Moderate Sedation test Flashcards
Sedation ranges from ___________ sedation to _________ anesthesia
Minimal, general
What’s another name for Minimal Sedation?
Anxiolysis
How many levels of sedation are there?
4
Emergency resuscitative equipment must be immediately available durning ______ sedation
Moderate
What are some significant variations in physiologic parameters that may occur after MODERATE SEDATION? (6)
- Variation of +/- 20% in HR & BP
- Serious dysrhythmias
- SpO2 s baseline
- Dyspnea (SOB), apnea or HYPOventilation
- Diaphoresis (Sweating)
- Inability to arouse pt
What medications are used routinely alone or with the combination of an OPIATE to achieve sedation?
Benzodiazepines
What are benzodiazepines used for? (6)
- Anxiolysis
- Muscle relaxation
- Tx of seizures
- Tx of withdrawal states
- Short term procedures
- Induction of general anesthesia
How many benzodiazepines are on the U.S. market?
More than 25
What questions must the RN ask prior to the beginning of sedation? (4)
Current meds
Allergies
Pre-existing medical conditions
Time of last food and fluid intake
(T/F) Fasting guidelines are for scheduled minimal sedation and are determined by the RN
False
…scheduled moderate sedation
…determined by the physician/medical staff approved protocols
(T/F) In minimal sedation, cognitive function and coordination may be impaired, but ventilatory & cardiovascular functions are not affected.
True
(T/F) Minimal sedation was formerly know as “conscious sedation”
False (Moderate Sedation)
Pt may need assistance to maintain a patent airway and ventilatory function but cardiovascular function is usually maintained. _____________ sedation.
Deep
In what type of sedation does a pt respond normally to verbal commands?
Minimal sedation
In what types of sedation there is no need for interventions to maintain a patent airway?
minimal and moderate sedation
During this type of sedation a pt cannot be easily aroused, but responds purposefully following repeated or painful stimulation
Deep Sedation
What two types of sedation are called “Analgesia”
Moderate and Deep
What’s the only type of sedation where cardiovascular function may be impaired?
General Anesthesia
What benzodiazepine is used to treat parasomnia (abnormal sleep patterns)
Clonazepam (Klonopin)
Fentanyl is dosed in _____ instead of ______
MCG instead of MG
General Anesthesia is defined by requiring what type of ventilation?
Positive pressure ventilation
State of sedation in which pt is not arousable, even by painful stimulation
General Anesthesia
(T/F) A physician must be immediately available at the initiation and during continued administration of moderate sedation or the procedure will not be started
Ture
Administration of moderate sedation may be done by: (3)
A physician
An anesthetist
RN with established competency under the supervision of on of the two mentioned before
(T/F) A nurse in the ICU can give Dipravan (propofol) IVP
False
Diprivan (propofol) falls into which class of drugs?
Anesthetic
Which of the following has fewer hemodynamic effects?
a. Diprivan b. Etomidate
Etomidate
Repeat doses of Narcan are dependent on what variables?
Amount, Type and Route of administration of the opioid being antagonized
Which class of drugs is reversed by Narcan?
Opioids
Romazicon reverses which class of drugs?
Benzodiazepines
What’s the reverse agent for Diprivan?
There in no known reversal agent
Whats the maximum dose of morphine?
No clearly defined maximum dose
What are alprazolam (Xanax), lorazepam (Ativan), and triazolam (Halicon) used for?
Generalized anxiety, and panic attacks
What four benzodiazepines are used to treat seizures?
Ativan, midazolam (Versed), Xanax, diazepam (Valium)
What’s the principle action of Morphine Sulfate?
Analgesia
What imposes the ceiling to analgesic effectiveness during morphine tx?
Side effects: somnolence, HYPOtension, and respiratory depression
Vital signs are taken every __ minutes until stable and then every __ minutes until pt meets discharge/recovery criteria
5, 10
Morphine 10 mg is approximately equal to how much Fentanyl?
100 mcg
Fasting guidelines are observed for _________ __________
Moderated sedation
(T/F) There a “time out” required prior to beginning a procedure with moderate sedation
TRUE
What is the potential problem when giving moderated sedation in an emergency?
The pt is not NPO, and there is a chance for vomit and aspiration
Why is re-sedation a concern when using Romazicon?
the duration and effect of a long acting dose or a short acting large dose of the benzodiazepine medication may exceed the effect of the reversal agent
(T/F) Morphine is more potent than Fentanyl
False
10 mg of Morphine equal about ___ mg of Demerol
75
