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CDS 831 Final Test Latest Update
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CDS 831 Final Test Latest Update3 characteristics of N2O that make it useful in dentistry: - Answer 1. analgesic
properties
2. anxiolytic properties
3. amnestic properties
True or False: Nitrous oxide is a nonflammable gas - Answer True
*however, mixtures of N2O and O2 (such as those used for anesthesia administration)
are flammable
The blood-gas partition coefficient for N2O is ____ - Answer 0.47
What does the blood-gas partition of N2O tell us about its ability to cross alveolar
membranes? - Answer it crosses easily and quickly
True or False: Once absorbed by the body, N2O is metabolized into its counterparts -
Answer False
it does not break down at all, this is why it has to be "flushed out"
Peak clinical effects of N2O are usually seen in ___-___ minutes - Answer 3-5 mins
True or False: N2O is stored in the body tissues for 10-15 minutes - Answer False
*it is not stored in body tissues at all, this is why elimination is rapid
_____________ is defined as the amount of drug necessary to prevent movement in 50% of
subjects responding to surgical incision - Answer minimum alveolar concentration
The minimum alveolar concentration (MAC) of N2O is ____% - Answer 104%
True or False: N2O cannot provide profound anesthesia alone and must be used in
combination with local anesthesia - Answer True
In a classic continuous flow sedation unit, the gas tanks and reservoir bag will be
attached via a ______ assembly - Answer Yoke
In a classic continuous flow sedation unit, the N2O tank will be what color? What about
the O2 tank? - Answer N2O = blue
O2 = green
In a classic continuous flow sedation unit, a _________ safety system will prevent
mistaken use of the wrong gas - Answer pin index
,True or False: there are no cardiovascular contraindications for the use of N2O -
Answer True
*can even be used for tx of MI to increase O2 flow
True or False: patients with asthma should not be treated with N2O - Answer False
*asthma is NOT a contraindication for N2O
5 respiratory contraindications for the use of N2O: - Answer 1. upper respiratory
infections
2. sinus infections
3. chronic COPD
4. cystic fibrosis
5. active pneumothorax
6 non-respiratory contraindications for the use of N2O: - Answer 1. cranial base
fractures
2. bowel obstructions
3. mind altering conditions
4. recent ear infection/surgery
5. recent eye surgery
6. pregnancy (esp 1st trimester)
5 symptoms of N2O treatment (aside from analgesia, anxiolysis, and amnesia): - Answer
1. heaviness/lightness
2. tingling in the fingers or toes
3. subjective hearing changes
4. voice resonance changes
5. warm/flushed feeling
_________ is defined as the method of administering a drug in incremental amounts until
a desired endpoint is met - Answer titration
True or False: there is no standard titration for N2O - Answer True
*individuals may even react differently to the same amount of N2O on a different
occasion
,At the end of a procedure, 100% oxygen should be used for ___-___ minutes to ensure full
reversal before discharge - Answer 5-10 mins
5 signs to look for when determining the appropriate level of sedation: - Answer 1.
psychological signs
2. body movement
3. eyes
4. facial expression
5. awareness
What types of psychological signs are typically seen with N2O? (2) - Answer mood
changes
happy, relaxed, comfortable
"laughing gas"
What types of body movements are typically seen with N2O? (4) - Answer 1. less body
tension
2. no white knuckles
3. relaxed shoulders
4. deeper respirations
What type of eye changes are typically seen with N2O? (4) - Answer 1. decreased
activity
2. less focus
3. slower blink rate
4. closed eyes
What type of facial expressions are typically seen with N2O? (4) - Answer 1. content
2. smiling/laughing
3. flat, not alert
4. forehead creases
How aware do you expect a patient undergoing N2O to be? - Answer fully aware
can hold a conversation and maintain all protective reflexes
6 signs of oversedation: - Answer 1. increasing discomfort
, 2. increasing anxiety
3. fixed stare with sluggish eyelids
4. vision changes
5. slurred speech
6. nausea
True or False: a patient who is fully recovered from N2O use will still need an escort and
should not drive - Answer False
*although mental and psychomotor impairment does occur with N2O use, these affects
will wear off with full recovery
Prolonged/chronic use of N2O has been linked to inactivation of ___________, which
causes a disruption in Vitamin ____ metabolism - Answer methionine synthase, B12
Neurologic disorders associated with chronic N2O use appear as ______________ -
Answer myeloneuropathies
__________ systems are used to protect those who work around N2O by removing trace
N2O before, during, and after use by the patient - Answer scavenging
3 ways trace N2O can escape before, during, or after treatment: - Answer 1. patient
speaking
2. patient moving
3. ill-fitting mask
In a dental office, the primary scavenging system is __________ at an optimal rate of ____
L/min - Answer suction, 45 L/min
Risk of developing a Vitamin B12 deficiency following N2O use is greatest in what types
of patients? (3) - Answer 1. pregnant women
2. those with impaired wound healing
3. those with preexisting vitamin B12 deficiencies
Physical properities of N2O (7) - Answer Stable, linear compound
Sweet smelling, colorless
Boiling point 88.5
Becomes a liquid when compressed into a cylinder
It is an oxidizing gas, so no hydrocarbon compounds, such as lubricants, grease, or oil
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