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Pain & Anxiety Control > Module 3 > Flashcards

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

A

green

17
Q

what is the equipment color for nitrous oxide

A

blue

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

A

30%

20
Q

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

A

70%

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

A

ONLY GAS

23
Q

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

A

yes

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
Q

does the N2O cylinder gauge reflect the actual content of the cylinder?

A

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
Q

what is in place so that tanks cannot be inadvertently reverse

A

pin index safety system

27
Q

what causes N2O flow to terminate if O2 delivery pressure falls

A

oxygen fail safe

28
Q

what allows atmospheric air in if flow or gases stop

A

emergency air inlet

28
Q

what allows for rapid delivery of high flow O2 to patient in cases of oversedation

A

oxygen flush button

29
Q

what is the first step of nitrous oxide administration

A

selecting the appropriately sized nasal hood

30
Q

what is the second step of nitrous oxide administration

A

inflating the reservoir bag

31
Q

what is the flow rate of the reservoir bag

A

5 - 6 L/min of 100% O2

32
Q

what is the third step of nitrous oxide administration

A

placing the nasal hood on the pt and adjusting and tightening for comfort

33
Q

what is the fourth step of nitrous oxide administration

A

instruct the pt to breathe normally and then adjust the flow rate accordingly

34
Q

what is the fifth step of nitrous oxide administration

A

gradually titrate N2O - O2 in 10% intervals

ask how the pt feels and watch for signs of sedation

35
Q

what is the typical required N2O - O2 levels for a pt

A

50% N2O & 50% O2

36
Q

what should you never do when nitrous oxide is administered

A

leave the patient unattended

37
Q

what do you do with the nitrous oxide levels when treatment is completed

A

reduce N2O to zero & increase O2 to 100% for 5 minutes

38
Q

what is the final step of nitrous oxide administration

A

documentation of the procedure

Pain & Anxiety Control (12 decks)

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