Pharmacologic Management of Pt Behavior

Question 1

Advanced behavior guidance techniques.

Answer 1

Protective stabilization
Sedation
General Anesthesia

Question 2

Benzodiazepine antagonist

Answer 2

Flumazenil

Question 3

Flumazenil route of administration.

Answer 3

IV

Question 4

Types of Benzodiazepines

Answer 4

Midazolam

Diazepam

Question 5

Types of Narcotics for Sedation

Answer 5

Meperidine

Sufentanil

Question 6

Narcotic antagonist

Answer 6

Naloxone

Question 7

Naloxone route of administration

Answer 7

IV or IM

Question 8

Class 0 tonsils

Answer 8

Surgically removed

Question 9

Class 1 tonsils

Answer 9

Hidden within the tonsillar pillars.

Question 10

Class 2 tonsils

Answer 10

Extend to the tonsillar pillars

Question 11

Class 3 tonsils

Answer 11

Extend beyond the pillars.

Question 12

Class 4 tonsils

Answer 12

Extend to midline

Question 13

Sedation contraindications

Answer 13

• ASA III or greater
• Pt who can be managed with basic behavior management
• Extensive tx plan
• Recent illness

Question 14

Complications of sedation

Answer 14

• Airway obstruction
• Seizures
• Allergic reactions
• Failure to sedate

Question 15

Why no food or drink prior to sedation?

Answer 15

Can vomit and aspirate it causing aspiration pneumonia, or can get laryngospasm (where vocal cords shut and you can’t breathe).

Question 16

Fasting period for clear liquids.

Answer 16

2 hours before sedation.

Question 17

Light meal consists of what?

Answer 17

Toast and clear liquids.

Question 18

Fasting period for breast milk.

Answer 18

4 hours

Question 19

Fasting period for infant formula, nonhuman milk, and light meals.

Answer 19

6 hours

Question 20

After the appt, how often should the parent check on breathing and the airway?

Answer 20

Every 3-5 minutes.

Question 21

What do you do if the sedated child starts snoring after the appointment?

Answer 21

Reposition the head by lifting the chin.

Question 22

This is likely given in addition to oral sedation.

Answer 22

Local anesthesia

Question 23

Can give these for pain or fever after sedation.

Answer 23

Tylenol or Motrin

Question 24

Minimum number of personnel needed in the room for sedation.

Answer 24

2

Question 25

Practitioner responsibilities.

Answer 25

- Tx patient - Administer drugs - Monitor vitals - Rescue skills for deeper level of sedation.

Question 26

How often is BP recorded in sedation?

Answer 26

Every 5 minutes

Question 27

Records respiratory rate.

Answer 27

Precordial stethoscope or capnograph.

Question 28

Measures amount of expelled CO2

Answer 28

Capnograph

Question 29

Monitors oxygenation and pulse rate

Answer 29

Pulse oximeter

Question 30

Are preprocedural prescriptions appropriate for children undergoing sedation?

Answer 30

NO

Question 31

Intubation procedure

Answer 31

SOAP ME Suction Oxygen Airway equipment Pharmacy Monitors Equipment-AED/Defibrillator

Question 32

What is intermittently recorded during sedation?

Answer 32

BP and respiratory rate.

Question 33

What is continuously recorded during sedation?

Answer 33

Oxygen saturation Heart rate

Question 34

Child has to stay awake in a quiet environment for how long in order to be discharged?

Answer 34

20 minutes

Question 35

This group is more vulnerable to the sedation medication's effects on respiratory drive, patency of the airway, and protective reflexes.

Answer 35

Young children.

Question 36

This level of sedation has great risk of respiratory or cardiovascular complications.

Answer 36

Deep sedation

Question 37

There's partial or complete loss of protective reflexes in this level of sedation.

Answer 37

Deep

Question 38

1 kg is how many pounds?

Answer 38

2.2

Question 39

Articaine maximum dose

Answer 39

7 mg/kg

Question 40

Volume of anesthetic in a carpule.

Answer 40

1.7 mL

Question 41

Max dose of Articaine

Answer 41

7 mg/kg

Question 42

Articaine AKA

Answer 42

Septocaine

Question 43

Percent of Articaine in a carpule

Answer 43

4%

Question 44

Which Piaget stage of cognitive development is this? Children begin to use language similar to adults and can form mental symbols and words to represent objects. Language is concrete and literal, and has limited logical reasoning skills. Children tend to perceive the world from their own perspective or be "egocentric."

Answer 44

Preoperational (2-5 years)

Question 45

Which Piaget stage of cognitive development is this? | Children can think about abstractions and hypothetical concepts and reason analytically.

Answer 45

Formal operations (11+ years)

Question 46

Which Piaget stage of cognitive development is this? Children demonstrate increased logical reasoning skills and can see the world from different points of view. They still have a difficult time with abstract ideas and benefit from concrete instructions.

Answer 46

Concrete operational stage (6-11 years old).

Question 47

Which Piaget stage of cognitive development is this? Infants use senses and motor abilities to understand the world and there's little to no meaningful verbal communication other than single word commands. They are, however, hyperaware of people around them as they reach this age and are perceptive to nonverbal communication.

Answer 47

Sensorimotor Stage (Birth-24 months)

Question 48

Types of Temperament by Chess and Thomas

Answer 48

Easy Difficult Slow-to-warm up

Question 49

- Biological regularity - Quick adaptability to change - Tendency to approach new situations vs withdraw - Predominantly positive mood/moderate intensity.

Answer 49

Easy temperament

Question 50

- "Shy" - Withdrawal tendencies to new things/situations - Slow adaptability to change - Frequent negative emotional expressions of low intensity.

Answer 50

Slow-to-warm-up temperament

Question 51

- Biological irregularity - Withdrawal tendencies to new things/situations - Slow adaptability to change - Frequent negative emotional expressions of high intensity.

Answer 51

Difficult temperament