Nitrous Oxide LEAs 2021
Select ALL the components of the sedation record. O2 saturation of hemoglobin when < 50% N2O Adverse reactions and/or comments Patient's minute volume Indication for nitrous oxide use DRugs and medications recently taken by the patient
?? TBD
At altitudes such as 5,000 feet the barometric pressure changes, thus nitrous oxide needs to be increased by ________ to compare to locations at sea level. 3% 5% 10% 15%
5%
At _______% of N2O is considered or defined as moderate sedation in pediatric patients. You can not have moderate sedation with N2O in pediatric patients 70 50 40
50%
Drug potency is determined by assessing the minimum alveolar concentration (MAC). MAC is defined as the amount of drug necessary to prevent movement in ___________of subjects responding to surgical incision. 50% 100% 75% 25%
50%
The level of sedation incurred when less than _________ N2O is used with a benzodiazepine is _______________ sedation. 50%; deep sedation 30%; minimal sedation 30%; moderate sedation 50%; moderate sedation
50%, moderate sedation
The average tidal volume for an adult patient is around ____________mL and _______________ respirations per minute. 1000; 12-15 500; 12-15 500, 15-20 5000; 15-20
500; 12 - 15
The average flow rate of oxygen for an adult patient when administering nitrous oxide is _________ liters per minute. 6-7 4 1-2 8
6-7
What is the recommended liter flow rate of oxygen prior to the induction of N2O? 6-7 liters 4-5 liters 8 to 9 liters 2-4 liters
6-7 liters
When beginning to add N2O, it is preferable to wait at least _____________after a dose before adding the next increment 30 seconds 2 minutes 60 seconds 90 seconds
60 seconds
A full size E tank of O2 weighs around _________ lbs and a full E N2O tank weighs around _________lbs. 3 and 10 6 and 10 7 and 16.5 56 and 153
7 and 16.5
What would the N2O gauge read on a half full cylinder? 500 psi 750 psi 375 psi 1000 psi
750 psi
DH qualifications for the administration of nitrous oxide course includes a minimum of __________ didactic hours and ________ clinical hours. 12; 8 8; 6 8; 12 6; 9
8, 6
Normal oxygen saturation levels are seen on a pulse oximeter range from _________________. 96% to 99% < 80% 88% to 93% 85% to 88%
96 to 99%
Which of the following, for the O2 saturation levels of the arterial blood, is considered normal for a healthy individual? 88% 92% 98% 90%
98%
______ of N2O is eliminated through the lungs without biotransformation. 99% 70% 50% 80%
99%
What is the MOST important safety feature of the N2O/O2 unit? Flowmeter Reservoir bag O2 fail-safe mechanism on/off button conduction tubing
O2 fail-safe mechanism
What is the MAC level for Halothane? .75 104 1.7 4.6
.75
For podiatry, N2O/O2 sedation has been used _______ diazepam during procedures. 10 mg 3 mg 5 mg 20 mg
10 mg
Postoperative pulse rates within _______ beats/min and respiration rates within _______ breaths per minute are acceptable parameters for comparison. 20; 10 5;5 20; 5 10; 5
10, 5
The O2 fail-safe device that is required on all N2O/O2 sedation machines ensures that: Equal amounts of N2O and O2 are being delivered. 100% O2 is being delivered. There is sufficient O2 remaining in the cylinder. 100% N2O cannot be delivered.
100% N20 cannot be delivered
Which of the following blood pressures would be classified as Stage 1 Hypertension? 128/78 146/90 110/60 132/82
132/82
The smaller reservoir bag holds _________ liters. 5 2 1 3
2
When starting N2O/O2 sedation, inflate the reservoir bag to approximately ____________ full. 1/2 1/3 2/3s Until full
2/3's
Lung volumes of males tend to be approximately _______ greater than females. 25% There is no difference in size 30% 15%
25%
The ________ ppm was set as achievable in the operating room, but not attainable in the setting of a dental operator, the NIOSH selected________ ppm to the maximum exposure limit for personnel in the setting 45; 50 25; 50 50; 100 50; 25
25, 50
In review, the adult reservoir bag holds approximate ____________ liters of gas. 3 liters 5 liters 2 liters 4 liters
3 liters
How long is oxygen administered at the completion of sedation? 1-3 minutes 10 minutes 20 minutes 3-5 minutes
3-5 minutes
Nitrous oxide/oxygen sedation equipment ensures the delivery of a minimum of _____________ oxygen. 50% 30% 60% 40%
30%
N2O is stored in large insulated refrigerated tanks as approximately ________ psi and ___________° F. 750; 0-10 45: 88 750; room temperature 300; 75 300; 0 to 10
300; 0 to 10
What is the percentage of N2O a patient receives when 2 liters of N2O are delivered per minute with a total flow rate of 6 liters per minute? 30% 40% 20% 33%
33%
The average flow rate of oxygen for a pedo patient when administering nitrous oxide is _________ liters per minute. 8 1-2 6-7 4
4
Appropriate volume for children ranges between _____________ L/min and for adolescents between _________ L/min. 2-3 and 4-5 2-3 and 5-6 4-5 and 5-7 5-6 and 6-7
4-5 and 5-7
As the gases pass from the tanks into the regulator, the PSI is controlled and kept between __________ PSI. 40 to 60 25 to 45 50 to 75 15 to 20
40 to 60
What is the molecular weight of N2O? 44 g/mol 104 g/mol 47 g/mol 70 g/mol
44 g/mol
A scavenging system will include an accurate flowmeter, scavenging masks, and a vacuum system able to eliminate gases at a rate of at least __________liters per minute (L/min). 15 45 75 25
45
Scavenging system needs an evacuation flow rate has been established by NIOSH at an optimal at _______45 L/min. 25 to 50 is the range 50 45 25
45
Oxygen is delivered for at least _______ minutes after dental sedation in order to prevent diffusion hypoxia. 10 5 2 3
5
The effects of N2O/O2 sedation are usually seen within _____ minutes. 5 10 15 20
5
Minimum of __________minutes of post-oxygenation is required, it is appropriate to terminate the flow of N2O and deliver ______________O2 before completion of the procedure to expedite the recovery period 5 and 50% 15 and 75% 5 and 100% 10 and 50%
5 and 100%
When administering N2O/O2 sedation, the clinician needs to be aware of possible leakage. Select areas where N2O can leak. Select all that apply. Connecters from the flow meter Conducting tubing to the breathing apparatus Reservoir bag Patient talking throughout the procedure Nasal hood is displaced during treatment
?? TBD
Which organizations are involved in the guidelines for N2O/O2 sedation in dental offices? Select all that apply. ADA ASA AAP ADHA AAPD
ADA ASA AAP AAPD
Which of the following have guidelines for patient assessment/pre-procedural evaluation and management before, during, and after sedation? Select all that apply. FDA ASA ADA AAPD ADHA
ASA ADA AAPD
According to the ASA Physical Status Classification System, a 52-year-old patient with hypertension being controlled by daily medication would be classified as a ASA I ASA III ASA IV ASA II
ASA II
For which of the following patients may nitrous oxide be a relative contraindication. Select all that apply. Asthma Emphysema Inability to understand the procedure Current upper respiratory tract infection
Emphysema Inability to understand the procedure Current upper respiratory tract infection
Which one of the following systems does nitrous oxide have the greatest impact on? Central nervous system Hepatic Cardiovascular Muscular system
CNS
The effects of nitrous oxide on the ____________ system can occur ___________, thus constant monitoring is needed. CNS, slowly CNS, quickly PNS, quickly PNS, slowly
CNS, quickly
Which of the following conditions can be a contraindication and needs a medical consultation before the use of N2O/O2 sedation? Select all that apply. High Blood Pressure COPD The patient is considered an ASA III Cystic Fibrosis Pneumothorax Controlled Asthma
COPD The patient is considered an ASA III Cystic Fibrosis Pneumothorax
Read through each statement. Select each statement that is CORRECT when discussing the distribution of N2O and O2 from Chapter 6. DOT places 13 item/markings on the shoulder of each tank. The color code for the N2O tank is green and the color code for the oxygen tank is white in the United States. CGA have recommended guidelines for N2O sales and security. D and E size tanks are the most common in the medical and dental facilities. FDA regulates the N2O industry and compliance results in near 100% pure N2O. The raw ingredient nitric oxide is heated to create N2O and water plus a few impurities.
DOT places 13 item/markings on the shoulder of each tank. CGA have recommended guidelines for N2O sales and security. FDA regulates the N2O industry and compliance results in near 100% pure N2O.
What is the first step a clinician should take when mild over-sedation is observed? Check the oxygen tank to be sure it has an adequate supply of oxygen or is out of oxygen Decrease the N2O concentration Check for properly functioning equipment Remove the nasal hood right then
Decrease the N2O concentration
Select all of the following that can be accomplished using the titration technique for N2O/O2 sedation. Again, select all that apply. Delivers only the amount of drug necessary Allows for individual biovariability Minimizes oversedation potential Uncovers idiosyncratric reactions Standardized patient dosage by weight Standardized amount of N2O for men, women and children
Delivers only the amount of drug necessary Allows for individual biovariability Minimizes oversedation potential Uncovers idiosyncratric reactions
What do abusers experience during the process of inhaling N2O? Select all that apply. Feels like they are flying Cold feeling in their arms and legs Colorful and vivid images Auditory illusions
Feels like they are flying Colorful and vivid images Auditory illusions
Select all that apply. According to the Piaget Model, children pass through stages of development. Select the states Piaget discusses within the model. Formal Operational Preoperational Sensorimotor
Formal Operational Preoperational Sensorimotor (all of the above)
Select adequate examples of ventilation in the dental office with nitrous oxide. Select all that apply. Fresh-air inlets located in the ceiling Fresh-air exchange Windows that open in the office, if possible Exhaust register louvers near the floor to flush N2O Oscillating room fans
Fresh-air inlets located in the ceiling Fresh-air exchange Windows that open in the office, if possible Exhaust register louvers near the floor to flush N2O Oscillating room fans
The reservoir bag serves which of the following purpose(s)? Select all that apply. Provides extra nitrous oxide if needed Functions when an emergency occurs, by providing negative-pressure O2 to the patient. One main purpose is an additional gas source should the patient inspire more gas than is being supplied through the hoses. A mechanism for monitoring the patient's respiration.
Functions when an emergency occurs, by providing negative-pressure O2 to the patient. One main purpose is an additional gas source should the patient inspire more gas than is being supplied through the hoses. A mechanism for monitoring the patient's respiration.
Select the groups at risk for occupational exposure abuse. Select all that apply. Hairstylist Dentists Painters Anesthesiologist K-12 educators Janitors
Hairstylist Dentists Painters Anesthesiologist Janitors
Select the commonly missed contraindications to N2O/O2 sedation. Select all that apply. KEY commonly missed! Herbal supplements for depression or psych disorders Sleep medications, including herbal supplements Claustrophobia Cancer treatment with bleomycin sulfate Hypertension
Herbal supplements for depression or psych disorders Sleep medications, including herbal supplements Claustrophobia
Nitrous oxide can increase the pressure within cavities or spaces in the human body. Select all that can be affected by nitrous oxide due to the pressure. Impact on the eyes Patient with acute sinusitis Expansion of the middle ear airspace Impact the pleural space of the lungs Bladder
Impact on the eyes Patient with acute sinusitis Expansion of the middle ear airspace Impact the pleural space of the lungs
Which of the following psychological features can inform the clinician of fear and anxiety the day of the appointment? Select all that apply. Increased heart rate Constricted pupils Slow and deep breathing Trembling Excessive sweating
Increased heart rate Trembling Excessive sweating
Select all that apply. Which of the following are additional significant factors that may affect the development of a child today. Individual child temperament & personality Parental interactions Parental attitudes toward medical and dental professionals Changes in patterns for rearing children
Individual child temperament & personality Parental interactions Parental attitudes toward medical and dental professionals Changes in patterns for rearing children (all of the above)
A device known as the _________________detects nitrous oxide in the ambient air by using electromagnetic energy to detect the levels. The technology can detect levels lower than 1 ppm and also detect minute levels of gas immediately in the ambient air. ACGIH Spectrophotometry Time-Weighted Dosimetry Viasensor Gas Analyzer Infrared Spectrophotometry
Infrared Spectrophotometry
Which of the following is an invasive, pharmacologic approach to sedation for the conscious patient? Select all that apply. Neuroleptanesthesia Local anesthesia Intravenous sedation Intramuscular sedation Oral sedation
Local anesthesia Intravenous sedation Intramuscular sedation Oral sedation
Read each statement on the evolution of nitrous oxide sedation. Select all TRUE statements. Read through pages 7-9 to help answer the question. Medical residencies in the 1930s included information on N2O within the curricula. 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. In the 1940s lidocaine was discovered, this LA temporarily diminished the use of N2O. Anesthesia became a specialty in 1904. Halothan gas was introduced in the 1950s and N2O was used as an adjuvant drug to induce the effects of halothan. During the time period between 1940s to the 1960 N2O/O2 sedation was almost nonexistent.
Medical residencies in the 1930s included information on N2O within the curricula. In the 1940s lidocaine was discovered, this LA temporarily diminished the use of N2O. Halothan gas was introduced in the 1950s and N2O was used as an adjuvant drug to induce the effects of halothan.
Research studies support, chronic exposure to nitrous oxide, can inhibit which vitamin B12 enzyme? Methionine synthases Reserve transcriptase Monoamine oxide Catechol-O-methyl transferase
Methionine synthases
All of the following statements are TRUE of N2O/O2 sedation, EXCEPT. There have been no known reported allergies to N2O Permicious anemia is a absolute contraindication for N2O/O2 sedation N2O is metabolized in the liver N2O/O2 sedation can be safely administered on patients with malignant hyperthermia
N2O is metabolized in the liver
Is N2O/O2 sedation contraindicated for an individual with congenital birth defects?
NO
Which of the following states allows a DH's to administer nitrous oxide ? Select all that apply. NJ NY RI NH ME
NY RI NH ME
Preprocedural fasting is mandated for patients undergoing N2O/O2 sedation by the ADA and the AAP/AAPD in an ambulatory setting because a frequent side effect of N2O drug is vomiting. Neither the statement nor the reason is correct. Both the statement and the reason are correct and related. Both the statement and the reason are correct but not related. The statement is correct, but the reason is not. The statement is not correct, but the reason is correct.
Neither the statement nor the reason is correct.
Select all the items that need to be documented after nitrous oxide/oxygen sedation in the patient's record. Percentage of drug delivered Patient's adverse reaction and/or comments Weight of patient Duration of drug delivered
Percentage of drug delivered Patient's adverse reaction and/or comments Duration of drug delivered
Explain what occurs during each step of SOAPME. Be sure to define each letter in the acronym.
S - Suction: A size appropriate suction catheter and functioning suction apparatus is selected for use O - Oxygen: Adequate O2 supply is delivered and functioning flowmeters and other devices needed for delivery are utilized A - Airway: Size appropriate airway equipment is selected for use (nasopharyngeal and oropharyngeal airways, larygnoscope blades checked for functioning, endotracheal tubing, stylets, face mask, bag-value-mask) P - Pharmacy: All necessary drugs needed to support life during an emergency are located and available during the procedure M - Monitors: A functioning pulse oximeter with size-appropriate oximeter probes as well as other monitoring devices (noninvasive blood pressure, end tidal CO2, electrocardiogram, stethoscope) are located and available during the procedure E - Equipment: Any special equipment or drugs needed for special patient cases are located and available during the procedure (example: defibrillator)
When reviewing the health history, which of the following may require further questioning before administer nitrous oxide? Select all that apply. Sleep apnea Use of reactional drugs Blood pressure 130/80 Ear or eye surgery in the past 4 months
Sleep apnea Use of reactional drugs Ear or eye surgery in the past 4 months
Read through each statement. Select all the TRUE statements about the storage cylinders used to transport gases. Small, fiberglass-wrapped cylinders offer a lightweight alternative for patients requiring ambulatory O2 supplementation, and ultralight carbon composite is becoming popular around the world. Clinders are typically noninsulated high-pressure tanks made of carbon steel. Color coded for easy identification, then color coded for the gas is the same around the world It is common to see cylinders 60 to 70 years old in distribution.
Small, fiberglass-wrapped cylinders offer a lightweight alternative for patients requiring ambulatory O2 supplementation, and ultralight carbon composite is becoming popular around the world. Clinders are typically noninsulated high-pressure tanks made of carbon steel. It is common to see cylinders 60 to 70 years old in distribution.
What needs to be documented after N2O/O2 sedation? Type a list of all the items to record in the record.
The following needs to be documented after nitrous oxide administration: -Patient name -ASA classification -Indications for nitrous oxide use -Assessment of oral intake - Preoperative and postoperative vitals -Minute volume -Peak percentage of N2O administered -O2 saturation of hemoglobin -Assessment of recovery -Adverse reactions -Additional comments related to the procedure -Signature of practitioner
Select the statements TRUE of the Pin Index Safety System. Is a threaded valve system The Pin Index is used on portable units and central gas supply systems The nitrous oxide holes are offset Prevents the incorrect cylinder from being attached
The nitrous oxide holes are offset Prevents the incorrect cylinder from being attached
Which of the following is a personal monitoring device that can be worn by a dental hygienist when administering nitrous oxide? Viasensor Analyzer Dosimetry Time-Weighted Average Dosimetry IA Spectrophotometry NIOSH Dosimetry
Time-Weighted Average Dosimetry
Anatomic factors that affect the respiratory system, such as enlarged tonsils and adenoids are of relative importance because they can cause an increased risk for airway obstruction. There is no need to evaluate the ASA Physical Classification status for pediatric patients. Both statements false First statement is true and the second statement is false First statement is false and second statement true Both statements true
True, false
Which of the following IS a contraindication of the N2O/O2 sedation? Cerebrovascular accidents Cancer Parkinson's disease Acute sinus infection
acute sinus infection
N2O/O2 sedation is contraindicated for a patient with _______________________________. a leaking lung a gastric ulcer liver disease psoriasis
a leaking lung
N2O/O2 sedation is contraindicated for a patient with _______________________________. a leaking lung liver disease asthma psoriasis
a leaking lung
The minimum alveolar concentration for nitrous oxide is _____. a. 104% and denotes its potent general anesthetic qualities b. 0.47 and denotes its potent general anesthetic qualities c. 1.4 and denotes its potent general anesthetic qualities d. 0.47 and denotes its weak general anesthetic qualities e. 104% and denotes its weak general anesthetic qualities
a. 104% and denotes its potent general anesthetic qualities
The individual who first studied the effects of nitrous oxide at the Pneumatic Institute was a. Humphrey Davy b. Joseph Priestley c. Gardner Quincy Colton d. Horace Wells e. Samuel Cooley
a. Humphrey Davy
Chronic exposure to nitrous oxide can inhibit which Vitamin B-12-dependent enzyme? a. Methionine synthetase b. Monoamine oxidase c. Catechol-O-methyl transferase d. Reverse transcriptase e. ATPase
a. Methionine synthetase
Signs of adequate sedation include which of the following? a. Relief of anxiety. b. Tingling sensation of extremities. c. Euphoria. d. All the above. e. a and c only
a. all of the above
Some possible indications for the clinical use of nitrous oxide include a. relief of anxiety for phobic patients. b. depression of a hyperactive gag reflex. c. increase in the pain threshold for more stimulating procedures. d. all the above. e. a and c only.
a. all of the above
Nitrous oxide a. is a very weak respiratory depressant and can be used safely in patients with COPD who are not on hypoxic drive. b. is a very potent respiratory depressant and is contraindicated for use in any patient with asthma or COPD. c. is a very potent myocardial depressant causing significant decreases in cardiac output and blood pressure. d. is without controversy in its use throughout the entire term of pregnancy. e. has no effect on the central sympathetic nervous system
a. is a very weak respiratory depressant and can be used safely in patients with COPD who are not on hypoxic drive.
The pressure of nitrous oxide in the tank will not show a decrease in pressure until the _____ phase is gone and only _____% of the tank remains. a. liquid, 20 b. gas, 20 c. liquid, 50 d. gas, 50 e. liquid, 10
a. liquid, 20
The correct position for the patient when beginning any sedation is _____. a. the position where the work will be done b. the supine position c. the Trendelenburg position d. the lithotomy position e. none of the above
a. the position where the work will be done
Minute ventilation is approximated by multiplying _____ by_____. a. tidal volume, breaths per minute b. tidal volume, cardiac output c. oxygen concentration, tidal volume d. nitrous oxide concentration, tidal volume e. tidal volume, weight in kilograms
a. tidal volume, breaths per minute
Patient, parental or legal guardian consent should be obtained prior to initiating any sedative procedure. a. True b. False
a. true
When administered in high concentrations, nitrous oxide is very quickly taken up by the bloodstream, causing a vacuum in the alveoli, thereby increasing minute ventilation and further hastening nitrous oxide uptake. This effect is termed diffusion hypoxia. a. First statement is true; second statement is false. b. First statement is false; second statement is true. c. Both statements are true. d. Both statements are false
a. true, false
What should the clinician do if the patient's postoperative pulse rate is more than 10 beats per minute different than the preoperative rate?
administer 100% oxygen for a few minutes and recheck
Emergency situations involving children commonly involve the __________________.
airway
A noninvasive, nonpharmacologic approach to sedation can include, which of the following methods? Select all that apply. The conscious effort of the provider in their word selection and tone, including verbal and non-verbal communication skills. Hypnosis can be utilized to help with fear and anxiety. Distraction mechanisms help divert the individual's attention away from the fear. Acupuncture and acupressure can be used to help decrease fear and anxiety. TENS and EDA
all of the above
Hypoventilation or decreased ventilation can occur during sedation and anesthesia. What should the clinician be observing or monitoring during sedation? Select all that apply. presence of sleep apnea airway obstruction Obesity short or limitation movement of the neck limited mouth opening or closing of mouth
all of the above
Inhalant abusers can present with: Select all that apply. blood shot eyes sores around the mouth breath odor glazed eyes runny nose
all of the above
Read through each statement on the maintenance of the sedation equipment. Which of the following are completed when servicing the equipment? Select all that apply. pressure testing recalibration of the flowmeter internal component checking inspection of the hoses, tubing, and reservoir bag for leaks
all of the above
Select all that apply. What are sources of leakage from the patient during treatment? Patient talking throughout the procedure Patient mouth breathing during treatment Ill-fitting mask Displacement of mask during treatment
all of the above
Select all the items an office needs to consider when using N2O/O2 sedation. Infrared spectrophotometry can be used to detect nitrous oxide in the air Can use a hand-held monitoring devices to detect leakages around the equipment Need to lmit the conversation during the appointment Have ventilation systems monitored for effective scavening
all of the above
Select all the noninvasive/non-pharmacologic approach to sedation. Hypnosis Relaxation therapy Biofeedback Virtual reality headset Acupuncture/acupressure Aromatherapy
all of the above
The NH Board of Dentistry requires the course to include at least the following course content: Select all that apply. Maintenance of proper records Anatomy and physiology as they relate to inhalation sedation Preventing, recognizing and managing possible complications of inhalation sedation Abuse potential of nitrous oxide Description and use of inhalation sedation equipment Health hazards and techniques to limit occupational exposure Pharmacology and physiological effects of nitrous oxide, including drug interactions
all of the above
When working with a patient with dental fear and anxiety, which of the following is beneficial? Select all that apply! Appropriate assessment and acknowledgement of the patient's fear and anxiety. Facilitate and interact with the patient to overcome their fear and anxiety Displaying empathy toward your patient Good communication skills
all of the above
Inhalation conscious sedation with nitrous oxide _____________________. requires the patient to have someone drive them home after treatment is the most effective on severe dental pain and anxiety allows the patient to recover quickly after use achieves a level of awareness and relaxation that puts the patient asleep during treatment
allows the patient to recover quickly after use
Which of the following is NOT a portion of the conducting zone? pharynx bronchioles larynx alveolar ducts
alveolar ducts
N2O is a raw ingredient of __________________ that is supplied as a clear liquid or pellet-sized particles. carbon dioxide carbon monoxide nitric oxide ammonium nitrate
ammonium nitrate
The distance from the gas source to the patient's lungs can increase the _________________ space. oral cavity dead anatomic dead conduction tubing dead pulmonary dead
anatomic dead
The distance from the gas source to the patient's lungs can increase the _________________ space. pulmonary dead anatomic dead conduction tubing dead oral cavity dead
anatomic dead
The blood/gas partition coefficient of nitrous oxide is _____ and denotes its _____. a. 104%, rapid onset and recovery b. 0.47, rapid onset and recovery c. 1.4, potency d. 104%, potency e. 0.47, potency
b. 0.47, rapid onset and recovery
Tidal volume can be approximated by estimating ____ cc / kg of patient weight. a. 5 b. 10 c. 15 d. 20 e. 25
b. 10
Nitrous oxide was first isolated by: a. Humphrey Davy b. Joseph Priestley c. Gardner Quincy Colton d. Horace Wells e. Samuel Cooley
b. Joseph Priestley
Nitrous oxide a. eliminates the need for local anesthesia. b. can expand air-filled cavities in the body. c. has an antagonistic effect to other sedative hypnotics. d. diffuses much more slowly than nitrogen. e. both a and c.
b. can expand air-filled cavities in the body.
When other potent inhalational agents are administered with high concentrations of nitrous oxide, their uptake is enhanced by _____. a. the concentration effect. b. the second gas effect. c. the diffusion hypoxia. d. the respiratory depression. e. the hypoxic drive.
b. the second gas effect.
Minute volume: volume of air inspired or expired with each normal breath; it amounts to about 5000 milliliters in the adult male. Tidal volume: the amount of air inspired or expired in a minute and calculated by multiplying the tidal volume by the respiration rate. both statements true first statement false and second statement true first statement true and second statement false both statements false
both false
A central gas supply system is an option for practitioners who prefer N2O/O2 sedation availability in several units as a "built-in" system within the facility. This system is preferred when there is a high frequency of N2O/O2 use and/or users because there are cost-savings, convenience, and space-saving features. Both statements false First statement is true and the second statement is false Both statements true First statement is false and second statement true
both true
A common mistake made with N2O/O2 sedation is to automatically deliver a preset percentage of N2O to a patient. Far too often patients blame any negative experience on the drug itself, not realizing it was operator error. First statement is false and second statement true Both statements true Both statements false First statement is true and the second statement is false
both true
Approximately 85% to 90% of the N2O produced by the major manufacturing companies is used in health settings. N2O is used in the food industry, for example, N2O is dissolved within the whipped cream until it vaporizes with ambient air when expelled from the can. First statement is true and the second statement is false Both statements true First statement is false and second statement true Both statements false
both true
Capnometry uses infrared light technology to measure the concentration of CO2 at exhalation. End-tidal CO2 is sampled through a line typically connected to a nasal cannula, thus can't be measured on older systems. Both statements false First statement is true and the second statement is false Both statements true First statement is false and second statement true
both true
Gases inhaled through the nose or mouth are transported to the respiratory zone of the lungs. The exchange of gases in alveoli depends on the diffusion of gases across membranes; is controlled by partial pressures of respective gases on either side of the alveolar membrane. first statement false and second statement true both statements false both statements true first statement true and second statement false
both true
N2O has the ability to depress the CNS. N2O/O2 sedation has no negative effect on the endocrine system. First statement is true and the second statement is false First statement is false and second statement true Both statements true Both statements false
both true
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. both statements false first statement false and second statement true first statement true and second statement false both statements true
both true
N2O/O2 sedation is being used during endoscopy procedures, such as a bronchoscopy. N2O/O2 sedation combined with local anesthesia has been proved effective and safe when performing a fiber optic bronchoscopy for children. Both statements true Both statements false First statement is true and the second statement is false First statement is false and second statement true
both true
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" First statement is true and the second statement is false First statement is true and the second statement is false Both statements are true Both statements are false
both true
Nitrous oxide oxidizes the form of cobalamin (Vit B12) when prevents cobalamin from acting as a coenzyme for methionine synthase. Methionine synthase is vital for the synthesis of materials within the body and plays a vital role in cellular reproduction. Both statements true Both statements false First statement is false and second statement true First statement is true and the second statement is false
both true
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. First statement false and second statement true Both statements true Both statements false First statement true and second statement false
both true
Nitrous oxide-oxygen sedation has a positive effect on myocardial ischemia due to its provision of supplemental oxygen, sedative properties, and tendency to dilate peripheral vessels. Nitrous oxide can also enhance the CNS depressant effects of agents such as barbiturates, tranquilizers, narcotics, and recreational drugs. (Think about these statements, a critical thinking question) Both statement true Both statements false First statement false and second statement true First statement true and second statement false
both true
Should the N2O cylinder fall and break off the stem valve, the cylinder will propel like a rocket until its contents are dispersed. This is largely because of the expansive nature of the N2O gas, as well as the pressurization within the cylinder. Both statements true First statement is true and the second statement is false First statement is false and second statement true Both statements false
both true
The deoxyuridine suppression test is a sensitive test used to accurately determine the first signs of biologic effect associated with chronic exposure to N2O. The test detects the early signs of inactivation of the enzyme methionine synthase. Both statements false First statement false and second statement true First statement true and second statement false Both statements true
both true
Which of the following conditions contraindicates the use of N2O-O2 sedation for treatment today? Diabetes Current ear infection Kidney disease History of asmtha as a kid, patient now an adult
current ear infection
The universal distress signal for choking is to grasp the throat with both hands. To help apply abdominal thrusts (Heimlich maneuver), chest thrusts, and/or back blows until the foreign object is expelled or the person becomes unconscious. First statement is false and second statement true Both statements false First statement is true and the second statement is false Both statements true
both true
When a patient is relaxed, muscles in the forehead and brow area should not be tight or strained. Patients will also smile easily when questioning how they are feeling, or patients will smile easily without conversation. First statement is true and the second statement is false First statement is false and second statement true Both statements false Both statements true
both true
21. Oxygen is dispensed as a compressed gas in the U.S.A. from green pressurized tanks. A full tank will register 2000 psi and will decrease commensurate to the amount of gas utilized. a. First statement is true; second statement is false. b. First statement is false; second statement is true. c. Both statements are true. d. Both statements are false.
c. both true
Nitrous oxide is dispensed in a blue pressurized tank (approximately 760 psi). It exists in both a gas and liquid form in the full tank. a. First statement is true; second statement is false. b. First statement is false; second statement is true. c. Both statements are true. d. Both statements are false
c. both true
Although this effect is rarely a clinical problem with nitrous oxide sedation, it is prudent to administer 100% oxygen after cessation of nitrous oxide to minimize_____. a. the concentration effect b. the second gas effect c. diffusion hypoxia d. respiratory depression e. hypoxic drive
c. diffusion hypoxia
Which of the following should you do first when a patient is at 50% N2O during sedation and the patient tells you they are not feeling anything? Key FIRST step! Check the nose piece seal for leakage Make sure the nitrous tank is not empty Check the scavenging system for proper function Increase the level of N2O by 10% per minute
check the nose piece seal for leakage
When working with pediatric patients N2O/O2 sedation is frequently used together with other sedative agents such as___________________ to achieve a deeper sedation. Select all that apply. chloral opioids diphenhydramine benzodiazepines
chloral opioids diphenhydramine benzodiazepines (all of the above)
The intent of N2O/O2 sedation is to make the patient relaxed and __________________. to forget the experience of dental treatment comfortable during treatment asleep during treatment unable to move during treatment
comfortable during treatment
A central gas system requires ___________ lines for the gas to travel from the manifold throughout the office. steel rubber copper plastic
copper
Which of the following conditions contraindicates the use of N2O/O2 sedation? Current ear infection Anemia Diabetes High blood presure
current ear infection
Which of the following conditions contraindicates the use of N2O/O2 sedation? High blood presure Diabetes Current ear infection Anemia
current ear infection
The analgesic qualities of nitrous oxide, when used in concentrations typically administered in the dental office, can be compared to a. 10-15 mg. diazepam. b. 150-200 mg. meperidine. c. 50-100 mg. pentobarbital. d. 10-15 mg. morphine. e. 1-5 mg. midazolam.
d. 10-15 mg. morphine.
Which of the following are true? a. Nitrous oxide reaches equilibrium with the bloodstream very quickly. b. Nitrous oxide diffuses very slowly across the pulmonary parenchyma. c. Recovery from nitrous oxide is very rapid. d. Both a and c. e. Both a and b.
d. Both a and c.
The dentist who has posthumously been recognized as the "Discoverer of Anesthesia" due to his clinical use of nitrous oxide is a. Humphrey Davy b. Joseph Priestley c. Gardner Quincy Colton d. Horace Wells e. Samuel Cooley
d. Horace Wells
Relative contraindications to the use of nitrous oxide sedation include a. the inability to breathe through the nose. b. COPD patients with hypoxic drive. c. the inability to communicate with the patient. d. all the above. e. a and c only
d. all of the above
Nitrous oxide is indicated to help reduce stress and anxiety in patients who are medically compromised. Typical nitrous concentrations should be 50-60% due to their increased need for stress reduction. a. First statement is true; second statement is false. b. First statement is false; second statement is true. c. Both statements are true. d. Both statements are false.
d. both false
As an adjunct for the behavior management of the pediatric patient, it would not be inappropriate to _____. a. initiate the sedation with 20% nitrous oxide for control, then titrate to 50% for the maintenance phase b. initiate the sedation with 70% nitrous oxide for control and leave at that concentration until the end of the appointment c. initiate the sedation with 50% nitrous oxide for control, then titrate to 70% for the maintenance phase d. initiate the sedation with 70% nitrous oxide for control, then titrate to 20-40% for the maintenance phase e. none of the above
d. initiate the sedation with 70% nitrous oxide for control, then titrate to 20-40% for the maintenance phase
N2O/O2 sedation can be useful when taking oral radiographs because it: depresses the oral gag reflex allows the patient to open his/her mouth wider reduces the amount of radiation delivered to the patient reduces patient movement during procedure
depresses the oral gag reflex
N2O exits faster than the N2 that replaces it, thereby diluting the supply of O2 and reducing the amount of O2 blood saturation. This phenomenon is called ____________________. partial pressure hypoxia diffusion hypoxia secondary gas effect partial pressure gas effect
diffusion hypoxia
The term used to define the decrease in blood oxygen saturation caused by the rapid exit of nitrous oxide upon termination is called: bronchus diffusion diffusion hypoxia dead anatomical space pulmonary diffusion
diffusion hypoxia
What is the #1 potential negative side effect of N2O/O2 sedation?
diffusion hypoxia
_____________________ is defined by a decrease in O2 saturation levels in the blood caused by the rapid exit of N2O on termination, which can result postoperative headaches and nausea. Diffusion hypoxia Pulmonary space hypoxia Arterial anoxia Pulmonary effusion
diffusion hypoxia
In the medical setting nitrous oxide sedation can be used to when: Select all that apply. dressing and caring for burns placing and removing sutures incising abscesses when removing a cyst or wart
dressing and caring for burns placing and removing sutures incising abscesses when removing a cyst or wart (all of the above)
NIOSH currently sets acceptable trace gas levels of nitrous oxide at _____. a. 450 ppm b. 350 ppm c. 200 ppm d. 100 ppm e. 25 ppm
e. 25 ppm
Which of the following statements is/are false? a. Nitrous oxide sedation is almost 100% effective. b. Nitrous oxide can potentiate other more potent inhalational agents. c. Nitrous oxide works best when used as a rescue agent after a difficult clinical situation has developed. d. All the above. e. a and c only.
e. a and c only.
Signs of over-sedation with nitrous oxide typically occur when more than 50% is administered and can include which of the following? a. Nausea b. Excessive dreaming c. Profuse sweating d. Auditory changes e. All the above
e. all of the above
Physiologic properties of nitrous oxide include a. minimal effect on the respiratory system in the healthy patient. b. minimal effect on the cardiovascular system in the healthy patient. c. mild central sympathetic stimulation. d. mild peripheral/cutaneous vasodilation. e. all the above
e. all the above
Most patients will achieve the desired clinical endpoint of sedation at _____ nitrous oxide. a. 10-20% b. 20-40% c. 50-70% d. above 70% e. none of the above
e. none of the above
The theory of pain modulation suggests that impulses are altered along the way by an ______________________ opioid system. norephinerphrine dopamine endogenous and exogenous endogenous exogenous
endogenous
There is some evidence that nitrous oxide is involved with ____________ system, thus activating our internal ________________ neurotransmitters. exogenous opioid; dopamine exogenous norephinerphrine; serotonin endogenous opioid; opioid endogenous serotonin; dopamine
endogenous opioid; opioid
Patients may report tingling, most likely, around their mouth and in their ___________________. Stomach Back area Head Eyes Extremities
extremities
Select ALL the signs and symptoms of IDEAL sedation. uncontrolled laughter eye glaze or glassy appearance skin becomes flushed and warm fixed stare and fast blinking tingling of extremities
eye glaze or glassy appearance skin becomes flushed and warm tingling of extremities
Administering N2O to a patient with an acute sinus infection may cause an increase of air volume because of the expansive nature of N2O within an air-filled space with a bony enclosure. True False
false
Healthcare providers need to be concerned about hemodynamics with using N2O/O2 sedation for pain control and relief in patients in the final stages of life.
false
N2O may be considered to have a strong opioid agonist, making it more addictive than a full agonist such as morphine. True False
false
Patients can be allergic to nitrous oxide.
false
Patients with an endocrine condition, such as hypothyroidism or diabetes are not good candidates for N2O/O2 sedation.
false
The AAP & AAPD have different published guidelines for pediatric dentistry and N2O/O2 sedation.
false
The amnestic effect associated with N2O/O2 sedation will result in the patient not remembering the procedure or the clinician at ALL. The patient has no memory of the appointment or the DH. True False
false
The amnestic effect associated with N2O/O2 sedation will result in the patient not remembering the procedure or the clinician. True False
false
A dental hygienist qualified in the administration of nitrous oxide shall administer nitrous oxide under the indirect supervision of a dentist. The DH will display in their place of practice proof of a nitrous oxide qualification course approved/certification. Both statements false First statement true and second statement false First statement false and second statement true Both statements true
false, true
In the state of NH, the administration of nitrous training can be completed in any dental office under a dentist signing off for qualifications meeting the state dental board. The course requires the passing of a written examination by the course provider. Both statements false Both statements true First statement false and second statement true First statement true and second statement false
false, true
It is mandated by the AAP that all patients must wear an oximeter during nitrous oxide sedation. The average tidal volume for an adult patient is around 500 mL and 12-15 respirations per minute. both statements true first statement true and second statement false first statement false and second statement true both statements false
false, true
Nitrous oxide use is contraindicated for asthma patients because it is irritating to mucous membranes. There has never been an allergy to N2O reported, only adverse reactions. First statement is false and second statement true Both statements true Both statements false First statement is true and the second statement is false
false, true
The AAP and AAPD use different language in regards to the definitions of sedation categories. AAP & AAPD consider children who fall into the ASA Classes 1 and 2 are appropriate patients for all levels of sedation. First statement true and second statement false First statement false and second statement true Both statements false Both statements true
false, true
The oxygen flush button/knob found on the conduction tubing will dispense 100% oxygen at a high flow rate into the reservoir bag. Once the bag is filled, the reservoir bag may serve to assist with patient respirations should an emergency situation arise. Both statements false First statement is true and the second statement is false First statement is false and second statement true Both statements true
false, true
The percentage of N2O noted in a patient's chart from the last visit is very relevant for the current appointment. Negative patient experiences from N2O/O2 sedation are most likely because the patient was oversedated as a result of operator error. Both statements false Both statements true First statement is true and the second statement is false First statement is false and second statement true
false, true
Turn the knob clockwise on the top of the cylinders associated with a portable system. Visually monitor the pressure gauges, if a tank is low it is important to have a second cylinder readily available and opened before the gases are completely depleted during the procedure. Both statements true Both statements false First statement false and second statement true First statement true and second statement false
false, true
When placing the mask, wait to turn on the O2 and N2O flow rate. Always turn off the N2O while the nasal hood is on the patient and continue 100% O2 for at least 5 minutes. First statement false and second statement true First statement true and second statement false Both statements false Both statements true
false, true
The __________________ is a highly calibrated device that sits on top of the yoke assemble or is mounted to the wall or located within the cabinetry. regulators psi readings O2 fail-safe device flowmeter
flowmeter
The __________________ is a highly calibrated device that sits on top of the yoke assemble or is mounted to the wall or located within the cabinetry. regulators psi readings flowmeter O2 fail-safe device
flowmeter
Which of these symptoms is NOT a sign of over-sedation? Loss of consciousness Rigid movements Diaphoresis Dizziness Giddiness and smiling
giddiness and smiling
Diffusion hypoxia has been hypothesized as the cause of postoperative: Select all that apply. headache lethargy nausea/vomiting loss of voice
headache lethargy nausea/vomiting
The phenomenon known as the _____________of compression can increase the temperature of the metal to a level that ignites any hydrocarbon contaminants and causes a _________________ reaction resulting in fire or explosion. heat; chemical chemical; heat transfer; chemical chemical; transfer
heat, chemical
If any hydrocarbon compound is used _____________ can be generated inside and outside the tank resulting in a _______________ the temp of the metal, thus a ___________________ reaction occurs. chemical; increase; explosion liquid; decrease; chemical heat; increase; chemical gas; decrease; heat
heat, increase, chemical
If the gas entering the alveolus has a significantly _____________ partial pressure than that in the capillary, the gas rapidly diffuses into the blood. This occurs until the partial pressure in the blood is _____________ that of the alveoli. higher; equal lower; higher lower; equal higher; higher
higher, equal
A drug that diffuses immediately into the blood and is rapidly distributed across the body and into the organs is considered: highly soluble relatively insoluble insoluble volume soluble
highly soluble
A patient who responds quickly to a small amount of nitrous oxide is considered to be a: truly fearful patient normal patient hyporesponder hyperresponder
hyperresponder
Which of the following does NOT contraindicate the administration of N2O/O2 sedation? Psychiatric disorder Hypertension Chronic obstructive pulmonary disease Gastrointestinal obstruction
hypertension
Which of the following does NOT contraindicate the administration of N2O/O2 sedation? Psychiatric disorder Hypertension Gastrointestinal obstruction Chronic obstructive pulmonary disease
hypertension
Who is credited for discovering nitrous oxide? Humphrey Davy Joseph Priestly Gardner Colton Horace Wells
joseph priestly
Which of the following extends from the epiglottis to the division of the esophagus and larynx? oropharynx laryngopharynx nasopharynx all three are correct
laryngopharynx
A common area of spasm evidenced by a significant cough and gag reflex occurs at the: soft palate larynx carina
larynx
Which part of the airway houses the vocal cords? Pharynx Trachea Larynx Oropharynx
larynx
A patient experiencing signs and symptoms of ideal nitrous oxide/oxygen sedation will report as though they are feeling: like flying and/floating away quickly spinning and/or falling slowly light feeling within their body and heaviness arms and legs out of body experience with a pink fluffy cat
light feeling within their body and heaviness arms and legs
Possible adverse reactions from over sedation include: Select all that apply. chills and pale skin altered taste for a few hours light headed or headache nausea
light headed or headache nausea
Which of the following is considered conscious sedation that can be used during routine operative treatment? Select all that apply. local anesthesia oral sedation inhalation sedation (N2O/O2) intramuscular sedation
local anesthesia oral sedation inhalation sedation (N2O/O2) intramuscular sedation
Nitrous oxide is eliminated from the body primarily by the ___________________. kidneys liver skin urine lungs
lungs
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? Deep sedation Moderate sedation General sedation Minimal sedation
moderate sedation
The drug able to reserve the effects of opioids and N2O is: Amoxicillin Polocaine Lidocaine Acetaminophen Naloxone
naloxone
Effectively managing the patient's pain, needs to occur________________________. postoperatively intraoperatively needs to include all three listed preoperatively
needs to include all three listed
Do all patients experience the same signs and symptoms during N2O/O2 sedation? Yes No
no
Is N2O/O2 sedation contraindicated for an individual with asthma? Yes No
no
Is sickle cell anemia contraindicated for N2O/O2 sedation?
no
N2O/O2 sedation is ideal for a patient who has or is __________________. Select all that apply. no dental anxiety and mild pain mild dental anxiety mild hypertension history of substance abuse cystic fibrosis moderate to severe dental anxiety
no dental anxiety and mild pain mild dental anxiety
Is there a time limit for the practitioner to consider when administering N2O/O2 sedation? What did the authors recommend as an extended time period? No specific time; 1.5 hours Yes; 1 hour No specific time; 3 hours Yes; 3 hours
no specific time, 3 hours
Can the N2O tank accidentally get attached to the O2 side of a portable unit?
no!
Is a pulse oximeter necessary for N2O/O2 sedation?
no, though it is recommended
Which pain receptors are the first to receive the stimulus from the PNS? nervoceptor nociceptors chemoreceptors cytoplasmic receptors
nociceptors
N2O is __________ absorbed by the blood because of this ________________, thus little gas is absorbed into the blood. not readily; insolubility quickly; insolubility quickly; solubility not readily; solubility
not readily, insolubility
It is recommended to check all conduction tubing and the reservoir bag leaks with soap and water. Once every 6 months Once every two years On a regular basis Yearly
on a regular basis
The interaction between a drug, the brain, and other tissues until equilibrium is reached is expressed in values called partition coefficients. partition coefficient second gas coefficient solubility coefficient N2O partition solubility coefficient
partition coefficient
From the list below, select all items associated with a portable gas system. G and H tanks pin idex safety system manifold E tanks regulator yoke stand
pin idex safety system E tanks regulator yoke stand
Administering N2O to an individual with an acute sinus infection may cause an increase in _____________ because of the expansive nature of N2O within an air-filled space with a bony enclosure. pressure volume solubility insolubility
pressure
When the cylinders are inspected according to the DOT ISO standards, the cylinders undergo: Select all that apply. pressure test expulsive test expansion test hydrostatic test
pressure test expansion test hydrostatic test
Many factors can influence an individual's reaction to pain. Select all that apply to this statement. psychogenic all or none principle mental health physical health culture biochemical
psychogenic mental health physical health culture biochemical
While the patient is under nitrous oxide/oxygen sedation, a patient will likely think the time has passed by_________________________. normally slowly quickly will not remember the procedure
quickly
The pulse oximeter operates on the principle that hemoglobin exists in two forms in the blood either: Select the TWO answers. reduced hemoglobin with no O2 molecules bound (Hb) oxygenated in arterial blood with O2 molecules loosely bound (HbO2) oxygenated in ventral blood with O2 molecules loosely bound (HbO2) reduced hemoglobin with N2O molecules bound (Hb)
reduced hemoglobin with no O2 molecules bound (Hb) oxygenated in arterial blood with O2 molecules loosely bound (HbO2)
N2O and O2 tanks have ______________ to control the pressure. Always turn the tanks on ____________ to dissipate gases. flowmeter; fast regulators; slow pressure reader; slow flowmeter; slow
regulators, slow
N2O and O2 tanks have ______________ to control the pressure. Always turn the tanks on ____________ to dissipate gases. regulators; slow flowmeter; slow pressure reader; slow flowmeter; fast
regulators, slow
Nitrous oxide is considered _________________ in the blood. lowly soluble highly soluble relatively insoluble relatively soluble
relatively insoluble
N2O/O2 sedation has a significant negative impact (harmful effect) on which of the following body systems? Genitourinary Reproductive Endocrine Gastrointestinal
reproductive
Which vital signs are required when administering nitrous oxide on an adult patient? Select all that apply. respiration pulse blood pressure oxygen saturation
respiration pulse BP
Which lung do aspirated objects tend to enter? Left Either side has equal chance right
right
The ____________________ occurs when an additional anesthetic gas is administered with nitrous oxide. concentration effect first-gas effect second-gas effect blood gas partition coefficient
second-gas effect
Which of the following adverse events or reactions is linked with over sedation with nitrous oxide? Sweating Slow blink rate and "glassy" eyes Nausea and vomiting Heaviness of the extremities
sweating nausea and vomiting
Minute ventilation is approximated by multiplying _________________ by _______________________. tidal volume; cardiac output tidal volume; respiration rate tidal volume; weight in pounds oxygen concentration; tidal volume tidal volume; nitrous concentration
tidal volume; respiration rate
Before the appointment the patient needs to: avoid eating 2 hours before the appointment to plan for someone to drive them home after the appointment avoid eating 4 hours before the appointment to have a lite meal 2 hours before the appointment
to have a lite meal 2 hours before the appointment
All child patients should be encouraged to touch, examine, and place the nasal hood on the nose before N2O administration.
true
Pharmacokinetics is defined as "the activity or fate of drugs in the body over a period of time, including the processes of absorption, distribution, localization in tissues, biotransformation, and excretion." True False
true
The NH Board of Dentistry requires successfully completing a clinical evaluation by the course provider.
true
The definition of pharmacodynamics is "the study of the biochemical and physiologic effects of drugs and the mechanisms of their actions, including the correlation of actions and effects of drugs with their chemical structure, and the effects on the actions of a drug or drugs." True False
true
The propensity exists for a patient to become sexually stimulated or dream or hallucinate sexual situations while sedated with N2O.
true
When starting nitrous oxide sedation, the patient's upper torso should be slightly reclined and the legs slightly elevated. True False
true
At least one clinician must remain in the treatment room to monitor a patient during N2O/O2 sedation. There is no additional need to have staff nearby or within view when administering and monitoring N2O/O2 sedation. First statement true and second statement false First statement false and second statement true Both statements true Both statements false
true, false
Begin titration of nitrous oxide with 10% to 15% or about 1 to 1.5 L of nitrous oxide. You will then increase the amount of nitrous oxide every five minutes by 1.5 liters. true or false?
true, false
Current sedation equipment guarantees a minimum O2 delivery of 30%. It is common to use approximately 4.5 tanks of O2 to every 1 tank of N2O during sedation procedures. First statement is true and the second statement is false First statement is false and second statement true Both statements true Both statements false
true, false
If the patient is suffering or recovering from addiction or mental illness, the relaxing, euphoric sensations from N2O may exacerbate or trigger unwanted episodes or may encourage addictive behaviors. Patients under psychiatric and/or psychologic care/medications that are controlled do not need a medical consultation before N2O/O2 sedation. Both statements true First statement is true and the second statement is false Both statements false First statement is false and second statement true
true, false
N2O is used in cryosurgery to cool metal instruments, which in turn initiates the freezing or tissue necrosis of a lesion. N2O/O2 sedation is also being used in ophthalmology in the ambulatory setting, at 25% N2O and 75% O2 producing the amnestic effect during the procedures. Both statements false Both statements true First statement false and second statement true First statement true and second statement false
true, false
N2O/O2 sedation is contraindicated for having undergone recent pneumoencephalography or for patients who are abusers of N2O. N2O/O2 sedation is considered safe and can continue for patients experiencing acute sinusitis or upper respiratory tract infections. Both statements false Both statements true First statement is true and the second statement is false First statement is false and second statement true
true, false
The Diameter Index Safety System is associated with the pressure hoses traveling from the regulator to the flowmeter. The oxygen and nitrous oxide pressure hoses have the same size connectors that insert into the flowmeter. Both statements true Both statements false First statement is false and second statement true First statement is true and the second statement is false
true, false
The gas is then compressed, dried to remove the remaining water, cooled, and liquefied. The resulting product is nearly pure (99.5%-99.9%) and is stored as a compressed gas at room temperature until N2O is placed in smaller tanks. Both statements false First statement is true and the second statement is false First statement is false and second statement true Both statements true
true, false
Can N2O/O2 sedation enhance difficult venipuncture?
yes (venous distention makes veins larger)
