California Board of Registered Nursing cep#15122

Aspects of Conscious/Sedation Analgesia

Compiled by Terry Rudd, RN, MSN

4.0 Contact Hours

California Board of Registered Nursing CEP#15122

Compiled by Terry Rudd RN, MSN, CCRN

Key Medical Resources, Inc.

P.O. Box 2033 Rancho Cucamonga, CA 91729

Training Center: 9774 Crescent Center Drive, Suite 505,

Rancho Cucamonga, CA 91730

909 980-0126 FAX: 909 980-0643

Email: KMR@keymedinfo.com

See www.cprclassroom.com for other Key Medical Resources classes, services, and programs.

Disclaimer: This packet is intended to provide information and is not a substitute for any facility policies or procedures or in-class training. Legal information provided here is for information only and is not intended to provide legal advice. Each state or facility may have different training requirements or regulations. Participants who practice the techniques do so voluntarily. Information has been compiled from various internet sources as indicated at the end of the packet.

Updated 1/2013

1. 
   All of the following describe Sedation Analgesia except:
   
   1. 
      Allows protective reflexes to be maintained
      
   2. 
      A medically controlled state of depressed Consciousness or unconscious- ness from which the patient is not easily aroused and is unable to respond purposefully to physical stimulation or verbal command
      
   3. 
      Retains the patient's ability to maintain a patent airway independently and continuously
      
   4. 
      Permits appropriate response by the patient to physical stimulation or verbal command (e.g:open your eyes")
      
   5. 
      The drugs, doses and techniques are not intended to produce a loss of consciousness.
      

2. 
   Moderate or Sedation Analgesia and general anesthesia are the same:
   
   1. 
      True
      
   2. 
      False
      

3. 
   A 55-year-old woman has a history of hypertension which is well controlled. She is scheduled for a colonoscopy. This patient is an ASA Physical Classification of
   
   1. 
      ASA I
      
   2. 
      ASA II
      
   3. 
      ASA III
      
   4. 
      ASA IV
      
   5. 
      ASA V
      

4. 
   Prior to performing a procedure with Sedation Analgesia the physician must perform or provide the following:
   
   1. 
      A brief medical history and physical exam
      
   2. 
      A signed consent form
      
   3. 
      An ASA Patient Classification Status
      
   4. 
      Verify the patient's NPO status
      
   5. 
      All of the above
      

5. 
   Patient assessment pre procedure includes:
   
   1. 
      Level of consciousness.
      
   2. 
      NPO status.
      
   3. 
      Completion of a consent.
      
   4. 
      All of the above.
      

6. 
   Which agent (usually preferred) used in Sedation Analgesia is a short acting benzodiazepine?
   
   1. 
      Midazolam (Versed)
      
   2. 
      Chloral Hydrate
      
   3. 
      Fentanyl (Sublimaze)
      
   4. 
      Naloxone (Narcan)
      

7. 
   Monitoring parameters during the procedure include:
   
   1. 
      Heart rate, blood pressure, respirations
      
   2. 
      Heart rate, blood pressure, and oxygen saturation
      
   3. 
      Heart rate & rhythm, blood pressure, respirations, oxygen saturation and level of consciousness
      
   4. 
      Heart rate & rhythm, blood pressure, oxygen saturation and respirations
      
   5. 
      Heart rate, blood pressure, respirations, and oxygen saturation
      

8. 
   During the procedure the vital signs should be taken and documented:
   
   1. 
      Pre and post procedure only
      
   2. 
      Every 5 minutes
      
   3. 
      Every 10 minutes
      
   4. 
      Every 15 minutes
      
   5. 
      As the physician feels necessary
      

9. 
   You are assisting with a colonoscopy on a patient. You position the patient on their stomach. The patient has been complaining of pain and you are instructed to give more Versed. Within a few minutes the oxygen saturation begins to drop. You should immediately:
   
   1. 
      Arouse the patient
      
   2. 
      Check the patient's respirations
      
   3. 
      Turn the patient over
      
   4. 
      All of the above
      

10. 
    The above patient's oxygen saturation continues to drop. You should:
    
    1. 
       Leave the room to find an anesthesiologist
       
    2. 
       Quickly finish the procedure so you can get the patient to the PACU
       
    3. 
       Support the patient's airway and if necessary give oxygen by an Ambu-bag (manual resuscitation) and face-mask
       
    4. 
       Have the nurse give naloxone (Narcan)
       

11. 
    The RN monitoring the patient receiving Sedation Analgesia:
    
    1. 
       May also circulate in the room and get equipment from the hallway
       
    2. 
       May not be engaged in any other activity during this period
       
    3. 
       May not apply oxygen if needed
       
    4. 
       Should do the preoperative history and physical prior to the procedure
       

12. 
    Naloxone (Narcan) can be used to reverse all of the following except:
    
    1. 
       Midazolam (Versed)
       
    2. 
       Meperidine (Demerol)
       
    3. 
       Morphine
       

13. 
    What information is not needed in the history for a patient undergoing Sedation Analgesia:
    
    1. 
       Allergies
       
    2. 
       Past experiences with anesthetic drugs
       
    3. 
       Pregnancy or menstrual history
       
    4. 
       Last meal
       
    5. 
       All of the above are necessary in the history
       

14. 
    All of the following are considered clear liquids except:
    
    1. 
       Plain coffee or tea
       
    2. 
       Breast milk
       
    3. 
       Orange juice
       
    4. 
       Apple juice
       
    5. 
       Water
       

15. 
    Complications of Sedation Analgesia include:
    
    1. 
       Respiratory depression.
       
    2. 
       Hypotension
       
    3. 
       Cardiac dysrhythmias
       
    4. 
       All of the above.
       

16. 
    Discharge Criteria is best determined by which of the following?
    
    1. 
       The ability of the patient to respond verbally.
       
    2. 
       An Aldrete score of 8-10 or return to presedation level.
       
    3. 
       When an hour has passed.
       
    4. 
       Vital signs that are stable for 2 hours.
       

17. 
    The initial dose of Versed should be given over:
    

c. 5 minutes d. 1 minute

18. 
    The preferred drug for anxiolysis in sedation analgesia is:
    

c. Morphine d. Romazicon

19. 
    Which of the following drugs DOES NOT have a side effect of respiratory depression?
    

c. Morphine d. Narcan

20. 
    Romazicon is indicated to reverse the effects of Benzodiazepine overdose:
    

21. 
    The “purest” opiod antagonist is _______ .
    

c. Activated charcoal d. Kayexelate

22. 
    The American Society of Anesthesiologists Classification of a patient with a severe systemic disturbance would be considered a ____________ patient:
    

c. Class III d. Class IV

e. Class V

23. 
    Personnel who administer or monitor patients receiving Sedation Analgesia/Moderate sedation must be able to perform which of the following:
    

1. 
   Demonstrate knowledge of the adverse reactions associated with drugs used for Sedation Analgesia/Moderate sedation
   
2. 
   Recognize an airway obstruction
   
3. 
   Assess heart rate and rhythm.
   
4. 
   All of the above
   

24. 
    Patients receiving Sedation Analgesia/Moderate sedation must have IV access established prior to the beginning of a Sedation Analgesia/Moderate sedation technique.
    

25. 
    When using "short acting" medication to achieve a Moderate Sedation/Analgesia technique, there is no need to monitor the patient beyond the procedure as the clinical effects of the medications used will end rapidly.
    

26. 
    Versed is useful for Sedation Analgesia/Moderate sedation when relief of anxiety and diminished recall of events associated with such procedures is desired.
    

27. 
    Romazicon has not been established as an effective treatment for hypoventilation due to benzodiazepine administration.
    

Title: Aspects of Conscious/Sedation Analgesia