Test 2- Mod 6- Nitrous

Question 1

what had been the greatest medical advance before n20

Answer 1

sutures

Question 2

what is the combination of of nitrous and local anesthesia

Answer 2

relative anaglesia

Question 3

What abilities does nitrous have

Answer 3

sedative and antianxiety

Question 4

what is analgesia

Answer 4

relief of pain without loss of conciousness

Question 5

what is anesthesia

Answer 5

loss of pain to permit surgery, with or without loss of conciousness

Question 6

what is concious sedation

Answer 6

control of airway

Question 7

who posed as a physican and did shows with nitrous

Answer 7

samuel colt

Question 8

who was the first dentist to use nitrous for a tooth extraction

Answer 8

horace wells

Question 9

did most patients recover from nitrous use

Answer 9

yes

Question 10

what 2 things were discovered after nitrous

Answer 10

ether-general surger

choloroform- general surgery

Question 11

who was the first to mix nitrous as oxygen

Answer 11

edmund andrews

Question 12

what percent of dentists use nitrous today?

Answer 12

56 general dentists

85 oral surgeons

Question 13

what are physical properties of nitrous

Answer 13

• colorless
• heavier than air
• no predictable odor or taste

Question 14

how is nitrous marketed

Answer 14

liquid nitrous

Question 15

when does nitrous turn from the liquid to the gaseous state

Answer 15

when it is released, the changen absorbs heat and the cylinder will feel cold

Question 16

nitrous is a _____drug

Answer 16

insoluble

Question 17

what does N20 replaces what in the blood

Answer 17

N2

Question 18

when are the peak clinical effects seen

Answer 18

within 3 -5 minutes

Question 19

Nitrous is not metabolized____

Answer 19

in the liver

Question 20

where is 99% of nitrous eliminated

Answer 20

the lungs

Question 21

where is the remaining 1% of nitrous metabolized

Answer 21

in the GI tract and skin

Question 22

what does N20 change

Answer 22

the patients perception of pain

Question 23

what percent of mixure of N20 and 02 produces analgesic effects if 10 -15 mg of morphine

Answer 23

20-80% mixture

Question 24

what effect does n20 have on the central nervous system

Answer 24

general depressant effect

Question 25

what may happen in the mechanisms of action of n20

Answer 25

stabilize axon membranes, act on opiate receptors

Question 26

what is the mechanism of action of n20

Answer 26

unknown

Question 27

what are indications for nitrous in dentistry

Answer 27

anxiety, painful perception of tx, increased pharyngeal reflex activity,long appts

Question 28

what is the greatest benefit in dentistry of nitrous

Answer 28

minimizes patients aprehension and fear

Question 29

what are contraindications for n20

Answer 29

compulsive personality- not like feeling of losing conrol claustrophobic patient children w/severe behavior problems debilitating cardiac or cerebrovascular disease COPD personality disorders

Question 30

What is the stimulus in COPD

Answer 30

lowered blood 02

Question 31

can HIV patients have N20

Answer 31

ask questions, alot have compromised cardiovascular problems that contraindicate

Question 32

can pregant patients have n20

Answer 32

not in first trimester

Question 33

can patients with nasal obstructions like cold, upper respiratory infecftions, deviated nasal septums have n20

Answer 33

not recommended

Question 34

nitrous can enhance drugs that are used to induce sleep t/f

Answer 34

true

Question 35

should patients who appear to be under the influence be administered

Answer 35

no

Question 36

what is the titration

Answer 36

the method of administration where nitrous is introduced in incremental doses until pt has reached a comfortable state

Question 37

what is the significance of titration*

Answer 37

- provides amt of drug necessary - minimizes side effects - allows for variability in each individual

Question 38

can you ever leave a patient alone

Answer 38

no

Question 39

its is below the standard of care to not have

Answer 39

scavenger nasal hood

Question 40

what is the number one cause of nitrous contamination in the office

Answer 40

patient talking

Question 41

wha tcolor is oxygen

Answer 41

green

Question 42

what color is nitrous

Answer 42

blue

Question 43

what is the minimum oxygen liter flow

Answer 43

3L/min

Question 44

what will turn off when the oxygen is depleted

Answer 44

nitrous

Question 45

what does the oxygen flush button do

Answer 45

allows 100% oxygen to be delivered

Question 46

how full should you fill the resivoir bag

Answer 46

3/4 full

Question 47

what are the 3 purposes of the resivoir bag

Answer 47

provide additional gas, monitor pts respiration, funcion in emergency

Question 48

what level of nitrous are we not allowed to exceed

Answer 48

3L/min

Question 49

what are characteristics of comfortable sedation

Answer 49

pt is at ease, comfortable and ready to proceed

Question 50

what are characteristics of inappropriate sedation

Answer 50

slurred speech, incoherent, nausea or inablility to verbally respond

Question 51

what are additonal signs of sedation

Answer 51

- glazed or twinkling look - tingling - heaviness - agitated or physically uncomforable

Question 52

waht are signs of oversedation

Answer 52

``` -uncontrolled laughing detachment warmnes drowsy agitated or physically uncomfortable ```

Question 53

how many liters per minute do you introduce when you are titrating

Answer 53

1 l

Question 54

what do you set the oxygen at, at the beginning of the procedure

Answer 54

5L

Question 55

what do you need to periodically check durin the administration

Answer 55

the bag

Question 56

how do you terminate sedation

Answer 56

turn nitrous flow off

Question 57

how long do you deliver oxygen at the termination of nitrous

Answer 57

5 min

Question 58

what is diffusion hypoxia

Answer 58

low oxygen levels to the tissues, when patientsj dont breath enough oxygen

Question 59

what are symptoms of diffusion hypoxia

Answer 59

headache nausea lethargic hangover

Question 60

when are you able to use nitrous without LA

Answer 60

``` -emergency exam removal of temp crowns and bridges occ adj. matrix bands and wedges inital perio exam apprehensive pt ```