than expected?

Answer 15

Falsely low

Question 16

At what bp is dental care not allowed at the school?

Answer 16

> 180/110

Question 17

If arm is too low, how is bp affected?

Answer 17

Falsely elevated bp

Question 18

If arm is too high, how is bp affected?

Answer 18

Falsely low

Question 19

What is the bpm where the pulse is tachycardic?

Answer 19

> 100 bpm

Question 20

What is the bpm where pulse is bradycardic?

Answer 20

<60 bpm

Question 21

What is the normal respiratory rate?

Answer 21

12-16 breaths/min

Question 22

_____ can indicate cardiac or pulmonary insufficiency

Answer 22

Cyanosis

Question 23

Yellowing or jaundice may be due to ____ disease

Answer 23

liver disease

Question 24

Petechiae or ecchymoses can be sign of ________ or _________

Answer 24

blood dyscrasia or bleeding

disorder

Question 25

Clubbing of digits are signs of ____ and/or ______ problems

Answer 25

CV or pulmonary problems

Question 26

``` ASA __ A normal healthy patient ▪ Pt is able to walk up one flight of stairs or 2 level city blocks without distress ▪ Little or no anxiety ▪ Little or no risk during treatment ```

Answer 26

ASA PS 1

Question 27

``` ASA ____ ▪ ASA 1 w/ respiratory condition, allergies, phobic, pregnant ▪ Diet or hypoglycemic agent-controlled diabetic ▪ Well-controlled asthmatic ▪ Well-controlled epileptic ▪ Well-controlled hypertensive, not on medication ▪ Pt has mild systemic disease ▪ ASA PS1 with extreme anxiety/fear ▪ Pt walk one flight of stairs or 2 level city blocks, but has to stop after exercise because of distress ▪ Minimal risk during treatment ```

Answer 27

ASA PS 2

Question 28

``` ASA ____ ▪ Well-controlled hypertensive on medication ▪ Well-controlled diabetic on insulin ▪ Slight COPD ▪ 30 days or more ago hxof: ➢ Myocardial infarction ➢ Cerebrovascular accident ➢ Congestive heart failure ▪ Severe systemic dz, limits activity but not incapacitated ▪ Can walk up 1 flight of stairs or 2 level city blocks but has to stop on the way b/c of distress ▪ If dental care is needed, stress reduction protocol and other tx modifications are indicated ```

Answer 28

ASA PS 3

Question 29

``` ASA ______ ▪ Hx unstable angina, MI, CVA in last 30-days ▪ Severe congestive heart failure ▪ Mod to severe COPD ▪ Uncontrolled hypertension ▪ Uncontrolled diabetes ▪ Uncontrolled epilepsy or seizure disorder ▪ Severe systemic dz, limits activity and constant threat to life ▪ Unable to walk up 1 flight of stairs or 2 level city blocks. Distress is present at rest ▪ Pt poses significant risk during treatment ▪ Elective dental care postponed until ASA 3 class ▪ Emergency dental care may be best in a hospital with a consultation with the Pt’s physician team ```

Answer 29

ASA PS 4