CH 1 - 6 REVIEW
ASA II
- Mild systemic disease - Controlled type 2 diabetes - Controlled epilepsy - Controlled hypertension (Stage 1) - Allergies - Fearful dental patient - Pregnancy - Mild lung infection
ASA I
- Normal healthy patient - No organic, physiologic, or psychiatric disturbance - Excludes the very young and very old - Non-smoker - No-minimal alcohol use
ASA IV
- incapacitating systemic disease that is a constant threat to life - - MI or CVA w/in past 6 mo (book) 3 mo ago (ppt) - Unstable angina - Heart failure - Uncontrolled diabetes - Uncontrolled epilepsy - Hypertension w/ BP > 180/110 - Uncontrolled thyroid conditions
ASA V
- moribund pt not expected to survive 24 hrs w/ or w/o operation - Multiorgan failure - Poorly controlled coagulopathy - Sepsis with hemodynamic instability
ASA III
- severe systemic disease that limits activity but is not incapacitating - - Stable angina - Myocardial infarction (MI) longer than 6 mo ago (book) 3 mo ago (ppt) - Controlled type 1 diabetes - Renal failure - Controlled heart failure - Poorly controlled hypertension w/ BP >160/100 (Stage 2) - Morbid obesity - COPD
________________ % of medical emergencies in the dental office are due to a mild allergic reaction.
8
All of the following are symptoms of hypertensive urgency EXCEPT: A. dysarthria. B. headache. C. tinnitus. D. epistaxis.
A
Individuals with hypertension are at higher risk for: A. cerebrovascular accident. B. diabetes. C. seizures. D. asthma.
A
Nitroglycerine is indicated for all of the following emergencies EXCEPT: A. cerebrovascular accident. B. acute angina. C. myocardial infarction. D. heart failure.
A
Symptoms of orthostatic hypotension include: A. dimming of vision. B. increased blood pressure. C. tachycardia. D. all of the above.
A
The blood pressure cuff should be inflated: A. 20-30 mmHg higher than the reading when you no longer feel the radial pulse. B. to 200 mmHg. C. until the branchial pulse is no longer heard in the stethoscope. D. none of the above.
A
The force of blood against the blood vessel walls during ventricular contraction is: A. systolic blood pressure. B. diastolic blood pressure. C. pulse pressure. D. hypertension.
A
The next MOST available person to the operator whose patient is experiencing an emergency is responsible for: A. recording events of the emergency. B. contacting EMS. C. retrieving the emergency kit. D. preparing drugs from the kit for use.
A
The use of oxygen and the production of carbon dioxide and their exchange between the cells and blood is: A. internal respiration. B. external respiration. C. bradypnea. D. orthopnea.
A
To determine that you have a tight seal with a bag mask the operator should look for: A. the chest to rise. B. the pupils to constrict. C. the nasal passages to dilate. D. none of the above.
A
What is the MOST common artery used to take a patient's pulse rate in the dental office? A. Radial B. Branchial C. Femoral D. Carotid
A
What is the pediatric dose of diphenhydramine? A. 1 mg/kg of body weight B. 2 mg/kg of body weight C. 3 mg/kg of body weight D. 4 mg/kg of body weight
A
Your patient's respiratory rate is 16 per minute. This would be considered: A. normal. B. bradypnea. C. hypernea. D. orthopnea.
A
ASA VI
a declared brain dead pt whose organs are being harvested for donation
An irregular pulse is indicative of a/an _________________.
arrythmia
A heart rate of less than 60 beats per minute is _________________.
bradycardia
If a patient states they have a bleeding disorder the operator needs to be alert to _________________ during patient treatment
bruising/hemorrhage
Person 2 (P2)
Assists P1; takes vital signs and administers oxygen, records events and time of medication delivery
A patient that has stable angina or well-controlled Type I diabetes would be considered: A. ASA I. B. ASA II. C. ASA III. D. ASA IV.
B
A size E oxygen cylinder will provide _____ minutes of oxygen. A. 15 B. 30 C. 45 D. 60
B
Albuterol: A. is administered intramuscularly. B. has a quick onset. C. lasts about 30 minutes. D. the adult dose is one spray and should not be repeated.
B
All of the following would be types of end organ damage signifying hypertensive emergency EXCEPT: A. cerebral hemorrhage. B. liver failure. C. renal insufficiency. D. aortic dissection.
B
An automated external defibrillator is an additional item for the emergency kit to care for which emergency? A. Asthma attack B. Cardiac arrest C. Broken instrument tip D. Anaphylaxis
B
The FIRST sound you hear when deflating the blood pressure cuff is the: A. diastolic blood pressure. B. systolic blood pressure. C. pulse pressure. D. radial pulse.
B
The amount of oxygen delivered through a bag mask is: A. 2-4 liters/minute. B. 4-6 liters/minute. C. 8-12 liters/minute.
B
The appropriate dosage of aspirin for use in an MI is: A. 81 mg. B. 162 mg. C. one baby aspirin. D. one-half baby aspirin.
B
Which is the only emergency for which oxygen is NOT usually recommended? A. Anaphylaxis B. Hyperventilation C. Hypoglycemia D. Asthma attack
B
Which of the following is a contributing factor in the increase in medical emergencies in the dental setting? A. Decreasing age of the population B. Advances in healthcare C. Advances in dentistry D. None of the above
B
The strength of the pulse against the blood vessel is referred to as the: A. cardiac output. B. pulse. C. stroke volume. D. pulse pressure.
C
What is the MOST common emergency to occur in the dental office? A. Mild allergic reaction B. Angina C. Syncope D. Anaphylaxis
C
Which of the following drugs is used for a severe allergic reaction? A. Albuterol B. Chlorpheneramine C. Epinephrine D. None of the above
C
Your patient has a blood pressure of 180/110. This would be considered: A. prehypertension. B. Stage I hypertension. C. Stage II hypertension. D. normal blood pressure.
C
Your patient's pulse rate is 102. This would be considered: A. normal. B. bradycardia. C. tachycardia. D. none of the above.
C
A patient with an incapacitating systemic disease that is a constant threat to life would be categorized as: A. ASA I. B. ASA II. C. ASA III. D. ASA IV.
D
A temperature of 99.8 degrees is considered: A. normal. B. hypothermia. C. low grade. D. pyrexia.
D
All of the following are common causes of tachycardia EXCEPT: A. fever. B. exercise. C. stimulant drugs. D. syncope.
D
All of the following are factors that affect respiration rate EXCEPT: A. age. B. body position. C. exercise. D. temperature.
D
All of the following questions should be asked of a patient who provides a positive response on the medical history for asthma EXCEPT: A. severity of attacks. B. frequency of attacks. C. trigger of attacks. D. all of the above questions should be asked.
D
All of the following should be taken into account when developing an emergency kit EXCEPT: A. proximity to emergency department. B. proximity to EMS. C. familiarity of dental team with kit contents. D. age of dental team members.
D
Brain damage or coma can occur if a patient has oxygen deprivation lasting for: A. 1 minute. B. 3 minutes. C. 5 minutes. D. 10 minutes.
D
In the REPAIR system for the management of medical emergencies the "I" refers to: A. recognizing the signs and symptoms. B. evaluating the patient's level of consciousness. C. positioning the patient appropriately. D. implementing the appropriate emergency protocol.
D
Patient vital signs include all of the following EXCEPT: A. pulse. B. respiration. C. blood pressure. D. weight.
D
T/F: A patient who can walk up two flights of stairs or two city blocks would be considered in the ASA III category.
F
T/F: An injectable benzodiazepine is necessary for the management of cerebrovascular accident
F
T/F: Cessation of breathing is termed tachypnea.
F
T/F: Hypertensive urgency is a significant severe rise in blood pressure with target end organ damage
F
T/F: Normal pulse rate is approximately 90-120 beats per minute.
F
T/F: Patients who are tachycardic or bradycardic are less likely to experience a medical emergency in the dental office than those that have a normal heart rhythm.
F
T/F: Patients with hypertension have a 70% increased risk of cerebrovascular accident.
F
T/F: Stridor is a high-pitched sound usually heard on respiration
F
T/F: The duration of action of albuterol is one to two hours.
F
T/F: The nasal cannula rests on the tip of the patient's nose and is looped around the ears. True
F
_________________ ______________ are an increased depth and rate of respirations over 20 per minute.
Kussmaul respirations
Person 3 (P3)
Retrieves emergency kit; prepares emergency drugs
Person 1 (P1)
Stays with patient; performs appropriate emergency treatment
T/F: A non-rebreather bag is recommended for patients suffering from an asthma attack or angina
T
T/F: A normal adult diastolic reading is 60-80 mmHg.
T
T/F: A reduction in systolic or diastolic blood pressure of 15-20 mmHg is considered hypotension.
T
T/F: Administration of a corticosteroid is indicated for the prevention of a recurrence of an anaphylactic reaction.
T
T/F: Biot's respirations are characterized by periods of shallow breathing alternating with periods of apnea.
T
T/F: Current CPR is necessary to be able to treat almost any medical emergency
T
T/F: Diphenhydramine IM is used for moderate allergic reactions that include primarily dermatologic signs with some respiratory symptoms.
T
T/F: External respiration is the intake of oxygen and elimination of carbon dioxide via the lungs.
T
T/F: For patients taking corticosteroids the operator needs to be alert to the signs and symptoms of adrenal insufficiency
T
T/F: Nitroglycerine tablets lose their effectiveness in 12 weeks if exposed to light or air. True
T
T/F: Patients who are tachypnic may be more likely to experience a medical emergency.
T
T/F: The non-rebreather bag has a one-way valve on the exhalation port to prevent room air from entering the mask.
T
T/F: The reducing valve allows for the safe release of the highly pressurized oxygen.
T
T/F: When applying the bag mask, the third, fourth, and fifth fingers should be placed on the bony portion of the mandible and the thumb and index finger placed on the mask to attain a tight seal.
T
_________________ of all medical emergencies in the dental office are life threatening.
1/3
The preferred type of oxygen delivery device used for patients in cardiac arrest is: A. nasal cannula. B. non-rebreather bag. C. bag mask. D. pocket mask.
C
If a patient responds positively on his or her medical history to epilepsy, you will need to be on the lookout for: A. dyspnea. B. hypoglycemia. C. seizures. D. none of the above.
C
A normal adult pulse pressure is _________________.
30-40 mmHg
The portion of the oxygen equipment that allows the operator to determine the amount of oxygen delivered to a patient is the: A. regulator. B. reducing valve. C. flow meter. D. cylinder.
C
Two important pieces of equipment needed for use during a medical emergency are a/an _________________ and a/an _________________.
AED; O2 tank
A patient with a mild systemic disease would be considered in the _________________ category.
ASA II
Normal blood pressure in children is based on their age, sex, and height and is at the _____ percentile or lower. A. 54th B. 76th C. 89th D. 95th
C
All of the following factors affect blood pressure EXCEPT: A. blood volume. B. blood viscosity. C. blood stenosis. D.blood vessel resistance
C
All of the following procedures will help to prevent an emergency in a dental office EXCEPT: A. accurate medical history taking. B. taking and recording vital signs. C. updating the medical emergency kit.
C
An unconscious patient suffering from severe hypoglycemia should receive: A. oral carbohydrate. B. SoluCortef IM. C. glucagon IM. D.nitroglycerine sublingually
C
Cyclic patterns of increased rate and depth of breathing alternating with periods of apnea is referred to as: A. Kussmaul respirations. B. Biot's respirations. C. Cheyne-Stokes respirations. D. None of the above.
C
_________________ may occur in children with extremely high fevers
convulsions
Labored breathing is termed _________________.
dyspnea
The use of steroids will help in the management of an allergic reaction by reducing the release of _________________.
histamine
The condition that was formerly known as hypertensive crisis is _________________.
hypertensive emergency
An oral carbohydrate is necessary to reduce the symptoms of _________________ in a conscious patient.
hypoglycemia
_________________ is a state in which the individual's body temperature is below normal range.
hypothermia
Normal breathing is _________________.
involuntary
Office receptionist (OR)
makes necessary phone calls
The MOST important component of the emergency kit is _________________.
oxygen
A/an _________________ is a magnetized device used for the removal of broken instrument tips.
perioretriever
The devices used to take a manual blood pressure reading are a stethoscope and a/an _________________.
sphygmomanometer
A/an _________________ should be included in the emergency kit to determine if a patient is suffering from pyrexia
thermometer
List the supplemental drugs of an emergency kit
· Glucagon · Atropine · Corticosteroid · Injectable benzodiazepine
List the essential drugs of an emergency kit.
· Oxygen · Epinephrine · Nitroglycerine · Diphenhydramine or chlorpheniramine · Albuterol · Aspirin · Oral carbohydrate
