July 15,2021

Question 1

T/F The manner in which we present ourselves to our patients may be one of the most important habit to develop?

Answer 1

T- may be a source of dental anxiety

Question 2

Basic dental fears

Answer 2

Fear of pain, unknown, helplessness and dependency, body mutilation, death.

Question 3

T/F Management of anxiety begins with recognition

Answer 3

True

Question 4

What decreases out pain threshold

Answer 4

Anxiety

Question 5

Stages of general anesthesia

Answer 5

Stage I - Analgesia
Stage II - Delirium
Stage III - Surgical anesthesia
Stage IV - Respiratory paralysis

Question 6

What stage does conscious sedation occur in?

Answer 6

Stage 1 analgesia

Question 7

What occurs in stage 1-analgesia?

Answer 7

Respirations are normal
Eye movements are normal
Protective reflexes are intact
Amnesia may or may not be present
Begins with administration of CNS depressant and ends with loss of consciousness
Remains conscious throughout
Affects cerebral cortex
Conscious sedation

Question 8

What occurs in stage 2 delirium?

Answer 8

Loss of consciousness
Irregular respirations
Responses to stimuli exaggerated (laryngospasm)
Amnesia
Respirations irregular…become regular in stage III
Eyeballs oscillate involuntarily (lateral nystagmus)
Pupils react to light normally
Muscle tone is increased
Protective reflexes quite active…become more obtunded as stage progresses

Question 9

What occurs in stage 3-surgical anesthesia

Answer 9

Most surgeries take place in this stage
Respirations are regular
Muscle tone is lost
4 planes categorized by respirations, eye movement, protective reflexes, reaction of pupils to light

Question 10

What occurs in stage 4- medullary paralysis?

Answer 10

Begins with respiratory arrest and ends with cardiac arrest

Rarely sought intentionally

Question 11

What is Iatrosedation?

Answer 11

A technique of communication between the doctor and the patient that creates a bond of trust and confidence
Truth

Question 12

Other nondrug psychosedative techniques

Answer 12

Hypnosis
Acupuncture
Acupressure
Audioanalgesia
Biofeedback
Electroanesthesia (tens)
Electroanesthesia (ea)
Electronic dental anesthesia (eda)
Electrosedation

Question 13

Oral route sedation onset and peak of duration?

Answer 13

30 minutes and 60 minutes

Question 14

What is drug titration?

Answer 14

Titration is defined as the administration of small incremental doses of a drug until a desired clinical action is observed

Question 15

Is rectal administration of sedative drugs recommended?

Answer 15

No. Use of antiemetic use maybe

Question 16

Topical administration of medications usefullness?

Answer 16

Absorption through skin is poor

Mucus membrane is better

Question 17

What sedative drugs administered via sublingual for pediatric patients?

Answer 17

Triazolam

Question 18

Disadvantages of subcutaneous administration of medications?

Answer 18

Delayed onset of action due to delayed absorption

Question 19

Advantages and disadvantages of intra-musculature administration of sedative drugs?

Answer 19

Advantages
More rapid onset than enteral
Maximum clinical effect in about 30 minutes
More reliable absorption

Disadvantages
Injection is necessary
Prolonged duration
No titration

Question 20

Advantages and disadvantages of intravenous sedation?

Answer 20

Advantages
Most reliable/effective
Short latent period

Disadvantages
Can’t decrease level of sedation after medication is injected
Some medications can be reversed, but not all

Question 21

What reflexes do patient loose in general anesthesia?

Answer 21

All protective reflexes and loss of consciousness. Pt no longer responsive. Must have extensive training to undertake GA.

Question 22

What is Iatrosedation?

Answer 22

Relief of patient’s anxiety through doctor/staff behavior. and doc/staff have a profound effect on pt behavior.
Pain that is expected and considered normal does not hurt as much. More anxiety when feel pain that isn’t expected versus pain that is expected. Must communicate w/patient even when sedated.

Question 23

Goal of Iatrosedation?

Answer 23

Reduce patient need for pharmacological sedation interventions.
Open lines of communication between patient and doctor

Question 24

What happens when you prepare for an emergency?

Answer 24

The emergencies begin to stop

Question 25

What do you do when you are unable to control a patient’s behavior?

Answer 25

Stop and be happy. This should not be considered a failure.