Nitrous Oxide
Each of the following items is recommended and/or required by law to document in the patient's chart regarding N2O-O2 sedation EXCEPT one. Which is the EXCEPTION? Amount of drug delivered Patient's occupation c. Postoperative oxygenation time d. Patient (guardian) consent
Patient's occupation
What is the appropriate percentage of oxygen in atmospheric air? a. 5% b. 21% c. 50% d. 99%
21%
A full tank of oxygen is pressurized at 2000 pounds of gas per square inch. When the gauge reads 500 psi, how full is the tank? a. 3/4 b. 1/2 c. 1/4 d. Empty
1/4
What is the concentration range of nitrous oxide that gives the body the feeling of warmth and tingling?
10-20%
The minimum amount of time recommended for delivering 100% postoperative oxygen is ____ minutes. a. 5 b. 10 c. 15 d. 20
5
Nitrous oxide should not be administered to drug addicts. Persons who are drug-seeking may present as patients in the dental setting. Both statements are true. Both statements are false. The first statement is true, the second is false. The first statement is false, the second is true.
Both statements are true.
Although the exact mechanism of nitrous oxide is unknown, it acts as narcotic. CNS depressant. local anesthetic. NSAID.
CNS depressant.
Each of the following is an indication for the use of N2O-O2 sedation EXCEPT one. Which is the EXCEPTION? Pain control Anxiety management Hypersensitive gag reflex Dental phobia
Dental phobia
Nitrous oxide is recommended for use in all of the following situations except:
Emphysema
Normal pregnancy would be an example of an ASA ____________ physical status level. a. I b. II c. III d. IV
II
Which level of sedation results when a combination of an oral sedative and nitrous oxide is administered to a patient? Minimal sedation Moderate sedation Deep sedation General anesthesia
Moderate sedation
Each of the following is a contraindication for N2O/O2 sedation EXCEPT one. Which is the EXCEPTION? Acute sinusitis First trimester of pregnancy Pneumoencephalography Rambunctious children
Rambunctious children
Preoperative and postoperative vital signs are recommended to document adequate physiologic emergence (recovery). Nothing else is required for documentation. Both statements are true. Both statements are false. The first statement is true, the second is false. The first statement is false, the second is true.
The first statement is true, the second is false
Medical consultation is recommended for patients with known or potential vitamin B12 deficiency. Vitamin B12 is also known as folic acid. Both statements are true. Both statements are false. The first statement is true, the second is false. The first statement is false, the second is true.
The first statement is true, the second is false.
Each of the following is a sign of ideal sedation EXCEPT one. Which is the EXCEPTION? Vomiting Glazed eyes Feet relaxed Lowered shoulders
Vomiting
COPD is considered a relative contraindication for the use of N2O/O2 sedation because Nitrous oxide does not work well to sedate these individuals. Additional oxygen could create respiratory issues in these individuals. Emergence from sedation is difficult. individuals are a high risk for myocardial infarction and/or stroke.
additional oxygen could create respiratory issues in these individuals.
The following is the correct order in sedation of nitrous oxide:
analgesia stage, dillerium/excitement stage, surgical analgesia, respiratory paralysis
Which condition responds favorably with nitrous oxide?
asthma
If the reservoir bag is overfilling while establishing a patient's minute volume, the operator should _____________ the gas flow rate. a. increase b. decrease c. terminate d. retain
b. decrease
Cylinders should not be stored near the sources of grease, oil, or other lubricants as there is a potential for combustion. leaking rusting. conversion.
combustion.
Patients who have been administrated N2O/O2 sedation have a slight amnestic effect in which the normal perception of time passage is: a. increased. b. decreased. c. retained. d. terminated
decreased.
Which is a sign of over sedation?
exaggerated inspirations
A green tank indicated nitrous oxide T/F
false
Before placing the mask on client, a predetermined measure of nitrous should be established for the client T/F
false
It is important to turn off both nitrous and oxygen tanks off at the same time T/F
false
Nitrous oxide combines with body tissue and is then metabolized T/F
false
Pregnancy is not a relative contraindication for nitrous oxide use T/F
false
Nitrous oxide effects which function?
gag reflex
Oxygen is dispensed in which colored cylinder?
green
Which of the following are signs and symptoms of excessive nitrous oxide?
headache and nausea
Which describes the purpose of the yoke?
holds the cylinders in contact with the machine
Nitrous oxide is appropriate to use on patients with:
hypersensitive gag reflex
Potential complications of nitrous oxide would include all of the following except:
increased gag reflex
Nitrous oxide is administerd by which route?
inhaled through the nose
Titration is demonstrated with N2O-O2 sedation by giving incremental doses over time until the patient demands additional drug. goes unconscious. is relaxed and comfortable. falls asleep.
is relaxed and comfortable.
Nitrous oxide is primarily compressed in a blue cylinder as a/an a. liquid. b. gas. c. element. d. solid.
liquid
The most common drug administered concomitantly with N2O/O2 sedation in a dental setting is a/an benzodiazepine. NSAID. local anesthetic. narcotic.
local anesthetic.
The use of the suction line as part of the scavenging system is a. mandatory. b. recommended. c. suspended. d. superfluous.
mandatory.
An important practice intended to minimize an operator's exposure to trace waste anesthetic gas is to Minimize patient talking Only use 30% nitrous oxide for any patient. Restrict nitrous oxide use to children only. Breathe with shallower, infrequent respirations
minimize patient talking
Delivery of 50% nitrous oxide to a pediatric patient is considered ___________ by definition. minimal sedation moderate sedation deep sedation general anesthesia
moderate sedation
The Pin Index Safety System ensures that copper piping is used in installation. nitrous oxide E cylinders cannot be cross-connected to the oxygen line. color-coded cylinders are matched to correct tubing colors. nitrous oxide G cylinders cannot be cross-connected to the oxygen line.
nitrous oxide E cylinders cannot be cross-connected to the oxygen line.
Of the following who is not a good candidate for the use of nitrous oxide?
person with COPD
Vasodilation of superficial blood vessels during N2O-O2 sedation can result in relaxed shoulders. slow blink rate. redness in the face and neck. heavy limbs.
redness in the face and neck.
The primary purpose of the regulator on a N2O-O2 sedation system is to Ensure the N2O and O2 lines are not crossed. Reduce the pressure from the tanks to the flowmeter. Monitor the patient's inspiration and expiration. Increase the pressure from the tanks to the flowmeter.
reduce the pressure from the tanks to the flowmeter.
Which of the following is not a contraindicated use for nitrous oxide analgesia?
refusal of local or general anesthesia
From the following signs and symptoms of nitrous oxide sedation, which is an objective sign?
respirations normal
Once the baseline of nitrous oxide the client should be maintained at:
slightly reduced NO2
When one is monitoring the use of nitrous oxide, the client should be in what stage of anesthesia?
stage I
Perioral numbness reported by the patient is a/an_____________ of N2O-O2 sedation. sign symptom unwanted side effect deeper than intended sedation
symptom
Diffusion hypoxia is a lack of oxygen to:
tissue
The administration of a drug in incremental doses over time until the desired endpoint is reached is the definition of: individual bioavailability. IV sedation. titration. induction.
titration.
For every 15 minutes of nitrous oxide you should receive 5 minutes of 100% oxygen T/F
true
Nitrous oxide tanks should be stored in a secluded room against the wall away from a heat source T/F
true
When a scavenger system is in place the nasal mask has:
two hoses coming off each side