Pre-clinic
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| infectious process is... | pathogen...reservoir...mode...entry...susceptible host...
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| standard precautions include | body fluids, secretions and excretions
does not include sweat
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| Universal Precautions were.... | first and pertained to only blood
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| Tuberculosis is spread by... | droplet nuclei, not transmitted by fomites
contracted by inhalation of droplets from infected person
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| In TB, exposure does not mean | infection
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| Factors affecting transmission for TB | high degree of infected person producing droplets
amount and duration of exposure
susceptible recipient
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| Hepatitis B is transmitted by.. | blood and bodily fluids, virus can live on fomites
HCW are 3x more at risk for this
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| Hepatitis C is transmitted by | similar to Hepatitis B (blood and bodily fluids)
most chronic blood borne illness in US
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| Which virus have no reports of transmission from infected DHCP to patients or patients to patients? | HCV
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| HIV an AIDS is transmitted by... | through exposure to blood or body fluids, no fomites and must have blood source
oral signs may be first symptoms
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| what are the most common mode of pathogen transmission? | hands
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| handwashing is... | washing hands with plain soap and water
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| antiseptic handwash is | washing hands with water and soap or other detergents containing an antiseptic agents
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| alcohol based handrub is | rubbing hands with an alcohol containing preparation like ethanol or isopropanol
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| HIV/AIDS is contracted through droplet nuclei (T/F) | False
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| HIV dies off immediately without a blood source (T/F) | True
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| Alcohol based hand rubs benefits | rapid and effective, improved skin condition, more accessible than sinks
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| Alcohol based hand rubs limitations | can't be used if hands are visibly soiled, can't be around high temperatures or flames, may build up
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| Hand washing time | 15 seconds
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| Hand rub time | 20 seconds
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| Aerosols are... | <50 u usually <5 u
remain suspended in the air and can be breathed deep into lungs
like parachutes
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| Splatter is | > 50 u
usually fall within 2 feet of origin
may be visible on skin, clothing or in hair
like grenades
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| Putting PPE order on | gown, mask, goggles, gloves
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| what are ineffective as pre-procedural mouth rinses? | listerine zero or scope
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| what are effective pre-procedural mouth rinses | listerine - 30 seconds
chlorhexadine- 60 seconds
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| critical instruments are | penetrate mucous membranes or contact bone, the bloodstream, or other normally sterile tissues
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| what should be used to sterilize critical instruments? | heat sterilize between uses or use sterile single use or disposable devices
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| semi critical instruments are | contact mucous membranes but do not penetrate soft tissues
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| what should be used to sterilize semi critical instruments | heat sterilize or high level disinfect
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| non critical instruments are | contact intact skin
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| test agent for moist heat | geobacillus stearothermophilus
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| test agent for dry heat | bacillus atrophaeus
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| test agent for chemical vapor | geobacillus stearothermophilus
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| sterilization is | process which destroys all types and forms of microorganisms including viruses, bacteria, fungi and bacterial endospores
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| conditions for moist heat | 15-30 minutes at 250F/151lbs psi
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| considerations for moist heat | may corrode carbon steel, unsuitable for oils and powders, dulls instruments, paper packages come out wet
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| dry heat conditions | 120 minutes at 320 degrees F
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| considerations for dry heat | may damage rubber and some plastics, hand pieces
long exposure time, high temperature required
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| chemical vapor conditions | 20 minutes/ 270F
20-40 lbs psi
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| chemical vapor considerations | cannot use for low melting plastics, liquids, heat sensitive hand pieces
ventilation necessary, may damage rubber and plastic items
Odor, adequate ventilation needed
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| what microorganism is used to test the killing power of disinfection agents? | mycobacterium tuberculosis
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| high level disinfecting agent kills | some bacterial spores
HBV,HIV, and TB
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| intermediate level disinfecting agent kills | HBV, HIV, TB
may not kill spores
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| low level disinfecting agent... | does not kill spores
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| disinfection definition | the process by which most pathogenic microbes are killed
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| disinfectant qualities... | substantivity (continues to work after wiped off)
broad spectrum, compatible to environment and surfaces, EPA approved, odorless, fast acting, cost prohibitive
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| chemical sterilants | glutaraldehydes used to disinfect impressions
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| chemical sterilants considerations | corrosive to some metals, very irritating to skin and eyes, not a surface disinfectant
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| do not used glutaraldehydes as | aerosol spray
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| what is the medical emergency number | 2299
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| what is the security number | 8335
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| where can you obtain the medical emergency kit | dispensary
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| where are no gloves allowed? | clean window of dispensary
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| where are the oxygen tanks located | unit 3
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| where is the eyewash station located | unit 5 and graduate perio
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| advantages for Chemical Vapor Sterilization | corrosion and rust free operation for carbon steel instruments
ability to sterilize in short cycle
ease of operation
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| advantages of moist heat | all microorganisms including spores and viruses are killed quickly
wide variety of materials can be treated, most economical form of sterilization
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| advantages of dry heat | materials that cannot be subject to steam under pressure work
well suited for sharp instruments when pressure is maintained
no corrosion compared with steam under pressure
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| procedure for flushing the lines | Flush water lines at least 2 minutes at the beginning of each day
Run water through water tubing for 30 seconds before and 30 seconds after each patient appointment
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| post exposure follow up | STOP note what and how and why it happened
REMOVE cause
Cleanse/Flush wound, SAVE GLOVE
Stabilize patient (do not dismiss)
tell patient what happened
GET HELP- notify faculty
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| post exposure protocol must be initiated within... | 2 hours
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| No exposure happened... | no bleeding, no breaking skin, no break in glove, no contact
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| tuberculosis is transmitted from one person to another by means of droplet nuclei (T/F) | True
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| The most common mode of pathogen transmission is | hands
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| When using an alcohol-based hand rub, approximately how long should the clinician rub the suspension into their hands? | 20 seconds
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| an abnormally low heart rate is called... | bradycardia
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| The AED is located | in hallway, by the women's restroom
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| carpel tunnel syndrome (CTS) | disorder of the wrist and hand due to compression of the median nerve in the wrist
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| symptoms of carpel tunnel syndrome (CTS) | Numbness, pain, tingling in the thumb, index, and middle fingers
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| Ulnar Nerve Entrapment | disorder of the lower arm and wrist caused by compression of the ulnar nerve at the wrist
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| Symptoms of ulnar nerve entrapment | Numbness, tingling, and/or loss of strength in the lower arm or wrist
pinkie finger and ring finger
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| Tendonitis | inflammation of the tendons of the wrist
caused by repeated bending the hand up, down or from side to side from the wrist
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| Tendonitis symptoms | Pain in the wrist, especially on the outer edges of the hand, rather than through the center of the wrist
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| Thoracic Outlet Syndrome | disorder of the fingers, hand and or wrist due to compression of the brachial nerve plexus and vessel
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| Thoracic Outlet Syndrom caused by | tilting the head forward
hunching the shoulders forward
continuously reaching overhead
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| Rotator Cuff Tendonitis | inflammation of the muscle tendons in the shoulder region
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| Rotator Cuff Tendonitis is caused by | holding the elbow above waist level
holding the upper arm away from the body
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| What are the contradictions to supine position | congestive heart disease
vertigo
breathing difficulty
pregnancy
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| where should the light be to see mandible | chin down on patient
light straight above shining on the tongue
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| Where should the light be to see the maxilla | chin up on the patient
light towards palate
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| what is a working distance acceptable for a hygienist? | 15-22 inches
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| mandibular chin is.. | always down
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| maxillary chin is... | always up
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| 9:00 | patient's head is always straight or to left
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| 12:00 | patient's head always straight or to right
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| use same positions on | all buccals on right side and all linguals on left side
all buccals on left side and all linguals on right side
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| what is included in the medical history? | medical history
dental history
current medications
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| amoxicillin dosage | 2 grams, 1 hour prior to treatment
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| clindamycin dosage | 600 mg, 1 hour prior to treatment
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| cephalexin | 2 grams, 1 hour prior to treatment
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| azithromycin/ clarithromycin dosage | 500 mg, 1 hour prior to treatment
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| if patient is allergic to amoxicillin, what can they take | clindamycin, cephalexin, azithromycin/clarithromycin
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| what is tachycardia | fast heart beat
greater than 100 bpm
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| what is bradycardia | slow hert beat
less than 50 bpm
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| what is the adult range for respiration | 14-20 rpm
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| where is pulse measured at? | radial artery
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| systolic is | highest blood pressure caused by ventricular contraction
first tap-tap
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| diastolic is | lowest pressure caused by ventricular relaxation
last tap
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| pulse pressure | difference between systolic pressure and diastolic pressure
safest at 40 mmhg
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| what is the normal adult pulse | 60-100 bpm
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| ASA I is | a normal healthy patient, no apparent disease present
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| ASA II is | mild, systemic disease; may or may not need dental modifications
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| ASA III is | moderate- to severe systemic disease, not incapacitating; may have drug concerns; dental management modifications
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| ASA IV is | severe systemic disease; life threatening; dental modifications necessary, may be seen in special facility
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| the heart rate is attained by palpating the brachial artery (T/F) | Fasle
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| 14-20 RPM is a heart rate within normal limits (T/F) | False
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| a patient with moderate to severe systemic disease that is not incapacitating would be classified as | ASA III
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| What are the three update questions | have there been any changes in your health since you were here? (give date)
are you taking any medication?
do you have any concerns or problems with your mouth or teeth?
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| Infective Endocarditis | viridans group streptococci
masses of bacteria and blood clots in areas of valvular abnormalities and turbulent blood flow
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| What is pre hypertension blood pressure and what do you do | 120-139/80-90
can perform elective treatment, inform and educate patient
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| what is stage 1 hypertension blood pressure and what do you do | 140-159/90-99
can perform elective treatment, educate patient, take serial readings and monitor later appointments. Suggest medical eval
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| what is stage 2 hypertension blood pressure and what do you do | greater than 160/ greater than 100
no elective treatment performed, inform and educate patient, take serial readings, medical consult needed
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| what is emergent blood pressure and what do you do | greater than 180/greater than 110
no elective treatment performed, terminate appointment after confirm readings, refer immediately to medical doctor
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| what is the normal respiration rate for an adult? | 14-20 RPM
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| Positioning for mandibular anteriors towards you | 9:00
head away from you, chin down, light on tongue
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| Positioning for mandibular anteriors away from you | 12:00
head straight or towards you, chin down, light on tongue
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| Positioning for maxillary anteriors all surfaces | 12:00
head facing straight, chin up, light on palate
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| positioning for mandibular posteriors, right buccal | 9:00
head left, chin down, light on tongue
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| Positioning for mandibular posteriors, left lingual | 9:00
head left, chin down, light on tongue
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| Positioning for Maxillary Posteriors, right buccal | 9:00
head left, chin up, light on palate
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| positioning for Maxillary Posteriors, left lingual | 9:00
head left, chin up, light on palate
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| Positioning mandibular posteriors, right lingual | 9:00
head right, chin down, light on tongue
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| Positioning for mandibular posteriors, Left buccal | 9:00
head right, chin down, light on tongue
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| Positioning for Maxillary Posteriors, right lingual | 12:00
head right, chin up, light on palate
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| Positioning for Maxillary Posteriors, left buccal | 12:00
head right, chin up, light on palate
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| flow chart for positioning | me (clock position), my patient (head position), equipment
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