Case Study Ch. 19

LaDonna M. is a second-year dental hygiene student preparing for her national board examination. She is in a serious relationship and plans to continue her studies in public health, so she visits the college health service to find out about effective contraception. The nurse practitioner prescribes Seasonale (ethinyl estradiol/levonorgestrel). After a few weeks, LaDonna begins to complain of nausea and dizziness and reports feeling bloated. She is concerned and has a friend take her blood pressure; it is slightly elevated. She also notices that her gingiva seems slightly inflamed, although her oral hygiene is good. She increases flossing from once to twice a day, and the inflammation seems to resolve; she begins to feel better in a few weeks. LaDonna's third molars are impacted, which is causing her some discomfort; she schedules oral surgery over semester break. Unfortunately, she develops alveolar osteitis (dry socket) after the extractions, and the oral surgeon prescribes antibiotics to help speed the healing.

1. Which type of oral contraceptive is Seasonale?

a. Combination of estrogen and progestin

b. Progestin alone

c. Triphasic type

d. Biphasic type

e. Extended cycle

f. a and d

g. a and e

g. a and e

LaDonna M. is a second-year dental hygiene student preparing for her national board examination. She is in a serious relationship and plans to continue her studies in public health, so she visits the college health service to find out about effective contraception. The nurse practitioner prescribes Seasonale (ethinyl estradiol/levonorgestrel). After a few weeks, LaDonna begins to complain of nausea and dizziness and reports feeling bloated. She is concerned and has a friend take her blood pressure; it is slightly elevated. She also notices that her gingiva seems slightly inflamed, although her oral hygiene is good. She increases flossing from once to twice a day, and the inflammation seems to resolve; she begins to feel better in a few weeks. LaDonna's third molars are impacted, which is causing her some discomfort; she schedules oral surgery over semester break. Unfortunately, she develops alveolar osteitis (dry socket) after the extractions, and the oral surgeon prescribes antibiotics to help speed the healing.

2. Which is the likely cause of LaDonna's nausea?

a. Poor diet

b. Stress from studying for boards

c. Adverse effect of contraceptive

d. Elevated blood pressure

c. Adverse effect of contraceptive

LaDonna M. is a second-year dental hygiene student preparing for her national board examination. She is in a serious relationship and plans to continue her studies in public health, so she visits the college health service to find out about effective contraception. The nurse practitioner prescribes Seasonale (ethinyl estradiol/levonorgestrel). After a few weeks, LaDonna begins to complain of nausea and dizziness and reports feeling bloated. She is concerned and has a friend take her blood pressure; it is slightly elevated. She also notices that her gingiva seems slightly inflamed, although her oral hygiene is good. She increases flossing from once to twice a day, and the inflammation seems to resolve; she begins to feel better in a few weeks. LaDonna's third molars are impacted, which is causing her some discomfort; she schedules oral surgery over semester break. Unfortunately, she develops alveolar osteitis (dry socket) after the extractions, and the oral surgeon prescribes antibiotics to help speed the healing.

3. Which is the most likely reason for the gingival inflammation LaDonna experienced?

a. Existing gingival disease

b. Exaggerated response to local factors (plaque)

c. Aggressive home care

d. Poor brushing technique

b. Exaggerated response to local factors (plaque)

LaDonna M. is a second-year dental hygiene student preparing for her national board examination. She is in a serious relationship and plans to continue her studies in public health, so she visits the college health service to find out about effective contraception. The nurse practitioner prescribes Seasonale (ethinyl estradiol/levonorgestrel). After a few weeks, LaDonna begins to complain of nausea and dizziness and reports feeling bloated. She is concerned and has a friend take her blood pressure; it is slightly elevated. She also notices that her gingiva seems slightly inflamed, although her oral hygiene is good. She increases flossing from once to twice a day, and the inflammation seems to resolve; she begins to feel better in a few weeks. LaDonna's third molars are impacted, which is causing her some discomfort; she schedules oral surgery over semester break. Unfortunately, she develops alveolar osteitis (dry socket) after the extractions, and the oral surgeon prescribes antibiotics to help speed the healing.

4. Which preventive measures could have been taken to minimize the incidence of dry socket after LaDonna's third molar extraction?

a. Prophylactic premedication with antibiotics

b. Packing the socket with antimicrobial agents

c. Timing the extraction to match her hormonal cycle

d. Reduction of trauma during extraction

e. All of the above

f. c and d only

g. a and c only

f. c and d only

LaDonna M. is a second-year dental hygiene student preparing for her national board examination. She is in a serious relationship and plans to continue her studies in public health, so she visits the college health service to find out about effective contraception. The nurse practitioner prescribes Seasonale (ethinyl estradiol/levonorgestrel). After a few weeks, LaDonna begins to complain of nausea and dizziness and reports feeling bloated. She is concerned and has a friend take her blood pressure; it is slightly elevated. She also notices that her gingiva seems slightly inflamed, although her oral hygiene is good. She increases flossing from once to twice a day, and the inflammation seems to resolve; she begins to feel better in a few weeks. LaDonna's third molars are impacted, which is causing her some discomfort; she schedules oral surgery over semester break. Unfortunately, she develops alveolar osteitis (dry socket) after the extractions, and the oral surgeon prescribes antibiotics to help speed the healing.

5. Which risks or special precautions occur when women take antibiotics concomitantly with oral contraceptives?

a. Liver dysfunction

b. Allergic reaction

c. Increased risk of blood clot

d. Decreased effectiveness of oral contraceptive

e. Increased effectiveness of oral contraceptive

d. Decreased effectiveness of oral contraceptive