Behavior Guidance Flashcards
Name the two primary side effects of nitrous oxide
1) Sweating, nausea
2) GI Discomfort, vomiting
Inhibition of airway reflexes also possible
T/F: Nitrous oxide is contraindicated in 1st trimester (fetal hypoxia)
Category C: although problems in patients have not been documented, studies in rats have shown that nitrous oxide causes fetal death, growth retardation, and skeletal anomalies
True
Where does diazepam act?
cortex, limbic system, thalamus, hypothalamus
Which is associated with Erikson?
a) Psycho-sexual
b) Psycho-social
c) Classical conditioning
d) Operant conditioning and selective reinforcement
e) Cognitive theory
f) Hierarchy of needs
b) Psycho-social
What is the reversal agent for diazepam and midazolam?
Flumazenil 0.01mg/kg
Valium: 0.25 mg/kg orally. Versed 0.5 mg/kg orally. Flumazenil is the reversal agent for benzoes and the does is 0.01 mg/kg repeated up to a total of ___ mg
1 mg. reversal effect doesn’t occur for up to 1-2 minutes
What is the narcotic reversal dosage for demerol/meperidine?
Naloxone 0.1 mg/kg
Behavior shaping incorporates TSD, but also corrects any mis-behavior
As well as demanding the reinforcement of cooperative behavior, behavior shaping also includes the need to retrace steps if misbehavior occurs. For example, if a child is shown an instrument and looks away, the dentist must revert to the explanatory portion of the procedure. Behavior shaping requires that the “Desired behavior” be observed along the way. If the dentist proceeds along the sequential steps and begins performing treatment when the desired behavior is not present, there is deviation from the learning model and a greater likelihood of increased misbehavior
Where does nitrous oxide act?
CNS depressant, minimal CV or respiratory effects. Anxiolytic and minimal analgesia
term for change per unit time?
velocity
T/F: Nitrous oxide is contraindicated for patients with patients with potential closed-space diseases such as bowel obstruction, middle ear disease, pneumothorax, pneumocephaly, TB, moderate-severe wheezing, otitis media, nasopharyngeal obstruction (secondary to sinus infection, anatomy, etc.)
True
Which is associated with Freud?
a) Psycho-sexual
b) Psycho-social
c) Classical conditioning
d) Operant conditioning and selective reinforcement
e) Cognitive theory
f) Hierarchy of needs
a_ Psycho-sexual
What drug is a narcotic that we use for sedation?
Demerol/Meperidine. It can cause CNS, CV, respiratory depression
Reversal is nalozone 0.1 mg/kg
Reversal for opioid / mg?
Narcan/Naloxone 0.1 mg/kg. Meperidine is a narcotic
Which is associated with Piaget?
a) Psycho-sexual
b) Psycho-social
c) Classical conditioning
d) Operant conditioning and selective reinforcement
e) Cognitive theory
f) Hierarchy of needs
e) Cognitive theory
how children think vs what they know, thoughts influence future actions and ideas
Which is associated with Skinner?
a) Psycho-sexual
b) Psycho-social
c) Classical conditioning
d) Operant conditioning and selective reinforcement
e) Cognitive theory
f) Hierarchy of needs
d) Operant conditioning and selective reinforcement
What are the effects of diazepam (valium)?
amnesia, ataxia (Note: The reversal agent for valium and versed is flumazenil 0.01 mg/kg)
term for linear direction overall
magnitude
What are the effects of Diazepam (Benzo)?
CNS depression with minial CV or respiratory effects (similar to nitrous oxide)
Sedative, hypnotic
What is considered the conerstone of behavior management?
TSD - use successive approximations. More than 4 decages ago, Addelston formalized a technique that encompasses several concepts from learning theory. It was called the tell-show-do technique. Since its introduction in 1959, it has remained a cornerstone of behavior management. TSD is a series of successive approximations. It is a component of behavior shaping that should be routinely used by all members of the dental team who work with children
Which is associated with Pavlov?
a) Psycho-sexual
b) Psycho-social
c) Classical conditioning
d) Operant conditioning and selective reinforcement
e) Cognitive theory
f) Hierarchy of needs
c) Classical conditioning-reflex
What does nitrous do during minutes 3-5 of administration?
Because of its low solubility in blood, it has a very rapid onset and recovery time. Nitrous oxide will become saturated in blood within 3-5 minutes following administration and is physically dissolved in the serum fraction of the blood. There is no biotransformation, and the gas is rapidly excreted by the lungs when the concentration gradient is reversed. Very small amounts may be found in excreted body fluids and intestinal gas
What are some side effects of hydroxyzine (vistaril)?
Antiemetic Antihistamine Anxiolytic Bronchodilator Analgesia Dry Mouth
Which is associated with Maslow?
a) Psycho-sexual
b) Psycho-social
c) Classical conditioning
d) Operant conditioning and selective reinforcement
e) Cognitive theory
f) Hierarchy of needs
f) Hierarchy of needs
T/F: Valium - onset 45-60 minutes peak at 60 minutes. Versed onset is 15 minutes, 30-40 minute working time
True
What is considered the gold standard for monitoring ventilatory status and will reveal respiratory compromise within 15 seconds?
Capnography - the capnography monitor detects both the presence and the quality of ventilation by analyzing the concentration of carbon dioxide in the exhaled gasses through differential infared absorption. The end-tidal carbon dioxide concentration is the concentration of carbon dioxide measured at the terminal portion
T/F: valium - amnesia and ataxia. Versed - amnesia only
True
What is the relationship between nitrous and the enzyme MTHFR, which is involved with the metabolism of folate B9? (and also with children with other vitB deficiencies)
Nitrous oxide inhibits the enzyme methylene-tetrahydrofolate reductase (MTHFR), which can limit the synthesis of DNA severely, causing megaloblastic changes in blood cells and bone marrow. In healthy, neurotypical patients, there generally is no problem when DNA synthesis is inhibited and MRHFR is synthesized quickly. However, there are case reports describing the death of children with a specific genetic enzyme deficiency involved in these chemical pathways
B12 is needed to make red blood cells. Deficiency in B12 can indirectly cause iron deficiency. Folate B9 binds to red blood cells when there is an iron deficiency
