MODERATE SEDATION VERIFIED STUDY GUIDE
Nurse role in moderate sedation - Answers - -Must have documented current BLS and
ACLS
-Must revalidate knowledge annually by: Completing moderate sedation exam
Completing moderate sedation competency
-RNs required to recover moderately sedated patients must have a validated
-Phase II competency. RNs are NOT allowed to give propofol, ketamine, or etomidate
for moderate sedation since it is beyond the RN and non-CRNA scope of practice per
the TX BON
Administration of Sedative/ Analgesic Medications Competency - Answers - -
Pharmacology of sedatives and opioids
-Treatment of over sedation: Airway management, Pharmacological reversal agents
Airway Assessment Skills - Answers - -Examine the airway and recognize a potentially
difficult airway -Significant obesity
-Obstructive sleep apnea
-Short neck or limited neck motion
-Thyromental distance less than 3 cm
-Small mouth opening
-Macroglossia
-Micrognathia
Signs of Airway Obstruction - Answers - -Snoring
-Rocking motion of chest/abdomen
-Capnography
How to rescue a compromised airway - Answers - -Head/neck reposition
-Jaw lift
-Insertion of an oral or nasal airway
-Bag-mask ventilation
Pre-Sedation Medical History - Answers - -Review of major organ systems
-Allergies
-Medications
-Reactions to past sedation or anesthesia
-Substance use disorder or chronic opioid therapy
-Time of last oral intake
Pre-Sedation Physical Exam - Answers - -Airway assessment
-Perform pulmonary and cardiac auscultation
, -Perform additional evaluation depending on patient comorbidities and ASA physical
status classification
Intraoperative Monitoring - Answers - -Monitor the patient's vital signs continuously and
record results every 5 minutes
-Level of consciousness
-EKG
-Heart rate
-Blood pressure
-Respiratory rate
-Oxygen saturation by pulse oximetry
-Capnography (end-tidal carbon dioxide [CO2] monitoring)
-Ensure that resuscitative equipment and rescue medications are available
Post- Procedure Monitoring - Answers - -Vital signs per JPS policy
-Assess level of consciousness
-Document intake & output
-Assess using Aldrete score and discharge criteria
ASA I: Normal healthy patient - Answers - -Healthy
-Non-smoking patient
-Minimal alcohol use
ASA II: Mild-systemic disease without substantive functional limitations - Answers - -
Current smoker
-Well-controlled diabetes
-Mild lung disease
-Social drinker
-BMI < 40
ASA III: Patient with severe systemic disease with definite functional limitations -
Answers - -Moderate to severe asthma
-Poorly controlled HTN
-COPD
-Poorly controlled diabetes
ASA IV: Patient with severe systemic disease that is a constant threat to life - Answers -
-Severe COPD requiring oxygen therapy
-End-state renal failure requiring dialysis
-Unstable angina
-MI < 3 months ago
-CVA
-Ongoing cardiac ischemia
ASA V: A moribund patient who is not expected to survive without surgery. Not
expected to live 24 hours. - Answers - -Septic shock
Nurse role in moderate sedation - Answers - -Must have documented current BLS and
ACLS
-Must revalidate knowledge annually by: Completing moderate sedation exam
Completing moderate sedation competency
-RNs required to recover moderately sedated patients must have a validated
-Phase II competency. RNs are NOT allowed to give propofol, ketamine, or etomidate
for moderate sedation since it is beyond the RN and non-CRNA scope of practice per
the TX BON
Administration of Sedative/ Analgesic Medications Competency - Answers - -
Pharmacology of sedatives and opioids
-Treatment of over sedation: Airway management, Pharmacological reversal agents
Airway Assessment Skills - Answers - -Examine the airway and recognize a potentially
difficult airway -Significant obesity
-Obstructive sleep apnea
-Short neck or limited neck motion
-Thyromental distance less than 3 cm
-Small mouth opening
-Macroglossia
-Micrognathia
Signs of Airway Obstruction - Answers - -Snoring
-Rocking motion of chest/abdomen
-Capnography
How to rescue a compromised airway - Answers - -Head/neck reposition
-Jaw lift
-Insertion of an oral or nasal airway
-Bag-mask ventilation
Pre-Sedation Medical History - Answers - -Review of major organ systems
-Allergies
-Medications
-Reactions to past sedation or anesthesia
-Substance use disorder or chronic opioid therapy
-Time of last oral intake
Pre-Sedation Physical Exam - Answers - -Airway assessment
-Perform pulmonary and cardiac auscultation
, -Perform additional evaluation depending on patient comorbidities and ASA physical
status classification
Intraoperative Monitoring - Answers - -Monitor the patient's vital signs continuously and
record results every 5 minutes
-Level of consciousness
-EKG
-Heart rate
-Blood pressure
-Respiratory rate
-Oxygen saturation by pulse oximetry
-Capnography (end-tidal carbon dioxide [CO2] monitoring)
-Ensure that resuscitative equipment and rescue medications are available
Post- Procedure Monitoring - Answers - -Vital signs per JPS policy
-Assess level of consciousness
-Document intake & output
-Assess using Aldrete score and discharge criteria
ASA I: Normal healthy patient - Answers - -Healthy
-Non-smoking patient
-Minimal alcohol use
ASA II: Mild-systemic disease without substantive functional limitations - Answers - -
Current smoker
-Well-controlled diabetes
-Mild lung disease
-Social drinker
-BMI < 40
ASA III: Patient with severe systemic disease with definite functional limitations -
Answers - -Moderate to severe asthma
-Poorly controlled HTN
-COPD
-Poorly controlled diabetes
ASA IV: Patient with severe systemic disease that is a constant threat to life - Answers -
-Severe COPD requiring oxygen therapy
-End-state renal failure requiring dialysis
-Unstable angina
-MI < 3 months ago
-CVA
-Ongoing cardiac ischemia
ASA V: A moribund patient who is not expected to survive without surgery. Not
expected to live 24 hours. - Answers - -Septic shock
