Hypertension
Patient: Benjamin BP: 160/98
Age: 52
Gender: Male
Race: African American
Weight: 275 lbs
Hometown: Rancho Cucamonga, CA
Physical Assessment: 5'10, not very active lifestyle
Mental Assessment: Visual disturbances, tinnitus (ringing in the ears), and occasional chest pain
Social Assessment: Works full-time as a Fed-Ex driver, married with 3 children
Medical Assessment: Has not seen a medical doctor due to fear of doctors, smokes a pack of cigarettes a day, but is trying to quit, drinks on the weekends (3-4 beers with football)
Dental History: generalized amalgam restorations, missing #1, 3, 16, 17, 19, 32, bridge on #2-4 and #18-20
EO/IO: generalized melanin pigmentation, marginal inflammation
Communication: In a calm relaxed tone I began to ask Benjamin the following questions
1) Are you taking any medications?
- No, I really don't like going to the doctor, but I'm guessing you are going to tell me that I should.
2) Well, some of the symptoms you told me about like ringing in your ears and occasional chest pain are some signs of hypertension. Also going by your blood pressure that we took today, it would be a good idea to get things checked and find out what's going on.
- I guess it wouldn't hurt to get things checked out.
3) So what we have planned today is to finish up your dental assessments and take radiographs. I will continue to monitor your blood pressure for the rest of today's treatment, but I would strongly advise you go see your doctor and get this medical consent form filled out before we proceed with any further treatment. Let's reschedule you for a morning appointment when you return.
Appointment planning: Short appointments in the morning are best for hypertensive patients. If the patient is feeling anxious or uncomfortable, then reschedule the patient.
Client positioning: Patient should be upright in the chair or adjust the chair to patient's comfort. There should be no sudden changes in chair position. Raise chair slowly when completed and help them out of the chair if needed. Alway make sure there is no dizziness before the patient attempts to stand up. Always keep BP controlled during appointment.
Dental Hygiene Procedures:
- Find out if disease is controlled. If yes, then okay to treat. If no, medical consult is required and elective procedures are not recommended.
- BP cuff may be left on during the appointment to monitor.
- In case of anxiety, stress reduction techniques may be used (N2O)
Safety Precautions: Use caution when using local anesthetics. A BP that is > 179/109 appointment needs to be terminated!
OHI:
- Emphasized the link with oral health and the whole body
- Recommended electric TB since he tends to brush fast
- Demonstrated flossing technique for help prevent further interproximal decay
- Tobacco cessation since he is trying to quit
- Praised patient for his regular brushing efforts, but instructed on better techniques
Personnal Reflection: The reason I chose this condition is because hypertension is known as the "silent killer." Many of us can be living, breathing, walking everyday without even knowing we may have this condition. It sparks an interest with me because as a healthcare provider we need to be aware of signs and symptoms as we treat our patients and to help educate them how to live a healthier lifestyle. We can help become that change agent in our patients lives.
Additional information:
http://www.mayoclinic.com/health/high-blood-pressure/DS00100
Mayo clinic signs and symptoms
http://www.ash-us.org/
American Society of Hypertension
http://www.youtube.com/watch?v=ATLXgeKG9y0&feature=related
The Silent Killer- Hypertension video
Age: 52
Gender: Male
Race: African American
Weight: 275 lbs
Hometown: Rancho Cucamonga, CA
Physical Assessment: 5'10, not very active lifestyle
Mental Assessment: Visual disturbances, tinnitus (ringing in the ears), and occasional chest pain
Social Assessment: Works full-time as a Fed-Ex driver, married with 3 children
Medical Assessment: Has not seen a medical doctor due to fear of doctors, smokes a pack of cigarettes a day, but is trying to quit, drinks on the weekends (3-4 beers with football)
Dental History: generalized amalgam restorations, missing #1, 3, 16, 17, 19, 32, bridge on #2-4 and #18-20
EO/IO: generalized melanin pigmentation, marginal inflammation
Communication: In a calm relaxed tone I began to ask Benjamin the following questions
1) Are you taking any medications?
- No, I really don't like going to the doctor, but I'm guessing you are going to tell me that I should.
2) Well, some of the symptoms you told me about like ringing in your ears and occasional chest pain are some signs of hypertension. Also going by your blood pressure that we took today, it would be a good idea to get things checked and find out what's going on.
- I guess it wouldn't hurt to get things checked out.
3) So what we have planned today is to finish up your dental assessments and take radiographs. I will continue to monitor your blood pressure for the rest of today's treatment, but I would strongly advise you go see your doctor and get this medical consent form filled out before we proceed with any further treatment. Let's reschedule you for a morning appointment when you return.
Appointment planning: Short appointments in the morning are best for hypertensive patients. If the patient is feeling anxious or uncomfortable, then reschedule the patient.
Client positioning: Patient should be upright in the chair or adjust the chair to patient's comfort. There should be no sudden changes in chair position. Raise chair slowly when completed and help them out of the chair if needed. Alway make sure there is no dizziness before the patient attempts to stand up. Always keep BP controlled during appointment.
Dental Hygiene Procedures:
- Find out if disease is controlled. If yes, then okay to treat. If no, medical consult is required and elective procedures are not recommended.
- BP cuff may be left on during the appointment to monitor.
- In case of anxiety, stress reduction techniques may be used (N2O)
Safety Precautions: Use caution when using local anesthetics. A BP that is > 179/109 appointment needs to be terminated!
OHI:
- Emphasized the link with oral health and the whole body
- Recommended electric TB since he tends to brush fast
- Demonstrated flossing technique for help prevent further interproximal decay
- Tobacco cessation since he is trying to quit
- Praised patient for his regular brushing efforts, but instructed on better techniques
Personnal Reflection: The reason I chose this condition is because hypertension is known as the "silent killer." Many of us can be living, breathing, walking everyday without even knowing we may have this condition. It sparks an interest with me because as a healthcare provider we need to be aware of signs and symptoms as we treat our patients and to help educate them how to live a healthier lifestyle. We can help become that change agent in our patients lives.
Additional information:
http://www.mayoclinic.com/health/high-blood-pressure/DS00100
Mayo clinic signs and symptoms
http://www.ash-us.org/
American Society of Hypertension
http://www.youtube.com/watch?v=ATLXgeKG9y0&feature=related
The Silent Killer- Hypertension video