Friday, April 13th, was my last day of clinic and it was a very intense day. I completed my special need patient, an extra patient that may count as an adolescent if Ms. Jones approves it, and screened my board patient. My special need patient was MB, a 39 year old female who suffers from bipolar disorder, depression and stomach ulcers due to medications. My patient is under a physician’s care and is taking her medications. Her vitals were BP: 116/77, R: 20, P: 75, and her intraoral and extraoral exam was within normal limits. Her AAP classification is III and her case type is 2. During her last appointment, patient was given a referral to Kool Smile to check some suspicious areas that Dr. Landry found, but patient has not completed the …show more content…
For her appointment, I had in mind to use Oraqix as needed to do the whole mouth debridement, because she presented light supragingival calculus on mandibular teeth and generalized moderate gingival and interproximal plaque. The patient does not have deed pockets, but has generalized recession. I did the prophylaxis with hand instrument, but it represented a challenge because patient at one point refused that I use the instruments because it was bothering her while I was removing soft deposit supragingival. In this situation, I had to think outside the box and come up with a way to remove plaque and calculus and make the patient comfortable. I decided that brushing the patient and flossing will help me to remove the plaque, and this way I would only had to focus on removing the calculus. Thanks god, it worked. It took a lot of patience, positive encouragement and feedback on how much she has improved since her last visit, but I was able to complete the prophylaxis. For her next visit, I think that do to her generalized recession and sensitivity, the patient will benefit by having LA during her prophylaxis, even if it means that she will have …show more content…
DH has a high prevalence worldwide, affecting 25%-46% of 18–70 years old people, and it is consider a clinical oral health problem. The most acceptable theory that explain how DH occurs is the “hydrodynamic theory”, which states that pain is the result of the activation of pulpal nociceptors by the movement of dentinal fluid inside the dentinal tubules. Based on this theory, there is two ways to treat DH, one is by blocking neural transmission from the pulp, and the other, is by occluding the dentinal tubules. Therefore, desensitizing toothpaste containing potassium salts is recommended as a treatment since it is known to have nerve numbing effects. In addition, calcium sodium phosphosilicate (CSPS), it used to close the dentinal tubules by delivering silica and ionic calcium, phosphorus, and sodium to the surface of the tooth. Even though there is not a therapeutic gold-standard treatment that completely and predictably eliminates DH, self-administered dentifrice is the first choice of treatment for generalized DH because is simple and inexpensive. In-office treatment is usually target DH localized to one or more teeth (Zhu,
The patient has a history of anxiety disorder, depression, diabetes, and hypertension, controlled with medications.
[7]Similarly they are contraindicated in patients with low caries risk, teeth with shallow self cleansing grooves, patients with good oral hygiene maintenance,
As I started my new journey of becoming a dental hygienist, I came into the program with no background of dental. I came into this program with an open mind and willing to embrace new concepts as well as develop new skills. During my time at the Canadian Academy of Dental Hygiene (CADH), I learned that as a dental hygienist that I am committed to promoting and helping each individual achieve their optimal oral health goals. In support of my client’s goals, I may assume any or all of the roles included in the dental hygiene scope of practice. My goal throughout this program was to help my clients achieve their optimal oral health goals through education, health promotion and providing preventive and clinical therapy.
Dental practitioners take action to minimize the risk of a disease from certain procedures that may allow bacteria from the mouth to enter the bloodstream. Antibiotic premedication therapy is a prophylactic measure that prevents bacteria from being released into the blood stream. The bacteria can infect the heart lining, as well as the valves or blood vessels, causing them to become inflamed. Infective endocarditis (IE), the name for the inflammation, has the potential to be fatal or debilitating. The risk of developing IE can happen from a combi¬nation of high-risk patients and dental procedures. While this is not an issue for most patients, some do require protection. The American Heart Association recommends antibiotic premedication therapy before dental procedures. But only for those whose cardiac conditions as well as a few other conditions are associated with the highest risk of adverse outcome.3
In conclusion, it is important for the dental staff to treat all patients as if they are infected. A patient may or may not choose to disclose any information pertaining to their disease or they may not be aware of it. It is also important for the dental staff to have immunizations done at regular intervals. The hygienist needs to make sure he or she protects him or herself as well as the patient during treatment. Discrimination against someone with a disease is illegal. With that in mind it is the clinician’s duty to be aware of diseases he or she may come into contact with and how to treat the patient.
Jane had not slept for 72 hours and had poor diet and was observed not to be drinking fluids. Jane has a diagnosis of Bipolar
During one of my rotations, I was assigned a young adult patient who had run out of insulin and had been admitted to the hospital following a Diabetes Ketoacidosis (DKA) episode. I realized that my patient was probably torn between buying insulin and buying healthy food because her chart showed several admissions in the past following the same problems. This particular patient was in her room, isolated in a corner, and she was irritable. As her student nurse, I was actively involved in her care; I was her advocate for the day. The patient lived with her single mother and worked at a fast food restaurant. Since this was my first time dealing with a patient with DKA, it became a definite challenge for me.
When I was working as a bedside nurse in the Emergency Department, in one of my duties I was not satisfied with the treatment plan made by a resident doctor for XYZ patient. He entered intravenous KCL (potassium chloride) for the patient. The purpose of that medication and its dose for that patient was not clear to me. I assessed patient history and came to know that a middle aged patient came with the complaint of loose bowel movements, vomiting, and generalized weakness. His GCS (Glasgow comma scale) was 15/15, looked pale but was vitally stable. I exactly do not remember about his previous disease, social or family history but I do remember that he was there with his son. According to the care plan, I inserted intravenous cannula, took blood
The patient was transferred into my care via the Emergency Assessment Unit for Surgical Patients (EAUS). I was given handover by the charge nurse who has already pre-a...
My first patient that I started as student nurse on one of the long Rehab Center was a seventy two year old man who had Clostridium difficile (C.diff), Dementia, Hip replacement, and Obesity. Due to the above sickness he had many complications. I can still remember his face suffering from pain. Because of his lack of ambulation and incontinence, he had developed a very serious pressure ulcer under his sacral area. I went through to the room with my instructor and the instructor introduces me for the patient as his student nurse from Towson University and will taking care of him. However the patient was not happy and he becomes a challenging patient in my first experience day. But I may learned more from that challenging patient for my future experience.
The prevention of periodontitis is straightforward for patients. The first step in prevention is to assure that the patient is brushing twice a day utilising the proper brushing technique. Patients who fear the contraction of periodontitis are not encouraged to brush too much however, as excessive brushing with poor technique can lead to other oral problems such as the reduction of the gums (gingival recession). Brushing at least twice a day help inhibit the growth of unwanted bacteria and prevents plaque, and thus tartar from forming. Patients who wish to prevent periodontitis should also floss daily. Flossing daily includes the spaces between each tooth, as well as behind the last two molars on the mandibular and maxillary arches. Flossing should get in below the gum line to prevent bacteria from congregating just below the surface. The last at home, over-the-counter treatment available for the prevention of periodontitis is the use of an antiseptic mouthwash. While proper use of mouthwash in conjunction with the other techniques can help cure gingivitis, once periodontal disease has elapsed stage 1 of periodontal disease, no amount of mouthwash or brushing can restore attachment lost in the periodontium.
On my first day of week three clinical at 0830, client W and I were on our way to the dinning room and client B asked me to put his jacket on, so I told client W that I would meet him in the dinning room. After I helped Client B, I was on my way to the dinning room and nurse A told me that client W was experiencing difficulty breathing and we needed to give him his 0900 inhalers earlier. He was having audible wheezing and rapid respiratory rate. Therefore, we had to give client W his inhalers, SalbutaMOL Sulfate, which is a bronchodilator to allow the alveoli in the lung to open so th...
However, on the a recent visit dated 23/12/13 the patient’s gingival condition had deteriorated, presenting with an increased plaque scores of 34% and bleeding scores to 63%. Intra oral examination also showed generalised oedema and erythema throughout in the mouth in response to this increase in plaque bacteria. The presence of supra-gingival calculus on lower anterior teeth and both sites of upper buccal molars and the patients BPE now reads 212 /121, putting the patients caries risk at a ‘High’ status.
The nurse confirmed patient identification, asked subjective questions focusing on chief complaints, performed a focused assessment, obtained medication list, baseline vitals, and assessed the patient’s past medical history. She asked the patient questions such as previous hospitalization/surgery, metal implants, allergies, health history, sleep apnea, and alcohol/tobacco use. The nurse told the patient the doctor would be with her shortly. The nurse reported to the doctor regarding the patient and obtained orders for treatment from the doctor. The nurse then started an IV line and hung an IV solution bag of normal saline because the patient was experiencing abdominal pain. The nurse also administered pain medications and the patient was ready to be discharged. The nurse gave discharge instructions and made sure that the patient had a ride
After the handover, I was asked by my mentor to attend to a patient who is bed ridden to have her personal care done with the assistance of one of the health care assistant staff. The patient was recently admitted to the ward and she looks sc...