Sedation June Test Flashcards
Define procedural conscious sedation
A medically controlled state of depressed consciousness where the patient retains the ability to continuously and independently maintain a patient airway and response appropriately to the physical and stimulation and verbal commands
Elevation assessment of airways include
Mouth opening
Neck extension
Mallampati score
Throymental distance
Non of above
All of above
All of the above
The pulse oximeter relies on principle that oxygenated and reduced HB have different light absorbances at 2 wavelengths
True
False
True
Peak onset of action after an IV dose of midozalam versed is 2-3 minutes 
True or false
True
During basic procedural sedation patient vital signs including level of consciousness should be documented every 15 minutes
True or false
False it should be documented every 10 minutes
Patients who have been given Benzodiazepines should be instructed to avoid operating a car, consuming alcohol or sign any legal paperwork for 24 hours after receiving medication
True or false
True
By it’s self versed is a potent respiratory inhibitor
True or false
False
Many adults have chronic PVC’s due to underlining cardiac and respiratory disease and caffeine intake
True or false
True
2.5mg of Midozalam has been administered over a period of five minutes to Titrate to affect administration should be no more than 1MG per minute to the maximum total dosage of 5MG
True or false
False / peak action is 2/3 minutes
Emergency treatment of oversedation with a benzodiazepine constricts of the following
Notify the physician MD should already be present access respiratory and cardiovascular status 
Intubate immediately
Have resuscitation equipment and flumazenil immediately available
All of the above
Notify the physician MD should already be present excess respiratory and cardiovascular status
Have resuscitation equipment and Flumazenil immediately available 
Which of the following is not characteristics of basic procedural sedation
Minimally depressed levels of consciousness
Airway protective refluxes are maintained
Pt easily aroused
Patient unable to respond appropriately to verbal and physical stimuli
Patient unable to respond appropriately to verbal and physical stimuli
The possible adverse effect of most concern when using midozalam is
Cardiac arrhythmias
Seizures
Respiratory depression
Flaccid paralysis 
Respiratory depression
Reversal of midozalam is produced by IV administration of
- 2 mg Flumazenil per 60 seconds
- 0mg Flumazenil per 60 seconds
- 1mg naltrexone titration to increase respirations
0.2mg Flumazenil per 60 seconds
Which of the following is not a narcotic
Sublimaze fentanyl
Ketorolac toradol (Toradol)
Meperidine (Demerol)
Morphine
Ketorolac (Toradol)
Adequate sedation has been achieved when the patient
Begins to Relax
No longer has a gag reflex
Can no longer initiate respirations
No longer response to painful stimuli 
Begins to relax
When benzodiazepines are combined with narcotics the risk of respiratory depression is decreased
True or false
False
Which condition does not decrease the amount of midozalam needed to achieve sedation
Concurrent medication with narcotics
Age of the patient especially over 60
Acute alcohol intoxication
Obesity
Obesity
Relative contraindications of procedural sedation include
Pregnancy
History of obstructive sleep apnea
Hypertension
Full stomach
Morbid obesity

Pregnancy
History of obstructive sleep apnoea
Full stomach
Morbid obesity
The three main reasons for complications during IV procedural sedation are
Inappropriate patient selection
Unanticipated effect or response from patient or equipment
Not using continual monitoring
Overmedication
Overmedication
Unanticipated effect or response from patient or equipment
Inappropriate patient selection
When the plan for sedation includes deep sedation there must be a minimum of one support person dedicated to continuous observation of patient
True or false
True
A stable 61-year-old patient with type two diabetes peripheral vascular disease and mild nephropathy would have an ASA classification of
ASA1
ASA 11
ASA 111
ASA 1V
ASA 111
Deep sedation is a medically controlled state of depression consciousness or unconsciousness in which
The patient is not easily arouse to physical or verbal stimuli
The patient is easily aroused to physical verbal stimuli
The patient may particularly or completely lose protective reflexes
The patient may completely lose the ability to independently maintain the airways 
The patient is not easily aroused a physical and verbal Simula
The patient may partially or completely lose protective refluxes
The patient may completely lose the ability to independently maintain the airways
When a patient is deeply sedated is it appropriate to ask the monitoring personnel to leave the room to answer the phone ?
true or false
False
Equipment needed for basic procedural sedation
Continuous oxygen saturation monitor
Intravenous access supplies
Supplemental oxygen and equipment to perform positive pressure ventilation i.e. ampoule bag anaesthesia procedural sedation must have intubation equipment available at bedside
Blood pressure monitoring equipment
Code 199 cart immediately accessible
Cardiac monitoring at physician discretion anaesthesia procedure sedation must have continuous ECG monitoring
Reversal agent shall be immediately available
Sedation equipment supplies all equipment and supplies must be suitable for the age and size of the patient being treated

All of the above is needed
Adults who are to receive basic procedural sedation should be NPO for a period of four hours
true or false
False 6 hrs
Signs of respiratory depression include
O2 sats 90% or 5% below base line
Respiratory rate 10 to 12
Dyspnea
Snoring 
All of the above APART from snoring
Patient given reversal agent can be discharged as soon as VS are similar to baseline
True or false
False at least two hours away after reversal agent has been given
Prior to discharge after the procedure the patient will be assessed according to the Aldrete scoring system A rating of 0,1 or 2 is given in the following areas circle that apply
Head lift chin up
Extremity movement
Respiration
Oxygen saturation
Blood pressure
Pulse rate
LOC
Skin colour
Extremity movement
Respiration
Blood pressure
Oxygen saturation
Skin colour
If a reversal agent is administered recommended minimum time of observation from the time of administration is how many hours
123 or four
2
