1. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 1 Chapter 11 Preparation for Patient Care

2. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 2 Information Gathering Personal Medical Dental

3. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 3 Personal Information Name and address Social security number Insurance information Physician name Emergency contact

4. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 4 Medical Information Past surgeries Systemic diseases Allergies Injuries

5. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 5 Past Surgeries Heart valve replacement Joint replacement

6. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 6 Antibiotic Prophylaxis American Heart Association guidelines –Amoxicillin/penicillin 2 grams 1 hour before procedure –Clindamycin For patients allergic to penicillin 600 mg 1 hour before procedure

7. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 7 Systemic Diseases Heart disease Epilepsy Diabetes Asthma/emphysema Parkinson’s disease Multiple sclerosis Cancer

8. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 8 Health Alerts for Antibiotic Prophylactics Mitral valve prolapse (MVP) Heart murmurs –Valvular regurgitation Prosthetic heart valve Systemic pulmonary shunts Past surgeries

9. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 9 Allergies of Concern Anesthetic Latex Medication

10. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 10 Injuries Back Jaw Neck

11. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 11 Dental Information Patient concerns/reason for appointment Patient attitude toward dentistry Quality of previous dental care

12. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 12 Clinical Observation Gait Speech Behavioral problems Hands and fingernails Eyes –Dilated Facial symmetry –Droopy eyelids

13. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 13 Extraoral Evaluation Mouth and lips –Cracking or ulceration External floor of mouth Lymph nodes Temporomandibular joint (TMJ)

14. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 14 Intraoral Evaluation Lesions Abscessed teeth Color changes Tissue irregularities Soft tissue: oral mucosa Hard tissue: teeth

15. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 15 Charting Existing Conditions

16. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 16 Examining the Lips Smile line Vermilion border Commissures of the lip

17. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 17 Examining the External Tissue of the Mandible and the Floor of the Mouth

18. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 18 Examining the Cervical Lymph Nodes Swelling Abnormalities Tenderness Infection

19. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 19 Examining the Temporomandibular Joint Noises Tenderness Pain Limited function

20. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 20 Examining the Floor of the Mouth Tenderness Abnormalities Lesions Bony tori

21. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 21 Examining the Oral Mucosa and Frenum Frenum attachment: a narrow band of tissue that connects two structures –Labial –Buccal –Lingual

22. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 22 Examining the Tongue and Palate Palatal tori Geographical tongue Precancerous lesions

23. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 23 Examining the Tongue Color Papillae Coating Abnormalities

24. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 24 Vital Signs Body temperature Pulse Blood pressure Respiration rate

25. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 25 Antipyretic: Method of Reducing Fever Cold pack Alcohol rub Aspirin

26. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 26 Hypothermic Body temperature is below normal. Possible causes: –Too much aspirin –Prolonged exposure to cold

27. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 27 Radial Pulse Adults: –60 to 90 beats per minute Children: –90 to 120 beats per minute

28. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 28 Pulse Rates Tachycardia –Rapid resting pulse rate Bradycardia –Abnormally slow pulse

29. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 29 Respiration The process of inhaling and exhaling (breathing) Normal respiration –Adults 10 to 20 breaths per minute –Children 20 to 26 breaths per minute

30. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 30 Blood Pressure The amount of labor the heart has to exert to pump blood throughout the body

31. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 31 Normal Readings Adults: 120/80 –Systolic: below 140 –Diastolic: below 90 Children: 100/66 Adolescents: 118/76

32. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 32 Systolic The first sound heard when taking blood pressure The highest number in the reading Caused by the heart contracting and forcing blood through the arteries

33. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 33 Diastolic Reflects the heart muscle at rest Heart takes blood to be oxygenated before the next contraction

34. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 34 Taking Blood Pressure Extend the patient’s arm to the level of the heart. Make sure arm is supported and relaxed. Place the cuff 1 to 2 inches above the antecubital space. Wrap and secure cuff around arm. Expel all air from cuff before taking BP. Inflate cuff to 160 to 180. Slowly release 2 to 4 mm mercury per second.

35. Copyright © 2004 by Delmar Learning, a division of Thomson Learning, Inc. ALL RIGHTS RESERVED. 35 Locating the Brachial Artery