9-Nitrous Oxide Pt. 1 Flashcards
what is the most costly part of the inhalation route?
the initial set up/equipment
T/F the inhalation route is the safest route
true
with the inhalation route _________ is easy but quickly reversed
overdose
what are the objectives of conscious sedation?
- Reduce fear and apprehension
- Obtain patient cooperation
- Avoid loss of consciousness
- Maintain vital signs within normal limits
what pt’s are good candidates for N2O?
Patients who are emotionally stable and cooperative but are apprehensive about undergoing dental treatment
what pt’s are bad candidates for N2O?
Some patients react poorly emotionally usually obsessive/compulsive or claustrophobic
Strange mental affect and/or mentally handicapped patients sometimes have less satisfactory sedation
what are the colors for the tanks (in the US)
Nitrous oxide: blue
oxygen: green
what are the different types of tanks for Nitrous Oxide?
G (giant) (13839 L) 750 psi
E-economy (1590 L) 750 psi
what are the different types of tanks for Oxygen?
H-(huge)cylinder (6900 L)2000 psi
E-cylinder (660 L) 2000 psi
T/F with Nitrous oxide the pressure is not an accurate indicator of the amount of gas whereas the oxygen pressure is accurate for the amount of gas present
true
-nitrous oxide stays at 750 psi until liquid has evaporated
-shows pressure decrease when tank hits ~20% full
with the older demand flow machines you were able to give ________% nitrous oxide while the modern ones can only give _______%
100%, 80%
with the continuous flow N2O machine how is the machine monitored?
by gauges in liters/minute
with the continuous flow N2O machine you can’t give less than _______% oxygen
30%
what is the porter triple outlet station?
for the continuous flow N2O machine
white = vac
green = O2
blue = N2O
what does the bag tree outlet do?
Connects to flowmeter
Connects to reservoir bag
Connects to fresh gas tubing
when was the fail-safe O2 mechanism added to the continuous flow N2O machine?
mid-1970’s
what does the fail-safe O2 mechanism do for the continuous flow N2O machine?
if O2 runs out, nitrous drops to zero flow
said this will be on the exam
how often should the flowmeter be calibrated on the continuous flow N2O machine?
every 2 years
how can you tell where the measurement is on the flowmeter on the continuous flow N2O machine?
middle of the ball will indicate L/min
scavenging systems prevent problems at approximately _______ L/min to minimize leakage of N2O for the continuous flow N2O machine
45
reservoir bag should be about _______ full for N2O for the continuous flow N2O machine
2/3
what are the 3 purposes of the reservoir bag for the continuous flow N2O machine?
- Source of additional gas should pt inspire more gas than is supplied through the hoses (Capacity approx 3 liters)
- Monitors pt’s respirations – expand/contract (No exhaled air goes into bag - scavenged)
- In an emergency can deliver positive pressure
(Not with a nasal hood
Need full mask/good seal)
T/F the nasal hood is made of latex and so you need to be careful with those who have allergies
false
T/F only certain nasal hoods will have scavenging capability
False all have it
T/F scavenging system is the Standard of care
true
if doing IV sedation the nasal hood must also have what?
capnography capability (all IV sedation needs this)
-monitoring exhaled by CO2
what are the safety factors of the continuous N2O flow machine?
Fail-Safe
Designed to deliver ≥ 30% oxygen
Pin indexing system
Diameter of attachment couplings (hose attachment)
Reservoir bag
how do you prepare the pt for the continuous flow N2O machine
First check nitrous machine/connections, then
Seat patient
RMH, confirm surgical site(s), informed consent,
Place monitors
Select correct size of nasal hood
Place patient in supine/semi-spine position
Place/adjust nasal hood
begin and end with _______% O2 when using the continuous flow N2O machine
100%
T/F do not leave sedated pt alone at any point
true
for the nitrous technique you should divide the nitrous flow by the ________
total gas flow
what’s a general ratio for O2 to N2O?
3:1
what should you encourage your pt to refrain from doing to get full benefit from the N2O?
talking
what are the adverse effects of N2O?
Nausea/Vomiting
Dysphoria
Headache
Excessive sweating
why do you continue O2 flow for at least 5 min?
Minimizes diffusion hypoxia
what is diffusion hypoxia?
When administration of nitrous is stopped, large volumes of nitrous oxide diffuse from the blood into the lung alveoli, diluting oxygen – a temporary reduction in the amount of alveolar oxygen
T/F a N2O pt needs an escort to drive them home
false
you already know this
