Case #5: MIKE Patient Profile: The patient is a 40 year old male, 5’10’’, 215 lbs. Blood pressure today is 118/68. Pulse is 68. Medical history reveals a history of depression and anxiety. He currently takes a tricyclic antidepressant. No allergies that he knows of. Chief Complaint: I have taken really good of care of my teeth. This is my first filling in my life and I am kind of nervous. Clinical Findings: #30 has a carious lesion on the occlusal surface Diagnosis: Generalized healthy, Caries Active, Deposit 1 Supplemental Notes: Works as a mail man.  

Choose the BEST answer for each description.

You and Lori have chosen nitrous oxide/oxygen sedation for her pain management during treatment. What action does nitrous oxide-oxygen have on the body in order to control pain experienced by the patient?

Which factor is of least concern when administering local anesthesia to an older adult?

Case #2: SARAH Patient Profile: The patient is a 76 year old female, 5’1’’, 150 lbs. Blood pressure is 120/84. Pulse is 62. Her medical history reveals angina (controlled), diabetes type II (A1c 8.2), high cholesterol, and depression. She currently takes Novolog (insulin), Lipitor, Elavil (tricyclic antidepressant), and Nitroglycerin as needed. Allergy to sulfa. Chief Complaint: I do not like the dentist. Clinical Findings: Xerostomia, Periodontal assessment reveals 4-6 mm pockets in posterior teeth with moderate bleeding on probing, bilateral crepitus of TMJ, jaw gets tired, mandibular anteriors sensitive to touch and cold Diagnosis: Localized Stage III Periodontitis Grade C (Diabetes modifier), Caries Active, Deposit 2 Supplemental Notes: Retired teacher, widowed. #3 and #20 extracted due to fractures after RCT, history of caries and orthodontia Treatment Plan includes SRP for #2, 4, 13, 14, 15, 19, 29, 30, 31.  

A provider orders 1.5 grams of cefazolin IV every 8 hours. The medication is available in 500 mg per vial. How many milligrams should the nurse prepare per dose?

Which of the following anesthetics would be most likely to produce successful pulpal anesthesia for a supraperiosteal (SP)/infiltration injection on tooth #19?

A client who is at high risk for alcohol use disorder has just found out that they are pregnant. The nurse counsels the client about the long-term effects of alcohol on the child. Which defect(s) should the nurse point out are potential effects of alcohol use in pregnancy? Select all that apply.

Case #1: BOB Patient Profile: The patient is a 68 year old male, 6’0’’, 240 lbs. Blood pressure is 130/80. Pulse is 70. His medical history reveals hyperthyroidism (controlled), liver disease, cardiac arrhythmias, and knee replacement in 2012. He currently takes multiple medications but he cannot remember all of the names. No allergies. Chief Complaint: Worried about my teeth and having to get numb. Clinical Findings: Periodontal assessment reveals 5-7mm pockets, heavy bleeding on probing, furcation involvement. Diagnosis: Generalized Stage III Periodontitis Grade B (no grade modifiers), Caries Active, Deposit 2 Supplemental Notes: He lost his maxillary anterior teeth in a car accident. He is missing premolars from orthodontia. He is missing #3 and #20 due to failed RCT. He wears a removable maxillary partial denture. It has been 3 years since his last periodontal treatment. Treatment Plan includes 4 quadrants of SRP with anesthesia.  

The occupational and environmental health nurse faces many different practice issues every day and can function comfortably in roles as a clinician, coordinator, and case manager following company procedures, using assessment checklists and clinical protocols to provide treatment. At which American Association of Occupational Health Nurses (AAOHN) competency level in occupational and environmental health nursing is this nurse functioning?