ChronicObstructivePulmonaryDisease(COPD)-Website2.pptVIP

* * * * * * * * * * * * * * Mr. Steve Reeves Steve Reeves… 60 year old male with extensive dental needs. His past medical history is significant for: Asthma Emphysema (COPD) Hypertension Congestive Heart Failure Cardiovascular Disease Signs Symptoms -- Breathing complications Distended neck veins Pitting edema Cyanosis Ascites Dizziness Fatigue COPD Signs Symptoms -- Barrel chested Dyspnea Orthopnea Respiratory infections/ cough Cyanosis Major Concerns… Risk of asthma attack in office. Risk of orthopnea during dental treatment. If hypertension not under control, risk of congestive heart failure, ischemic heart disease, and cerebrovascular accident. If congestive heart failure is present, risk of myocardial infarction cerebrovascular accident, arrhythmias, and cardiac arrest. Questions to ask… History of Asthma Date of Dx Age of onset What type of asthma does patient have? (allergenic, mild -- severe?) What induces an asthma attack? Level of control? How frequent and how severe are the attacks? What times of day do the attacks occur? How are the attacks managed? Has the patient ever received emergency treatment for an acute attack? Questions to ask… History of emphysema (COPD) Date of onset? Does he smoke? If so, how many cigarettes and for how long? Does he have trouble sleeping? Respiratory Infections involved? Is sputum present with his cough? Orthopnea? Contributing Factors to difficulty breathing (what activities) ? Questions to ask… Cardiovascular Disease: Common symptoms of heart disease dyspnea, chest pain, fatigue, weight gain/loss, weakness Has there been a recent change in medications? How long has he been on the medications? Are there any side effects with his medications? How frequently does he take is blood pressure, and what is it usually? How often does he have headaches, chest pain, or shortness of breath? Questions to ask… Congestive Heart Failure Does he have symptoms of congestive heart failure? Fever, Liver pain, Exercise intoler