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is nitrous oxide used by itself or in combination with another agent? if so, which agent?
It is used with oxygen
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List four effects of nitrous oxide mixed with oxygen for conscious analgesia
- the pt remains conscious
- the protective reflexes are in tact
- relief of anxiety
- analgesia
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identify the recommended dose of oxygen and that of nitrous oxide for conscious analgesia
50% of each
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describe the procedure for administering nitrous oxide for conscious sedation, including pt responses.
- beging with 100% oxygen for 2-3 minutes
- add nitrous slowly in 10% increments - the onset of sedation occurs within 3-5 minutes
- have pt tell you when they feel tingling
- maintain the level where pt is comfortable
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describe the cause of diffusion hypoxia and how it is prevented
- it is the rapid movement of large amounts of nitrous oxide from the circulation into the lungs which may dilute the oxygen in the lungs (headache)
- prevent it by having pt breath in 100% oxygen for 5 minutes after prodedure
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how is the effect of nitrous oxide terminated?
exhalation
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list two used for nitrous oxide
- with other drugs to induce general anesthesia
- for conscious sedation and analgesia
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Describe the effects of general anesthesia. What is the limitation?
- reversible depression of the CNS, loss of consciousness, amnesia, and immobility
- not complete analgesia
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What is the primary site of action for general anesthetic agents?
Central nervous system
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List the various types of drugs used to achieve general anesthesia.
- volatile gaseous and IV anesthetics
- nitrous oxide
- analgesics
- sedatives
- antianxiety agents
- neuromuscular blocking agents
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List six goals of general anesthetic drugs.
- rapid loss of consciousness
- amnesia of surgical events
- minimal amount of time in the excitement phase
- stable plateau of surgical anesthesia
- analgesia
- appropriate levels of respiratory and cardiovascular responsiveness, and skeletal muscle relaxation
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Note the clinical uses for general anesthetic agents. what drugs provide an amnesiac effect?
diethyl ether
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List drugs used to quickly move the pt through the excitement stage of general anesthesia.
- thiopental
- methohexital
- etomidate
- propofol
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Which is the safest of the general anesthetic agent?
ketamine
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Whic of the drugs in the general anesthetic combination provides for effective analgesia during surgery?
nitrous oxide
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Compare recommended dose for induction of general anesthesia versus the dose for conscious sedation, what is the concentration for maintenance?
- GA induction - 60% N 40% O
- conscious sedation - 50%-50% or 40N - 50 O
- maintenance - 30% N - 70% O
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list side effects or adverse drug effects for nitrous oxide. Which pts should not recieve nitrous oxide
- nausea, vomiting, delirium, no drug interactions, can cause headache
- pts who have had eye surgery within the past 3 months, pregnant pts
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Identify potential occupational hazards of having nitrous oxide in the dental office
- fetal exposure, spontaneous abortion
- over exposure resulting in neuropathy
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