Sedation Learning Module - Moderate
Sedation Quiz
Who may not be suitable for sedation? - Answers -1. Abnormalities of the major organ
systems
2. Drug allergies, current medications, and potential drug interactions
3. Hx of tobacco, EtoH, or sustance use/abuse
What patients are at risk with moderate sedation? - Answers -1. Uncooperative patients
2. Mentally handicapped patients
3. Patients with severe cardiac, pulmonary, hepatic, renal or central nervous disease
4. Morbidly obese patients
5. Patients with EtoH/drug abuse
6. Pregnant pts
7. Pts with hx of sleep apnea
What are factors of difficult airway intubations? - Answers -1. Previous problems with
anesthesia or sedation
2. Previous sx, trauma, radiation to the face/neck
3. Stridor, snoring, or sleep apnea
4. Dysmorphic facial features (Pierre Robin syndrome, trisomy 21)
5. Advanced rheumatoid arthritis
What are factors of difficult a/w management in the physical examination? - Answers -1.
Significant obesity (neck/facial structures)
2. Head & neck: short neck, limited neck extension, decreased hyoid mental distance
(<3 cm in an adult)
3. Mouth: small opening (<3 cm in adult); edentulous, protruding incisions, loose or
capped teeth; high, arched palate; macroglossia; tonsillar hypertrophy; non-visible uvula
4. Jaw: micrognathia, retreognathia, trismus, significant malocclusion
Ingested Material & Minimum Fasting Period - Answers -1. Clear liquids - 2 hours
2. Breast milk - 4 hours
3. Infant formula/nonhuman milk/light meal - 6 hours
4. Heavy meal/fats - 8 hours
What VS are recorded? - Answers -1. BP
2. EKG
3. RR
4. Pulse ox
5. LOC
, 6. O2 lpm
7. IV solution
8. HR/pulse
What are the side effects of opiates? - Answers -1. Respiratory depression
2. Cough suppression
3. Muscular rigidity
4. Histamine release
5. Itching
6. N/V
7. Constipation
8. Biliary colic
9. Urinary retention
What are the effects of Morphine? - Answers -1. analgesia
2. sedation
3. mood alteration
What happens when you give Morphine to a pain free individual? - Answers -N/V
Morphine - CVS
1. What commonly occurs when standing?
2. How is hypotension produced?
3. What typically develops from direct vagal nucleus stimulation? - Answers -1.
orthostatic hypotension
2. release of histmines (leads to bronchoconstriction)
3. bradycardia
Morphine - Ventilation/Respiration
1. What occurs as a side effect of Morphine? - Answers -DECREASE in RR, and
INCREASE in Vt
Morphine - CNS Effects
1. How does the elevation of pC02 effect the respiratory center? - Answers -It may
increase cerebral blood flow and elevate intracranial pressure
Morphine - Side Effects
1. What is biliary spasm typically confused with?
2. What body system should be carefully watched? - Answers -1. angina pectoris
2. renal failure pts are susceptible to accumulation of metabolites of morphine and
subsequent respiratory depression
Meperidine (Demerol)
What is the strength of Meperidine (Demerol) compared to Morphine? - Answers -1/10th
as potent as Morphine
Sedation Quiz
Who may not be suitable for sedation? - Answers -1. Abnormalities of the major organ
systems
2. Drug allergies, current medications, and potential drug interactions
3. Hx of tobacco, EtoH, or sustance use/abuse
What patients are at risk with moderate sedation? - Answers -1. Uncooperative patients
2. Mentally handicapped patients
3. Patients with severe cardiac, pulmonary, hepatic, renal or central nervous disease
4. Morbidly obese patients
5. Patients with EtoH/drug abuse
6. Pregnant pts
7. Pts with hx of sleep apnea
What are factors of difficult airway intubations? - Answers -1. Previous problems with
anesthesia or sedation
2. Previous sx, trauma, radiation to the face/neck
3. Stridor, snoring, or sleep apnea
4. Dysmorphic facial features (Pierre Robin syndrome, trisomy 21)
5. Advanced rheumatoid arthritis
What are factors of difficult a/w management in the physical examination? - Answers -1.
Significant obesity (neck/facial structures)
2. Head & neck: short neck, limited neck extension, decreased hyoid mental distance
(<3 cm in an adult)
3. Mouth: small opening (<3 cm in adult); edentulous, protruding incisions, loose or
capped teeth; high, arched palate; macroglossia; tonsillar hypertrophy; non-visible uvula
4. Jaw: micrognathia, retreognathia, trismus, significant malocclusion
Ingested Material & Minimum Fasting Period - Answers -1. Clear liquids - 2 hours
2. Breast milk - 4 hours
3. Infant formula/nonhuman milk/light meal - 6 hours
4. Heavy meal/fats - 8 hours
What VS are recorded? - Answers -1. BP
2. EKG
3. RR
4. Pulse ox
5. LOC
, 6. O2 lpm
7. IV solution
8. HR/pulse
What are the side effects of opiates? - Answers -1. Respiratory depression
2. Cough suppression
3. Muscular rigidity
4. Histamine release
5. Itching
6. N/V
7. Constipation
8. Biliary colic
9. Urinary retention
What are the effects of Morphine? - Answers -1. analgesia
2. sedation
3. mood alteration
What happens when you give Morphine to a pain free individual? - Answers -N/V
Morphine - CVS
1. What commonly occurs when standing?
2. How is hypotension produced?
3. What typically develops from direct vagal nucleus stimulation? - Answers -1.
orthostatic hypotension
2. release of histmines (leads to bronchoconstriction)
3. bradycardia
Morphine - Ventilation/Respiration
1. What occurs as a side effect of Morphine? - Answers -DECREASE in RR, and
INCREASE in Vt
Morphine - CNS Effects
1. How does the elevation of pC02 effect the respiratory center? - Answers -It may
increase cerebral blood flow and elevate intracranial pressure
Morphine - Side Effects
1. What is biliary spasm typically confused with?
2. What body system should be carefully watched? - Answers -1. angina pectoris
2. renal failure pts are susceptible to accumulation of metabolites of morphine and
subsequent respiratory depression
Meperidine (Demerol)
What is the strength of Meperidine (Demerol) compared to Morphine? - Answers -1/10th
as potent as Morphine
