Module 3 Flashcards

1
Q

For nitrous oxide used what documentation must be obtained

A
  • informed consent & documentation in chart
  • percentage of N2O administered
  • length of time the patient was sedated
  • flow rate of gases during administration
  • indications for use of N2O
  • patient response & tolerance
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2
Q

what are the properties of ideal sedation with nitrous oxide

A
  • produces analgesic & anxiolytic effects
  • rapid onset –> 2 - 5 minutes
  • wide safety margin
  • quick recovery time
  • no “hangover” effect
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3
Q

why does nitrous oxide have a rapid onset

A

low blood solubility

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4
Q

does nitrous oxide have an effect on HR or BP

A

no (can have the slightest increase on BP)

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5
Q

what can nitrous oxide induce at high concentrations

A

unconsciousness

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6
Q

T/F nitrous oxide diffuses slowly across alveolar-arterial membrane

A

FALSE - rapidly

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7
Q

T/F nitrous is excreted unchanged through the lungs

A

TRUE

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8
Q

does nitrous oxide cross the BBB and/or the placenta

A

yes

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9
Q

what are the indications for nitrous oxide sedation

A
  • anxiety
  • tendency of fainting
  • strong gag reflex
  • medically compromised (decreases stress –> angina pectoris, post MI, post CVA)
  • long procedures
  • inadequate local anesthesia
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10
Q

what defines ABSOLUTE contraindications for nitrous oxide

A

administration of drug INCREASES possibility of a life threatening situation

NEVER ADMINISTER

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11
Q

what defines RELATIVE contraindications for nitrous oxide

A

administration of drug is PREFERABLY AVOIDED due to possible adverse reactions

ADMINISTER JUDICIOUSLY

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12
Q

what are examples of ABSOLUTE contraindications

A
  • nasal obstruction
  • vitamin B12 deficiency
  • alcohol / recovering addict
  • uncommunicative
  • pt refusal
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13
Q

what are examples of RELATIVE contraindications

A
  • middle ear infection
  • balance disorder
  • susceptibility to motion sickness
  • claustrophobia
  • pulmonary diseases
  • immunocompromised
  • pregnancy
  • psychiatric disorders / bipolar
  • marijuana or hallucinogenic drug use
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14
Q

what are the side effects of nitrous oxide sedation

A
  • nausea & vomiting
  • dysphoria, hallucination, dizziness
  • headache
  • mask claustrophobia
  • urinary incontinence
  • increased apprehension
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15
Q

what can long term exposure to nitrous oxide induce

A
  • bone marrow suppression
  • reproductive system disturbances (spontaneous abortion, premature delivery, infertility)
  • neurological deficits (numbness, paresthesias, impaired equilibrium, difficulty concentrating)
  • possible hepatotoxicity
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16
Q

what is the equipment color for oxygen

17
Q

what is the equipment color for nitrous oxide

18
Q

what does the flush button do

A

fills reservoir bag and can be used for OVER-SEDATION

19
Q

what is the minimum O2 level for the oxygen fail safe mechanism

20
Q

what is the maximum N2O level for the oxygen fail safe mechanism

21
Q

what does the oxygen fail safe mechanism do

A

shuts off if O2 flow stops

22
Q

what does the O2 cylinder contain

23
Q

does the O2 cylinder gauge reflect the actual contents of the cylinder?

24
Q

what does the N2O cylinder contain

A

compressed gas in both liquid and gaseous states

filled to 90-95% capacity with liquid U& a gas layer above

25
does the N2O cylinder gauge reflect the actual content of the cylinder?
no - as long as liquid remains the gauge will show full once ALL liquid is gone & ONLY gas remains then the gauge will fall to show remaining gas level
26
what is in place so that tanks cannot be inadvertently reverse
pin index safety system
27
what causes N2O flow to terminate if O2 delivery pressure falls
oxygen fail safe
28
what allows atmospheric air in if flow or gases stop
emergency air inlet
28
what allows for rapid delivery of high flow O2 to patient in cases of oversedation
oxygen flush button
29
what is the first step of nitrous oxide administration
selecting the appropriately sized nasal hood
30
what is the second step of nitrous oxide administration
inflating the reservoir bag
31
what is the flow rate of the reservoir bag
5 - 6 L/min of 100% O2
32
what is the third step of nitrous oxide administration
placing the nasal hood on the pt and adjusting and tightening for comfort
33
what is the fourth step of nitrous oxide administration
instruct the pt to breathe normally and then adjust the flow rate accordingly
34
what is the fifth step of nitrous oxide administration
gradually titrate N2O - O2 in 10% intervals ask how the pt feels and watch for signs of sedation
35
what is the typical required N2O - O2 levels for a pt
50% N2O & 50% O2
36
what should you never do when nitrous oxide is administered
leave the patient unattended
37
what do you do with the nitrous oxide levels when treatment is completed
reduce N2O to zero & increase O2 to 100% for 5 minutes
38
what is the final step of nitrous oxide administration
documentation of the procedure