Respiratory Emergencies

Question 1

Why is candidiasis a dental consideration for asthmatic patients?

Accepted Answer

Corticosteroid inhalers increase susceptibility to infection, More susceptible in someone who is immunocompromised, More susceptible in someone who takes medication that changes oral mucous, Red or white lesions where spray hits the soft palate

Question 2

What are predisposing factors for asthma?

Accepted Answer

Emotional stress (anxiety), Exercise, Allergens, Pollution, Early childhood infection

Question 3

What are some examples of allergens that may cause asthma?

Accepted Answer

Mold, Dust mite and cockroach waste, Grass, Pet epithelial cells, Pollen

Question 4

A severe asthma reaction is when 3 doses of bronchodilator fail to resolve the condition

Accepted Answer

True

Question 5

Why would epinephrine NOT be given if there are no symptoms of allergic reaction?

Accepted Answer

Condition could be made worse, Unconscious could be due to other condition

Question 6

ASA IV receive conservative ER dental treatment only, NOT appropriate for dental hygiene

Accepted Answer

True

Question 7

What is included in management of a pulmonary embolism?

Accepted Answer

Active CABs of CPR, Monitor vitals, Activate code blue/EMS immediately, Sit patient upright

Question 8

How are allergic reactions prevented in the dental setting?

Accepted Answer

Thorough Mhx, Do not use any drugs/substances the patient is allergic to, Avoidance

Question 9

What are the different types of asthma?

Accepted Answer

Infectious asthma, Extrinsic asthma, Intrinsic asthma, Exercise induced asthma, Drug induced asthma

Question 10

Characteristics of intrinsic asthma include:

Accepted Answer

Caused by non-allergic factors like stress, Commonly in older adults (>35)

Question 11

What would be done in the refer part of REPAIR if the asthma reaction was severe?

Accepted Answer

ER team administer IV epinephrine

Question 12

What conditions may be associated with ASA II?

Accepted Answer

Controlled/stable systemic disease (diabetes, hypertension, asthma), Smoker/social drinker, Behavior problems/extremely anxious, Obesity (BMI between 30-40), Severe allergies, Pregnancy

Question 13

What should be done when managing a total obstruction?

Accepted Answer

Activate code blue if unconscious, Administer Heimlich maneuver until patient is unconscious, Administer Heimlich maneuver until object is expelled, Lay patient back and begin BLS

Question 14

What are some characteristics of ASA IV?

Accepted Answer

Severe reduction of ejection fraction, End stage renal disease without regular dialysis, Sepsis, Recent <3 mo - heart attack, stroke, TIA, CAD/stents, Unable to walk a flight of stairs or 2 level city blocks, Ongoing cardiac ischemia or severe valve dysfunction

Question 15

What does IV epinephrine do?

Accepted Answer

Bronchodilator, Vasoconstriction

Question 16

What are characteristics of ASA I?

Accepted Answer

Can walk a flight of stairs without shortness of breath, Minimal dental anxiety

Question 17

Why is xerostomia a dental consideration for those with asthma?

Accepted Answer

Mouth breathers due to asthma, Many asthma medications decrease saliva flow (corticosteroids)

Question 18

What does COPD stand for?

Accepted Answer

Chronic obstructive pulmonary disease

Question 19

What are symptoms of allergic reaction relating to the circulatory system?

Accepted Answer

Hypotension, Complete circulatory collapse, Cardiac arrhythmias, Shock

Question 20

Signs and symptoms of asthma include:

Accepted Answer

Tightness in chest, Increased patient anxiety leading to increased respirations, Severe attacks may lead to total airways obstruction/failure, Coughing, wheezing, dyspnea, Increased heart rate, Status asthmaticus

Question 21

What is important to note on a patients medical history with allergies?

Accepted Answer

Pain relievers, Antibiotics, Anti anxiety drugs, Local anesthetic

Question 22

Angioedema is painful and itchy

Accepted Answer

False

Question 23

What is considered a mild allergic reaction?

Accepted Answer

No cardiovascular effects, No respiratory effects

Question 24

What are two types of foreign body airway obstructions (FBAQ)?

Accepted Answer

Total airway obstruction, Partial airway obstruction

Question 25

What are symptoms of allergic reaction relating to the gastrointestinal system?

Accepted Answer

Vomiting, Nausea, Diarrhea

Question 26

What are characteristics of ASA II?

Accepted Answer

Can walk a flight of stair but will have shortness of breath when done, Can walk 2 level city blocks but will have shortness of breath when done, Proceed with dental treatment with caution

Question 27

Which type of asthma episode could treatment be continued?

Accepted Answer

Acute episode

Question 28

Ways to prevent an asthma attack:

Accepted Answer

Explain/demonstrate procedures, Avoid threatening terms, Have bronchodilator’s on the counter, Keep anxiety levels down

Question 29

What is considered a severe allergic reaction?

Accepted Answer

Severe hypotension, Dyspnea, Laryngeal edema

Question 30

What are characteristics of epinephrine?

Accepted Answer

Rapid onset, Counteracts histamine, NEVER administered unless SURE of allergic reaction, Contracts capillaries and arteries, Main med for severe allergic reaction

Question 31

An acute episode of an asthma attack is NOT resolved with a bronchodilator

Accepted Answer

False

Question 32

What is included in management of an allergic reaction WITHOUT symptoms?

Accepted Answer

Supine with feet elevated, Acativate code blue/EMS, Oxygen, Continually monitor vitals/BLS, DO NOT ADMINISTER EPINEPHRINE

Question 33

It is necessary to refer to ER if any suspicion of aspiration due to dangers of leaving object in lungs.

Accepted Answer

True

Question 34

What are causes of pulmonary embolisms?

Accepted Answer

Fat, Air, Tumor, Thrombus

Question 35

What is included in the implement part of management of an allergic reaction WITH symptoms?

Accepted Answer

Mild reaction = consider histamine blocker, Severe reaction = give epinephrine, Severe reaction = oxygen

Question 36

What are modifications for patients with COPD?

Accepted Answer

May not be able to lay all the way back, May need to work standing so patient remains upright

Question 37

What are predisposing factors of pulmonary embolisms?

Accepted Answer

Recent lower limb trauma, Surgery, Immobilization, Pregnancy/delivery

Question 38

What does the asthma immune response cause?

Accepted Answer

Increased cough reflex, Increased secretion production, Increased bronchial constriction

Question 39

What is included in the evaluate part of management of an allergic reaction WITH symptoms?

Accepted Answer

Speed of reaction, Respiratory, cardiovascular involvement, Vitals (especially respirations, Systemic allergic suspected = activate CODE BLUE/EMS immediately

Question 40

If a patient can no longer cough or speak with a partial obstruction, a total obstruction should be suspected

Accepted Answer

True

Question 41

What is included in the recognize part of management of an allergic reaction WITH signs and symptoms?

Accepted Answer

Confirm reaction, Remove irritants

Question 42

What exposure is when the patient experiences a reaction?

Accepted Answer

2nd exposure

Question 43

What antibodies make up the immunoglobulin system?

Accepted Answer

IgA, IgG, IgM, IgE, IgD

Question 44

What should be done for patients with latex allergies if it is NOT a latex free environment?

Accepted Answer

Alert others, Schedule first in the day, Set up unit and handle instrument with non latex gloves only, Make sure all items used are non latex

Question 45

What are characteristics of ASA III?

Accepted Answer

Alcohol dependence/abuse, Can walk one flight of stair but have to stop en route due to breathing, History >3 mo of heart attack, stroke, TIA, CAD/stents, Moderate reduction of ejection fraction, Poorly controlled diabetes/hypertension, Can walk 2 level city blocks but may have to stop en route due to breathing

Question 46

Angioedema often affects:

Accepted Answer

Hands, Face

Question 47

What would be included in the implementation section of REPAIR?

Accepted Answer

Oxygen, Allow patient to administer their own bronchodilator

Question 48

What should be done when managing aspiration?

Accepted Answer

Trendelenburg position, If not expelled, escort to ER for x-ray, Head over side of chair, Encourage coughing

Question 49

What are characteristics of a latex allergy?

Accepted Answer

Contact dermatitis, Fatal anaphylactic reactions, Airborne allergic reaction, Overlooked and misdiagnosed, Immediate allergic reaction, Minor skin irritations

Question 50

What happens when histamine is released?

Accepted Answer

Constricts smooth muscles of bronchioles, Dilates capillaries, Increases gastric secretion

Question 51

Contact dermatitis is a delayed allergic response (>12 hours to develop)

Accepted Answer

True

Question 52

Characteristics of extrinsic asthma include:

Accepted Answer

Common in children, Common in young adults, Inherited allergic sensitivity to certain stimuli, Severity/frequency often diminishes with age

Question 53

Signs and symptoms of FBAQ and aspiration include:

Accepted Answer

Dyspnea, Stridor, Placing hands on throat, Coughing/wheezing (except in total obstruction), Cyanosis

Question 54

What exposure is the sensitizing dose for allergies?

Accepted Answer

1st exposure

Question 55

What are some other characteristics of ASA III?

Accepted Answer

I plated pacemaker, COPD, End stage renal disease with dialysis, Morbid obesity (BMI greater or equal to 40), Active hepatitis

Question 56

What should be done when managing a partial obstruction?

Accepted Answer

On side, head over chair, Trendelenberg position, Encourage coughing

Question 57

What are important facts related to anaphylaxis?

Accepted Answer

Severity depends on amount of exposure, More rapid reaction = more severe symptoms, Occurs within 30 mins = increased change fatality, Severity depends on rate of exposure

Respiratory Emergencies

Questions 57

Respiratory Emergencies

Questions 57