![Picture](/uploads/1/0/4/0/10408826/529792.png?1328159976)
Asthma
Mock Case Study
Demographics:
· Name: Brandon
· Age: 17 years
· Gender: Male
· Race: African American
Physical Assessment:
· Patient appears to be in good health.
Mental Assessment:
· Depressed because he can’t play all of the sports that he loves.
· Embarrassed by use of inhaler.
Social Assessment:
· Lives with parents and 3 siblings.
· Loves to watch and play sports
· Wants to go to college to become a physical therapist for sport injuries.
Medical Assessment:
· Patient was diagnosed with asthma when he was 9 years old.
· Patient notices the following symptoms when he has exercised too much:
-wheezing
-coughing
-chest tightness
-difficulty speaking
Dental History:
· Patient has fillings on teeth #’s 2, 3, 13, 19, 30, and 31.
· All 4 wisdom teeth extracted (#’s 1, 16, 17, and 32).
· Localized supragingival calculus on lower anterior teeth.
Extra Oral Assessment:
· Head is symmetrical
· Scar on left side of cheek 3mm x 8mm.
· Clicking/popping on left side of TMJ.
· No palpable or tender nodes.
Intra Oral Assessment:
· Patient has xerostomia.
· Insufficient salivary flow.
· Slight marginal redness on lower anteriors.
Communication:
-I would go over the patient’s health history and ask him the following questions:
· What types of medication are you using and how stable is your condition?
· How often do you get asthma attacks?
· What triggers your asthma attacks?
· When was the last time you had an emergency visit to the hospital?
· Do you have your inhaler with you and what is the expiration date on your inhaler?
-Patient’s response to questions: Brandon uses an inhaler (Albuterol) and it seems to help when he feels any symptoms. He gets asthma attacks maybe once every few months when he plays sports for a longer period of time. Exercising too hard for a long period of time triggers Brandon’s asthma attacks. The last time he had an emergency visit to the hospital was a couple years ago when he tried out for freshmen football at his high school. Brandon does have his inhaler with him and it expires in 7 months.
Appointment Planning:
· Even though patient’s asthma seems under control, plan his appointment in the late morning or the late afternoon.
· Plan short appointments to decrease any stress he may have.
Client Positioning:
· Make sure patient is in a comfortable position to facilitate normal breathing.
· Should normally sit patient in a semi-supine or upright chair position.
Dental Hygiene Procedures:
· Continue to see patient every 6 months.
· Have inhaler close by or in sight during each procedure.
· Know that bacteria aerosols from plaque or carious lesions and the water can also be an asthma triggerr in the dental setting.
· Monitor periodontal status and check for ineffective salivary flow related to medication.
· Patient is prone to increased cavities, bad breath, xerostomia and gum problems.
Safety Precautions:
· Patient may be sensitive to the preservative in vasoconstrictors, so if local anesthesia is needed, use a local anesthetic without epinephrine.
· If patient states that he is stressed, the use of nitrous may be used.
· Do not use ultrasonic scalers or air polishing, and avoid using dental materials.
· Have bronchodilators available in the dental office (and always check their expiration date).
Oral Hygiene Instruction (OHI):
· Recommend Biotene for dry mouth/ xerostomia.
· Instruct patient to rinse his mouth after using an inhaler.
· Educate patient and parent on sugars and increased caries.
· Prescribe fluoride to help with caries.
Personal Reflection:
I chose this disease to do my mock case study on because some of my family and close family friends have asthma. My aunt has pretty severe asthma and will get symptoms frequently with certain allergens. My best friend also has asthma, and I actually witnessed her having an asthma attack. It is a very scary situation, and if you don’t know how to handle it, the situation gets even worse. From my own personal experience, besides making sure an asthmatic has their inhaler with them, one of the key factors to helping a person get through an asthma attack is to keep them and yourself as calm as possible.
Additional Information:
How to use an inhaler with a spacer:
Demographics:
· Name: Brandon
· Age: 17 years
· Gender: Male
· Race: African American
Physical Assessment:
· Patient appears to be in good health.
Mental Assessment:
· Depressed because he can’t play all of the sports that he loves.
· Embarrassed by use of inhaler.
Social Assessment:
· Lives with parents and 3 siblings.
· Loves to watch and play sports
· Wants to go to college to become a physical therapist for sport injuries.
Medical Assessment:
· Patient was diagnosed with asthma when he was 9 years old.
· Patient notices the following symptoms when he has exercised too much:
-wheezing
-coughing
-chest tightness
-difficulty speaking
Dental History:
· Patient has fillings on teeth #’s 2, 3, 13, 19, 30, and 31.
· All 4 wisdom teeth extracted (#’s 1, 16, 17, and 32).
· Localized supragingival calculus on lower anterior teeth.
Extra Oral Assessment:
· Head is symmetrical
· Scar on left side of cheek 3mm x 8mm.
· Clicking/popping on left side of TMJ.
· No palpable or tender nodes.
Intra Oral Assessment:
· Patient has xerostomia.
· Insufficient salivary flow.
· Slight marginal redness on lower anteriors.
Communication:
-I would go over the patient’s health history and ask him the following questions:
· What types of medication are you using and how stable is your condition?
· How often do you get asthma attacks?
· What triggers your asthma attacks?
· When was the last time you had an emergency visit to the hospital?
· Do you have your inhaler with you and what is the expiration date on your inhaler?
-Patient’s response to questions: Brandon uses an inhaler (Albuterol) and it seems to help when he feels any symptoms. He gets asthma attacks maybe once every few months when he plays sports for a longer period of time. Exercising too hard for a long period of time triggers Brandon’s asthma attacks. The last time he had an emergency visit to the hospital was a couple years ago when he tried out for freshmen football at his high school. Brandon does have his inhaler with him and it expires in 7 months.
Appointment Planning:
· Even though patient’s asthma seems under control, plan his appointment in the late morning or the late afternoon.
· Plan short appointments to decrease any stress he may have.
Client Positioning:
· Make sure patient is in a comfortable position to facilitate normal breathing.
· Should normally sit patient in a semi-supine or upright chair position.
Dental Hygiene Procedures:
· Continue to see patient every 6 months.
· Have inhaler close by or in sight during each procedure.
· Know that bacteria aerosols from plaque or carious lesions and the water can also be an asthma triggerr in the dental setting.
· Monitor periodontal status and check for ineffective salivary flow related to medication.
· Patient is prone to increased cavities, bad breath, xerostomia and gum problems.
Safety Precautions:
· Patient may be sensitive to the preservative in vasoconstrictors, so if local anesthesia is needed, use a local anesthetic without epinephrine.
· If patient states that he is stressed, the use of nitrous may be used.
· Do not use ultrasonic scalers or air polishing, and avoid using dental materials.
· Have bronchodilators available in the dental office (and always check their expiration date).
Oral Hygiene Instruction (OHI):
· Recommend Biotene for dry mouth/ xerostomia.
· Instruct patient to rinse his mouth after using an inhaler.
· Educate patient and parent on sugars and increased caries.
· Prescribe fluoride to help with caries.
Personal Reflection:
I chose this disease to do my mock case study on because some of my family and close family friends have asthma. My aunt has pretty severe asthma and will get symptoms frequently with certain allergens. My best friend also has asthma, and I actually witnessed her having an asthma attack. It is a very scary situation, and if you don’t know how to handle it, the situation gets even worse. From my own personal experience, besides making sure an asthmatic has their inhaler with them, one of the key factors to helping a person get through an asthma attack is to keep them and yourself as calm as possible.
Additional Information:
How to use an inhaler with a spacer:
More additional information regarding asthma can be found at the American Lung Association at:
www.lungusa.org/lung-disease/asthma
www.lungusa.org/lung-disease/asthma