ASTHMA
DH 24 - Mrs. Kunz
DEMOGRAPHICS:
Name: Mr. Lee
Age: 35
Gender: Male
Race: Asian
PHYSICAL ASSESSMENT:
Wheezing, coughing, dyspnea, repiratory distress, nasal flaring, difficulty speaking, breathlessness, chest tightness.
SOCIAL ASSESSMENT:
Living in a small and old apartment which has mold, cockroaches, and a dirty environment. He lost his job 6 months ago. He smokes at least a
half pack of cigarettes a day.
MENTAL ASSESSMENT:
He has been looking for a job for months but he has had no luck. His savings are getting low and he is getting worried. He suffers from stress.
MEDICAL ASSESSMENT:
Exercise induced asthma, smokes half a pack of cigarettes per day. His father inherited asthma from his father.
DENTAL HISTORY
His teeth have heavy brown stains from smoking. He does not use floss, he brushes twice a day, and he has not visited the dentist for 5 years.
COMUNICATION
* Review medical history with patient.
* Ask patient how frequency of asthmatic attacks?
* Determine the patient’s specific triggering agents.
* Length of time since an emergency visit owing to acute asthma.
* Does he take any medicine for the asthma?
* Does he use inhaler and has with him on hand?
* Check expiration date on inhaler.
* Determine if patient can safely tolerate procedure.
APPOINMENT PLANNING
* Patient’s appointment should be in the late morning or the late afternoon.
* Plan short appointments to decrease stress.
CLIENT POSITIONING
* Sit patient in semi-supine or upright chair position.
* Encourage patient to assume a position that facilitates breathing.
DH PROCEDURES
* Bacteria aerosols from plaque or caries lesions and the water also can be asthma triggers in the dental setting.
* Monitor periodontal status, client is increased risk for disease if a smoker.
* Asses for ineffective salivary flow related to medication induced xerostomia.
* Avoid eliciting a coughing reflex.
* Increased cavities, bad breath and gum problems are seen in patients with asthma.
SAFETY PRECAUTIONS
* Use of nitrous may prevent stress symptoms.
* Some asthmatics are sensitive to the sulfite preservative present in vascoconstrictors, in that case
* The use of a local anesthetic without epinephrine is indicated if they have severe allergies.
* No ultrasonic scaling/air polishing.
* Avoid using dental materials
* Have bronchodilators available on counter.
ORAL HYGIENE INSTRUCTION
* Prescribe fluoride
* Instruct patients to rinse their mouths after using an inhaler.
* Reinforce oral hygiene instructions
* Be aware of possible need to prescribe antifungal agentfor patients who chronical use nebulized corticosteroids.
* Consider smoking cessation.
* Recommend Xylitol, Biotene and hygiene aids.
* Educate parent on sugars and increased caries.
PERSONAL REFLECTION
Asthma is one of several respiratory conditions, but it is the one that has happened in my family. When I was young, I did not have any ideas to understand it when I saw my grandfather had to breath hard with an open mouth and made loud noises. I thought because he was old just like he told me. During my working life, I have seen many old patients and a few young teens who also have problem with asthma. I know they have to suffer just like my grandfather, but I did not have much knowlege about it.
My youngest brother had had asthma since he was born. He had to be hospitalized for weeks at the age of six. It caused so much pain and was so stressful for my parents at that time. After he arrived in America and visited the doctor a few times, his asthma gradually disappeared until it was completely gone. My dad told us that it was running in the family. His dad had asthma and he also had a mild, & under control asthma as well. My brother had extrinsic asthma. We have been very happy for him since then.
The information that was given in the class was helpful and answered all my questions about the mystery of asthma that I did not understand. I'm glad to have had a chance to learn more about all the diseases that make human beings suffer. And I'm glad I'm still healthy for now.
ADDITIONAL INFORMATION
www.webmd.com/asthma/guide/asthma-symptoms
www.emedicinehealth.com/asthma/article_em.htm
www.en.wikipedia.org/wiki/Asthma
DH 24 - Mrs. Kunz
DEMOGRAPHICS:
Name: Mr. Lee
Age: 35
Gender: Male
Race: Asian
PHYSICAL ASSESSMENT:
Wheezing, coughing, dyspnea, repiratory distress, nasal flaring, difficulty speaking, breathlessness, chest tightness.
SOCIAL ASSESSMENT:
Living in a small and old apartment which has mold, cockroaches, and a dirty environment. He lost his job 6 months ago. He smokes at least a
half pack of cigarettes a day.
MENTAL ASSESSMENT:
He has been looking for a job for months but he has had no luck. His savings are getting low and he is getting worried. He suffers from stress.
MEDICAL ASSESSMENT:
Exercise induced asthma, smokes half a pack of cigarettes per day. His father inherited asthma from his father.
DENTAL HISTORY
His teeth have heavy brown stains from smoking. He does not use floss, he brushes twice a day, and he has not visited the dentist for 5 years.
COMUNICATION
* Review medical history with patient.
* Ask patient how frequency of asthmatic attacks?
* Determine the patient’s specific triggering agents.
* Length of time since an emergency visit owing to acute asthma.
* Does he take any medicine for the asthma?
* Does he use inhaler and has with him on hand?
* Check expiration date on inhaler.
* Determine if patient can safely tolerate procedure.
APPOINMENT PLANNING
* Patient’s appointment should be in the late morning or the late afternoon.
* Plan short appointments to decrease stress.
CLIENT POSITIONING
* Sit patient in semi-supine or upright chair position.
* Encourage patient to assume a position that facilitates breathing.
DH PROCEDURES
* Bacteria aerosols from plaque or caries lesions and the water also can be asthma triggers in the dental setting.
* Monitor periodontal status, client is increased risk for disease if a smoker.
* Asses for ineffective salivary flow related to medication induced xerostomia.
* Avoid eliciting a coughing reflex.
* Increased cavities, bad breath and gum problems are seen in patients with asthma.
SAFETY PRECAUTIONS
* Use of nitrous may prevent stress symptoms.
* Some asthmatics are sensitive to the sulfite preservative present in vascoconstrictors, in that case
* The use of a local anesthetic without epinephrine is indicated if they have severe allergies.
* No ultrasonic scaling/air polishing.
* Avoid using dental materials
* Have bronchodilators available on counter.
ORAL HYGIENE INSTRUCTION
* Prescribe fluoride
* Instruct patients to rinse their mouths after using an inhaler.
* Reinforce oral hygiene instructions
* Be aware of possible need to prescribe antifungal agentfor patients who chronical use nebulized corticosteroids.
* Consider smoking cessation.
* Recommend Xylitol, Biotene and hygiene aids.
* Educate parent on sugars and increased caries.
PERSONAL REFLECTION
Asthma is one of several respiratory conditions, but it is the one that has happened in my family. When I was young, I did not have any ideas to understand it when I saw my grandfather had to breath hard with an open mouth and made loud noises. I thought because he was old just like he told me. During my working life, I have seen many old patients and a few young teens who also have problem with asthma. I know they have to suffer just like my grandfather, but I did not have much knowlege about it.
My youngest brother had had asthma since he was born. He had to be hospitalized for weeks at the age of six. It caused so much pain and was so stressful for my parents at that time. After he arrived in America and visited the doctor a few times, his asthma gradually disappeared until it was completely gone. My dad told us that it was running in the family. His dad had asthma and he also had a mild, & under control asthma as well. My brother had extrinsic asthma. We have been very happy for him since then.
The information that was given in the class was helpful and answered all my questions about the mystery of asthma that I did not understand. I'm glad to have had a chance to learn more about all the diseases that make human beings suffer. And I'm glad I'm still healthy for now.
ADDITIONAL INFORMATION
www.webmd.com/asthma/guide/asthma-symptoms
www.emedicinehealth.com/asthma/article_em.htm
www.en.wikipedia.org/wiki/Asthma