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Medical Emergencies

Chapter 10

Benign noncancerous, will not move from local area of the body
Hyperglycemia abnormally high levels of glucose in the blood
Hypoglycemia abnormally low levels of glucose in the blood, usually caused by taking too much insulin
Insulin resistance the condition in which insulin receptors will not bind with insulin and hyperglycemia results because blood glucose cannot enter the cells
Ketoacidosis high acidic pH of tissues accompanied by increased ketones in the body resulting from inappropriate protein metabolism
Malignant abnormal cells capable of invading tissue and causing death
Mucositis inflammation of a mucous membrane, often manifesting as an ulceration
Osteoradionecrosis the destruction and death of bone tissue from radiation therapy
Palliative therapy designed to soothe or relieve uncomfortable symptoms, not a cure
Pathology the study of disease
Stomatotoxic chemotherapy that causes injury to oral mucosal cells
Trismus prolonged spasm of muscles of the jaw area
Xerostomia loss of salivation, dry mouth
For individuals undergoing initial cancer therapy, oral healthcare should be performed: a- at least 14 days before cancer therapy when possible b- at least 14 days after initial cancer therapy c- between therapy tx d- not until cancer tx is completed a- at least 14 days before cancer therapy when possible
For clients who require oral healthcare during cancer therapy, laboratory blood studies should be performed to: a- determine baseline b- determine if antibiotics are needed c- prevent hemorrhage and infection d- prevent immunosuppression c- prevent hemorrhage and infection
Oral healthcare should be postponed when the neutrophil count is: a.1,000 mm3. b.1,500 mm3. c.2,000 mm3. d.2,500 mm3. a.1,000 mm3.
Individuals with a history of bone marrow or stem cell transplants should delay elective oral procedures for: a.1 month. b.6 months. c.9 months. d.1 year. d.1 year.
Radiation treatment carries a lifelong risk of: a.osteoradionecrosis. b.xerostomia. c.friable oral tissues. d.all of the above. d.all of the above.
Radiation therapy clients with salivary gland dysfunction should use daily fluoride applications: a.during cancer therapy. b.lifelong. c.6 months after cancer therapy. d.1 year after cancer therapy. b.lifelong.
DM causes which of the following complica-tions?a.Blindness b.Cardiovascular disease c.Kidney disease d.All of the above d.All of the above
The majority of DM cases are: a.type 1. b.type 2. c.gestational diabetes. d.secondary diabetes. b.type 2.
The most common medical emergency to occur in individuals with DM is: a.hypoglycemia. b.hyperglycemia. c.low blood pressure. d.syncope. a.hypoglycemia.
Hypoglycemia can be treated with the administration of: a.glucose. b.50% dextrose IV. c.glucagon IM. d.all of the above. d.all of the above.
Individuals with SLE taking long-term corti-costeroid therapy are at risk for acute adrenal insufficiency. They should be placed on supplemental steroids for oral procedures. a.both are T b.both are F c.the 1st is T, the 2nd is F d. False; True b.both are F
Antibiotic prophylaxis may be indicated for individuals with SLE who: a.have cardiac valve damage. b.take immunosuppressive drug therapy. c.have hypertension. d.a and b. d.a and b.
Potential emergencies in clients with SLE include: a.increased bleeding. b.kidney infection. c.acute adrenal insufficiency. d.all of the above. d.all of the above.
Individuals with RA may have other auto -immune diseases. Prophylactic antibiotics are strongly recommended for these clients. a.both are F b.both are T c.the first is true, the second is false d.the first is false, the second is true c.the first is true, the second is false
Individuals who have an organ transplantand who are taking immunosuppressant medications will be more susceptible to the following dental infections: a.bacterial b.fungal c.viral d.All of the above. d.All of the above.
List three signs of undiagnosed diabetes. Signs of undiagnosed diabetes include frequent urination, frequent thirst, healing slowly, and frequent infections, although the client may be asymptomatic.
Differentiate type 1 and type 2 DM. Type 1 in approximately 5% to 10% & during adolescence. heredity, idiopathic, & autoimmune destruction of pancreatic b cells. Type 2 in 90% to 95% of 45 yr. hereditary predisposition,obesity, & sedentary lifestyle. High-risk ethnic groups for type 2
Identify three disease conditions that involve persistent swollen glands or unexpected weight loss. Conditions that involve swollen glands or unexpected weight loss may include metastatic malignancy, metabolic disorders, and diseases of lymphatic tissues.
CASE STUDY A: What steps should the dentist and dental hygienist take to perform a comprehensive oral health evaluation for this client? Identify & tx existing infections, problem teeth, & tissue injury or trauma; stabilize or eliminate potential sites of infection; extract teeth that pose a problem; instruct client on oral hygiene use of fluoride gel, nutrition avoid tobacco & alcohol.
CASE STUDY A: List four benefits of providing oral care as part of a cancer pre-treatment regimen. Reduces the risk of oral complications, improve individual optimal doses of tx, prevent oral infection or minimize complications, reduces the incidence of bonenecrosis in radiation clients, preserves or improves oral health, and improve quality of life.
CASE STUDY A: What suggestions would you recommend if the client develops xerostomia associated with radiation therapy? frequent sips of water, suggest using liquids to soften or thin foods, recommend using sugarless gum or sugar-free hard candies to help stimulate saliva, suggest using a commercial oral lubricant, prescribing a saliva stimulant drug, and fluoride therapy.
CASE STUDY A: What questions should you ask the oncol-ogist to prevent adverse emergency situations? What is the complete blood count,including absolute neutrophil and platelet counts? Are there adequate clotting factors? individual have a central venous catheter? What is the scheduled sequence of treatments so that safe oral health tx can be planned?
CASE STUDY A: f the client presents for a follow-up appointment during cancer therapy and reports a platelet count of 40,000 platelets/mm3, should treatment be postponed? Why or why not? Postpone treatment as client is at risk of hemorrhage and infection.
CASE STUDY B: What follow-up questions should you ask based on the client’s report of a recent diagnosis of DM? What have your recent blood sugar levels been? How often do you test for control of diabetes? Have you experienced hypoglycemia recently? Have you had any problems during dental treatment? When was your last appointment with your physician?
CASE STUDY B: During the course of the appointment, the client begins to experience perspiration,confusion, and lethargy. These signs rep-resent what condition? Hypoglycemia
CASE STUDY B: What management would you provide for the client who experiences perspiration,confusion, and lethargy? Provide a sugar source such as candy, juice,or glucose tablet. If the client is uncooperative or loses consciousness, dial 911 and provide basic life support. Either 50% dextrose intravenously or intramuscular glucagon can be administered.
CASE STUDY B: What strategies could be used to prevent this type of emergency? has eaten a meal after taking anti-diabetic medication and observe for signs of hypoglycemia, avoid scheduling appointments around the peak effect of taking diabetes medications, and avoid lengthy appointments
Created by: daisenmurray