Pediatric sedation

Question 1

What is Frankl 1?

Answer 1

-Definitively negative - refuses treatment

Question 2

What is Frankl 2?

Answer 2

-Negative reluctant but slightly cooperative somewhat withdrawn

Question 3

What is Frankl 3?

Answer 3

-Positive cautions but willing to comply

Question 4

What is Frankl 4?

Answer 4

-Definitively positive enjoys being at the dentist

Question 5

What are the four goals in pediatric sedation?

Answer 5

• Make the child cooperative and comfortable
• Decrease anxiety for the patient
• Decrease strain, apprehension, and excessive fatigue for the dentist and staff
• Minimize the need for hospitalization

Question 6

What are 5 techniques used for pediatric sedation?

Answer 6

• Inhalation sedation
• Oral sedation and inhalation sedation
• Oral sedation
• In office general anesthesia
• General anesthesia in hospital

Question 7

What can you use for oral sedation in a pediatric pt?

Answer 7

-Hydroxyzine

Question 8

What is the age to be considered a geriatric patient?

Answer 8

-Age 65

Question 9

What is the most significant age related postoperative complication of sedation and general anesthesia?

Answer 9

-Delirium

Question 10

What anatomic changes in body composition occur in a geriatric pt?

Answer 10

• Increased lipid fraction

- Loss of skeletal muscle and other components of lean body mass

Question 11

What anatomic changes in nervous systems occur in a geriatric pt?

Answer 11

• Attrition of neurons

- Decreased neurotransmitter activity

Question 12

What anatomic changes in the cardiovascular systems occur in a geriatric pt?

Answer 12

• Decreased arterial elasticity
• Ventricular hypertrophy
• Reduced adrenergic responsiveness

Question 13

what anatomic changes in the pulmonary system occurs in a geriatric pt?

Answer 13

• Loss of lung elastin
• Increased thoracic stiffness
• Reduced alveolar surface area

Question 14

What anatomic changes in the renal system occur in geriatric pts?

Answer 14

• Reduced vascularity

- Tissue atrophy

Question 15

What anatomic changes in the hepatic system occurs in geriatric pts?

Answer 15

-Reduced tissue mass

Question 16

What functional changes in the body composition occurs in geriatric pts?

Answer 16

• Increased half life for lipid soluble drugs

- Decreased O2 consumption, heat production and cardiac output

Question 17

What functional changes in the nervous system occur in the geriatric pt?

Answer 17

• Deafferentation, neurogenic atrophy and decreased anesthetic requirement
• Impaired autonomic homeostasis

Question 18

What function changes in the cardiovascular system occur in the geriatric pt?

Answer 18

• Increased impedance to ejection, widened pulse pressure

- Decreased maximum cardiac output

Question 19

What functional changes in the pulmonary system occurs in the geriatric pt?

Answer 19

• Increased residual volume
• Loss of vital capacity
• Impaired efficiency of gas exchange
• Increased work of breathing

Question 20

What functional changes in the renal system occurs in the geriatric pt?

Answer 20

-Decreased plasma flow, glomerular filtration rate, drug clearance, and ability to handle salt and water loads

Question 21

What functional changes in the hepatic system occurs in the geriatric pt?

Answer 21

-Reduced hepatic blood flow and drug clearance