Nitrous Ch. 1-3 (LEAs)
All of the following are factors that can influence an individual's response to pain except one. Which one is the exception? -Current stress levels -illness/infection presence -eye color -cultural expectations
- eye color
With N2O/O2 sedation, it is difficult to reach the appropriate plane for performing a surgical procedure; however, although difficult, it is possible to render a patient unconscious with N2O/O2. -true or false
-true
Select all TRUE statements 1. Halothan gas was introduced in the 1950s and N2O was used as an adjuvant drug to induce the effects of halothan. 2. In the 1940s lidocaine was discovered, this LA temporarily diminished the use of N2O. 3. Medical residencies in the 1930s included information on N2O within the curricula. 4. During the time period between 1940s to the 1960 N2O/O2 sedation was almost nonexistent 5. In 1997 the ADA supported standards to ensure the sedation delivery equipment included failsafe devices. This ensured the minimal of 20% O2 and the inability to deliver 100% N2O. 6. Anesthesia became a speciality in 1904
1, 2 & 3
Who is credited for discovering nitrous oxide?
Joseph Priestly
The level of sedation incurred when less than _________ N2O is used with a benzodiazepine is _______________ sedation. A)50%; deep sedation B)30%; moderate sedation C)30%; minimal sedation D)50%; moderate sedation
D)50%; moderate sedation
Nitrous oxide is the most common inhalation anesthetic used in dentistry. Dr Horace Wells was the first dentist to use nitrous oxide and is known as the "father of anesthesia" A)First statement is true and the second statement is false B)First statement is true and the second statement is false C)Both statements are false D)Both statements are true
D)Both statements are true
The "Father of Anesthesia" is ________________ A. Humphrey Davy B. Horace Wells C. Joseph Priestley D. Gardner Colton
b. Horace Wells
Which organizations are involved in the guidelines for N2O/O2 sedation in dental offices? Select all that apply. -AAP -ASA -AAPD -ADA -ADHA
-AAP -ASA -AAPD -ADA
Select any TRUE statement in the development of practice guidelines for N2O/ O2 Sedation. -ASA developed the definitions for the levels of sedation, which were approved in 1999 and emended in 2014. -The ADA oversees and updates the: "Guidelines for teaching pain control and sedation to dentists and dental students" -The "practice guidelines for sedation and analgesia by noon anesthesiologist", were published in 1992 and used for directing policy. - AAP and AAPD have established guidelines for the sedation of pediatric patients.
-ASA developed the definitions for the levels of sedation, which were approved in 1999 and emended in 2014. -The ADA oversees and updates the: "Guidelines for teaching pain control and sedation to dentists and dental students" - AAP and AAPD have established guidelines for the sedation of pediatric patients.
When working with a patient with dental fear and anxiety, which of the following is beneficial? Select all that apply! -Appropriate assessment and acknowledgment of the patient's fear and anxiety. -Displaying empathy toward your patient -Facilitate and interact with the patient to overcome their fear and anxiety -Good communication skills
-Appropriate assessment and acknowledgment of the patient's fear and anxiety. -Displaying empathy toward your patient -Facilitate and interact with the patient to overcome their fear and anxiety -Good communication skills
Nitrous oxide sedation has remained in continuous use longer than any other drug, despite the advent of other attractive agents. Nitrous oxide has never been replaced and will continue to be used in dentistry into the future. -Both statements true
-Both statements true
Select all: Stage II: Delirium or Excitement -Consciousness is lost -Muscular rigidity can present -Protective reflexes is not affected -Slight amnesia and normal respiration -Want to skip stage II is the goal is stage III
-Consciousness is lost -Muscular rigidity can present -Want to skip stage II is the goal is stage III
Which of the following is an invasive, pharmacologic approach to sedation for the conscious patient? Select all -Neuroleptanesthesia -Local anesthesia -Intramuscular sedation -Oral sedation -Intravenous sedation
-Local anesthesia -Intramuscular sedation -Oral sedation -Intravenous sedation
In a drug-induced depression of consciousness, the patient responds to verbal commands, however, reflex withdrawal from a painful stimulus is NOT considered a purposeful response. Which level of sedation is being defined above? -Moderate sedation -Deep sedation -General sedation -Minimal sedation
-Moderate sedation
Select all the noninvasive/non-pharmacologic approach to sedation. -Relaxation therapy -Hypnosis -Aromatherapy -Acupuncture/acupressure -Virtual reality headset -Biofeedback
-Relaxation therapy -Hypnosis -Aromatherapy -Acupuncture/acupressure -Virtual reality headset -Biofeedback
The intent of N2O/O2 sedation is to make the patient relaxed and __________________. -asleep during treatment -to forget the experience of dental treatment -comfortable during treatment -unable to move during treatment
-comfortable during treatment
Which of the following can help a patient with mild anxiety during minor dental treatment? -intramuscular sedation -distraction therapy -acupuncture -hypnosis
-distraction therapy -acupuncture -hypnosis
Many factors can influence an individual's reaction to pain. Select all that apply to this statement. -mental health -physical health -psychogenic -culture -biochemical -all or none principle
-mental health -physical health -psychogenic -culture -biochemical
The level of sedation incurred with less than 50% of N2O is used with benzodiazepines is : -minimal sedation -moderate sedation -deep sedation -general anesthesia
-moderate sedation
The drug able to reverse the effects of opioids and N2O is: -acetaminophen -naloxone -amoxicillin -lidocaine
-naloxone
Effectively managing the patient's pain, needs to occur________________________. -postoperatively -intraoperatively -preoperatively -needs to include all three listed
-needs to include all three listed
Fear and pain are interrelated and often hard to separate because both have a physiologic and emotional impact on the patient. As pain increases anxiety, this can increase the patient's pain reaction threshold, thus the patient becomes enhanced and the patient is less tolerable. A)First statement true and second statement false B)First statement false and second statement true C)Both statements true D)Both statements false
A)First statement true and second statement false
The individual who first recognized the analgesic properties of nitrous oxide was A. Humphrey Davey B. Joseph Priestley C. Gardner Quincy Colton D. Horace Wells
A. Humphrey Davey
-Inability to titrate dose -Unreliable absorption affected by gastric contents -Prolonged duration -Significant latent period -Potential patient noncompliance, especially with children A. Oral B. Intramuscular C. Intravenous D. General
A. Oral
Inhalation conscious sedation with nitrous oxide ______________________ A. Allows the patient to recover quickly after use B. Achieves a level of awareness and relaxation that puts the patient asleep during treatment C. is the most effective on severe dental pain and anxiety D. requires the patient to have someone drive them home after treatment
A. allows the patient to recover quickly after use
The drug-induced state during which patients respond normall to verbal commands and have possible cognitive and coordination impairment, yet respiratory and cardiovascular functions are unaffected is A. minimal sedation B. moderate sedation C. deep sedation D. general anesthesia
A. minimal sedation
The number of deaths associated with N2O/O2 sedation in a dental office as the sole sedative agent and using appropriate equiptment and technique is A. none B. approximately 10 C. approximately 100 D. approximately 1000
A. none
The primary objective of physiologic pain is to A. provide protection for the body against potential damage B. prevent nerve impulses from reaching the brain C. alert the individual of the need for pharmacologic intervention D. signal the need for oxygen
A. provide protection for the body against potential damage
A noninvasive, nonpharmacologic approach to sedation can include, which of the following methods? Select all that apply. TENS and EDA The conscious effort of the provider in their word selection and tone, including verbal and non-verbal communication skills. Acupuncture and acupressure can be used to help decrease fear and anxiety. Hypnosis can be utilized to help with fear and anxiety. Distraction mechanisms help divert the individual's attention away from the fear.
ALL APPLY
Which of the following is considered conscious sedation that can be used during routine operative treatment? Select all that apply. -Oral sedation -Inhalation sedation (N2O/O2) -Intramuscular sedation -local anesthesia
All of them
The drug able to reserve the effects of opioids and N2O is: A)Acetaminophen B)Naloxone C)Polocaine D)Lidocaine E)Amoxicillin
B)Naloxone
Persistent and irrational fear of something specific, such as an object or activity that results in avoidance or desire to avoid the feared stimulus. A)Fear B)Phobia C)Stress D)Anxiety
B)Phobia
Which pain receptors are the first to receive the stimulus from the PNS? A)nervoceptor B)nociceptors C)chemoreceptors D)cytoplasmic recptors
B)nociceptors
The first clinical procedure using nitrous oxide as the anesthetic agent was A. limb amputation B. tooth extraction C. abscess drainage D. laceration repair
B. tooth extraction
Each of the following is a sign that an individual may be anxious except one. Which one is this exception? A) Tight grip on chair or "white knuckles" B) Beads of perspiration C) Tendency to fall asleep D) Cool, clammy skin
C) Tendency to fall asleep
Current "best practice guidelines" for N2O/O2 sedation use in the united states are recommended by each of the following organizations except one. Which one is the exception? A) ASA B) ADA C) US DOE D) AAP/AAPD
C) US DOE
Chloroform was used at one time for an analgesic for labor pains despite claims of significant negative consequences that could occur. Soldiers injured in battle could self-administer chloroform as well for pain control. A)Both statements false B)First statement true and second statement false C)Both statements true D)First statement false and second statement true
C)Both statements true
The individual who first recognized the analgesic properties of nitrous oxide was__________________________. The individual created for the discover of nitrous oxide was _________________________. A)Gardner Colton; Horace Wells B)Horace Wells, Joseph Priestly C)Humphrey Davy; Joseph Priestly D)Joseph Priestly; Humphrey Davy
C)Humphrey Davy; Joseph Priestly
Effectively managing the patient's pain, needs to occur________________________. A)preoperatively B)intraoperatively C)needs to include all three listed D)postoperatively
C)needs to include all three listed
The individual responsible for lecturing about the virtues of nitrous oxide and sporting it as entertainment in town halls was A. Humphrey Davey B. Joseph Priestley C. Gardner Quincy Colton D. Horace Wells
C. Gardner Quincy Colton
N2O/O2 equipment allows no more than 70% N2O and no less than 30% O2 to be delivered at one time. Most often, patients who have a negative experience with N2O/O2 sedation are caused by oversedation. A. first statement false and second statement true B. both statements false C. both statements true D. first statement true second statement false
C. both statements true
The individual who has posthumously been recognized as the "Father of Anesthesia" because of his clinical use of nitrous oxide is A. Humphrey Davey B. Joseph Priestley C. Gardner Quincy Colton D. Horace Wells
D. Horace Wells
The intent of N2O/O2 sedation is to make the patient relaxed and A. unable to move B. asleep C. forget what is happening D. comfortable
D. comfortable
The theory of pain modulation suggests that impulses are altered along the way by an ______________________ opioid system. A. exogenous B. endogenous and exogenous C. norepineohrine D. dopamine E. endogenous
E. endogenous
Select all the noninvasive/non-pharaacologic approach to sedation. A. acupuncture/acupressure B. virtual reality headset C. Hypnosis D. Biofeedback E. Aromatherapy F. Relaxation therapy G. C,D,E H. All the above
H. all the above
