Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

xD3 Pharm Exam 1 > Nitrous Oxide (Liu and Desai) > Flashcards

Nitrous Oxide (Liu and Desai) Flashcards

1
Q

What is a colorless gas with a faint, sweetish odor that does not break down in the body, but is excreted unchanged by the lungs?

A

Nitrous oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Can nitrous oxide be a general anesthetic on its own?

A

No

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the primary site of action for nitrous oxide?

A

Cerebral cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What percentage nitrous oxide will cause slight cardiac depression?

A

Less than 80 percent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is “concentration effect”?

A

The greater the concentration of gas, the more rapid the induction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is “second gas effect”?

A

When a less potent gas is added in high concentration to a more potent gas in a low concentration, the potent gas will have a more rapid uptake

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is a side effect of nitrous oxide if not given 100% oxygen post-procedure 3-5 minutes?

A

Nitrous diffuses rapidly out of blood and into alveoli causing diffusion hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the primary complaint in a majority of dental patients?

A

Fear of pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the diminution or partial elimination of pain in the conscious patient?

A

Analgesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the term for the minimally depressed level of consciousness, produced by a pharmacological method, that retains the patient’s ability to independently and continuously maintain an airway and respond normally to tactile simulation and verbal command?

A

Minimal sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Though cognitive function and coordination can be impaired during minimal sedation, what must be unaffected?

A

Ventilator and cardiovascular functions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Nitrous oxide can be used with only 1 enteral drug for minimal sedation only if that drug is prescribed how?

A

No more than maximum recommended dose of drug for unmonitored home use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When could nitrous oxide be used to produce minimal, moderate, deep sedation or general anesthesia?

A

When it is used in combination with other sedation agents

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the term for drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulations, and their ability to maintain ventilatory function may be impaired?

A

Deep sedation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the term for the drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation?

A

General anesthesia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are 3 types of tanks?

A

E cylinder
G tank = 5300 L
H tank 6000L

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Green tanks have what gas?

A

Oxygen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Blue tanks have what gas?

A

Nitrous oxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Why can you not go above 70% nitrous with a nitrous unit?

A

21% oxygen in room air and system is not closed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a sign that you are getting second hand nitrous?

A

Fingers start tingling

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the first safety mechanism to ensure that you don’t hook up the hoses wrong between oxygen and nitrous?

A

Diamter index safety system (DISS)

22
Q

What is a second safety mechanism to ensure that you don’t hook up the hoses wrong between oxygen and nitrous?

A

Pin index safety system (PISS)

NItrous connector pins are offset while oxygen connector has centered pins

23
Q

What is the most important level to check before a procedure with respect to gases?

A

Oxygen levels. Do not begin if below 500psi

24
Q

Will the nitrous tank gauge indicate anything until it is empty? Why or why not?

A

No. It will only be full or empty. Nitrous is primarily liquid in the tank.

25
Q

The main knob on the nitrous machine sets the flow/concentration of which gas: oxygen or nitrous?

A

Oxygen

Counterclockwise will increase flow

26
Q

What is a normal pulse oximeter reading?

A

94-99%

27
Q

What is the average liter flow of oxygen for nitrous cases?

A

5-6L/min

28
Q

Should the patient be immediately started on nitrous when the nasal hood is placed?

A

No. Start on 100% O2.

29
Q

What is the initial dosage of nitrous and titration?

A

Start at 30% and increase by 10% at 2 min

30
Q

What is the goal of a nitrous case?

A

A relaxed, cooperative patient who can respond to simple commands

31
Q

What should you tell the patient to expect with the onset of nitrous?

A

LIght-headedness, numb or tingling fingers, spinning room, feeling like they are sinking into their chair, sounds are more distant

32
Q

Prior to releasing the patient after nitrous, what must be done?

A

100% oxygen 3-5 minutes
Room air 5 minutes
Post op vitals
Modified Romberg Test (e.g. field sobriety test)

33
Q

What are 3 planes of stage 1 anesthesia?

A

Plane 1 - no analgesia
Plane 2 - partial analgesia
Plane 3 - partial amnesia, analgesia

34
Q

What are the characteristics of stage 2 anesthesia and why?

A

Excitement and delirium because the inhibitory CNS is inhibited first

35
Q

What anesthesia stage is surgery performed in?

A

Stage 3

36
Q

A patient with a hard angry stare, sweating, disoriented, or uncooperative are all signs of what with nitrous oxide?

A

Nitrous overdose

37
Q

What are 5 expected effects from nitrous oxide?

A
  1. Diminish anxiety and normal fears
  2. Analgesia
  3. Dulling unpleasant stimuli
  4. Decreased gagging
  5. Partial amnesia
38
Q

An overdose of nitrous resulting in nausea, amnesia, snoring, and clenching mouth shut, correspond to what Guedel Stage of anesthesia?

A

Guedel Stage II

39
Q

A flushed face, decreased muscle tone, lightheadedness, tingling, warmth, euphoria of Nitrous Sedation/analgesia correspond to what Guedel stage of anesthesia?

A

Guedel Stage I

40
Q

What nitrous concentration corresponds to the Guedel Stage I?

A

10-30%

41
Q

What occular sign do you see at a nitrous concentration of 55% and higher?

A

Divergent eyes (Nystagmus) and dilated pupils

42
Q

The national institute of occupation safety and health (NIOSH) defines Chronic exposure as what? (Dr Desai said to know this)

A

Exceeds 50 ppm of nitrous as an 8 hr weighted average

43
Q

Acceptable nitrous exposure by NIOSH standards? (Dr Desai said to know this)

A

Less than 25 ppm in ambient air

44
Q

What are the risks of chronic nitrous exposure?

A
  1. Spontaneous abortion
  2. Reduced fertility
  3. Birth defects
  4. Liver, kidney and general neurologic disease
45
Q

What is the greatest source of contamination for the dental staff and why?

A

Patient exhaling from mouth because nitrous is exhaled unchanged

46
Q

What are some absolute contraindications to nitrous use?

A
  1. Acute upper respiratory infection or nasal obstruction
  2. Active infective bronchitis
  3. First trimester pregnancy
  4. Myasthenia gravis
  5. Muscular dystrophy
47
Q

Why are pneumothorax, bowel obstructions, and inner ear infections absolute contraindications for nitrous?

A

Have air pockets where nitrous can sequester

48
Q

What are some relative contraindications for nitrous use?

A
  1. Second and third trimester
  2. Psychiatric instability
  3. Acute asthma
  4. Severe COPD
  5. Recent eye surgery (risk of expanding bubble in eye)
49
Q

Never administer nitrous without what?

A

An assistant present due to medico-legal

50
Q

Does a patient have to be NPO or require an escort to drive home after a procedure involving nitrous?

A

No

xD3 Pharm Exam 1 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions