National Sedation Center: Adult Moderate Sedation Questions & Anxswers 100% Correct!

After administering 3 doses of Fentanyl over 20 minutes, you observe a loss of ETCO2 waveform on the monitor. You immediately check your patient and he is responsive, but only to repeated painful stimuli. A jaw thrust is performed and respirations are now present, but slow. The SpO2 is decreasing even after applying an airway adjunct. You believe the patient has slipped into deep sedation and it is best to administer reversal. What medication and dosage is considered the initial dosage for reversal of procedural sedation and analgesia (PSA). - ANSWER-Narcan 0.1-0.2 IV/IM/SQ The procedure is complete and you transfer the patient to the recovery area. For completeness, your report will be given in the SBAR-C (Situation, Background, Assessment, Recommendation, and Confirmation) format to the receiving recovery room nurse. Match the examples below with the appropriate corresponding letters. - ANSWERAssessment - Narcan was administered, which returned Mr. Mann to the appropriate level of sedation and vital signs. He is now alert and oriented with stable vital signs and oxygen saturation of 99% on 2 liters of oxygen per nasal cannula. Background - Mr. Mann required multiple doses of fentanyl, which resulted in deeper than expected level of sedation. Situation - This is Mr. Mann. He is post dressing change and moderate sedation was administered. Recommendation - Mr. Mann should be continually monitored and discharge delayed for 2 hours post administration of Narcan Confirmation - Do you agree with the plan to delay discharge? Which of the following would describe a patient that is moderately sedated? - ANSWERPurposeful response to verbal or tactile stimulation. No airway intervention is required and spontaneous ventilation is adequate. At what point on the capnogram waveform below is the end-tidal measurement taken? - ANSWERAt the very tip of the gentle upslope of Phase III, just prior to D. You elect to insert a nasopharyngeal airway (NPA) into your semiconscious patient. How would you measure for the appropriate size? - ANSWERThe length of the device should be the same as the distance from the tip of the patient's nose to the earlobe. Your plan is to administer moderate sedation to an ASA II patient in radiology. While applying monitors and oxygen, the patient states he has no pulmonary problems and will not need oxygen. There are no contraindications for the use of supplemental oxygen. Your correct action would be: - ANSWERExplain the rational for supplemental oxygen use during sedation and apply nasal cannula oxygen prior to the start of sedation and the procedure.