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"Patient: 60-year-old male

Chief complaint: ""I want a dental checkup.""
Background: Patient's last dental checkup was 2 years ago. He has a medical history of HTN, Type 2 Diabetes, and high cholesterol. He is taking the following medications: Amlodipine, Metformin, Aspirin, and Crestor.
Current Findings: Patient vital signs are: BP 167/96, Pulse 82 BP 170/98, Pulse 85

If the patient is still experiencing a bad headache, how would you proceed? (Select all correct answers.)
a. Give the patient an NSAID, send him home to relax and reschedule for next week.
b. Place the dental chair in a supported supine position and ask the patient to take a deep breath.
c. Keep the patient in an upright position and ask him if he is dizzy.
d. Remain calm and ask your assistant to Call 911 or the local emergency number."

1 Answer

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Final answer:

d. Remain calm and ask your assistant to Call 911 or the local emergency number.In the given scenario with a patient exhibiting high blood pressure and a severe headache, appropriate actions include positioning the patient safely, monitoring for dizziness, and potentially calling emergency services, rather than administering NSAIDs or sending the patient home.

Step-by-step explanation:

If a 60-year-old patient with a history of HTN, Type 2 Diabetes, and high cholesterol presents with a blood pressure of 167/96 and 170/98 mm Hg, along with a bad headache, it is crucial to address this situation as a potential medical emergency. Providing an NSAID is not advisable due to the patient's medical history and current symptoms. Instead, the correct procedures would involve:Placing the dental chair in a supported supine position to reduce the risk of syncope and assist with patient comfort.Keeping the patient in an upright position can help if the patient is experiencing dizziness, but only if they are not at risk of fainting or if a supine position does not help.Calling 911 is necessary if there is a possibility of a hypertensive crisis or other acute condition exacerbated by the hypertension, especially given the patient's complaint of a severe headache.

Overall, the patient's symptoms and current vital signs warrant immediate and careful attention, potentially referral to an emergency service, rather than sending the patient home.If the patient is still experiencing a bad headache, the correct steps to proceed would be:Keep the patient in an upright position and ask him if he is dizzy. Headaches can be a symptom of high blood pressure, and dizziness may indicate a potential drop in blood pressure.Remain calm and ask your assistant to call 911 or the local emergency number. Given the patient's history of hypertension, diabetes, and high cholesterol, along with the elevated blood pressure readings, a severe headache could be a sign of a medical emergency such as a hypertensive crisis or other complications.

User Philip Couling
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