Moderate Sedation In-Service Training Written 2024
Questions and Answers with complete solution
Practitioners performing moderate sedation must have all the skills to provide
support to a patient in a state of deep sedation.
TRUE
The Joint Commission standards on sedation and anesthesia apply whenever a
patient receives moderate sedation, deep sedation, or general anesthesia. They
do not apply when patients receive anxiolysis/minimal sedation.
TRUE
The RN giving moderate sedation to the patient should not be scheduled to be
involved in duties other than continuous monitoring of the patient.
TRUE
Case Scenario 1: A 70-year-old 80 kg male is scheduled for cystoscopy and
prostate biopsies for prostatic hypertrophy. He has a long history of hypertension
and intermittent CHF treated with Lasix and Digoxin. He also has an implanted
pacemaker that was placed for his history of heart block. Upon arrival to the clinic
his B/P is 160/90, HR 75, RR14 and O2 Sat 96% on room air. Per physician order
the patient receives Valium 10mg p.o. and is transferred to the procedure room 30
min. later. The patient feels relaxed and he moves to the exam table himself. B/P
150/80, HR 70, O2 Sat 95 Percent on room air.
This case report is an example for:
minimal sedation
A pre-sedation assessment needs to include all of the following except:
hematocrit
A 62-year-old 100 kg man with chronic alcoholism and acute hematemesis is
scheduled for an upper endoscopy. On admission his mental status is described
as alert and oriented. B/P 140/90, HR 110. His Hct is 27. Upon arrival to the GI
suite the patient is placed on all monitors. He receives oxygen at 2 liters/min. by
nasal cannula and is sedated with Demerol 50mg x 2 IV. The patient is sleepy, but
easy to arouse and follows commands. His O2 Sat. is 96% and he shows no signs
of airway obstruction. Ten minutes into the procedure the patients' B/P dropped
briefly to 86/45 and his HR is 110.
moderate sedation
A 66-year-old 62 kg male was admitted to the hospital after a 3-day history of new
onset of hemoptysis. A left upper lobe mass was noted on his chest x-ray. He is
now scheduled for a bronchoscopy. He has a long history of tobacco abuse and
he uses heroin up to three times per day. He has a history of hypertension for
which he takes Clonidine. B/P 140/90, HR 62, RR 24, O2 Sat 96% on 2 liters/min.
nasal cannula. The patient is very anxious. During the first 15 min. the respiratory
therapist and pulmonologist try to talk to the patient. He receives his Lidocaine
INH, a total of 10 mg of morphine IV, and midazolam 3mg IV. The patient's speech
is slurred and he soon becomes unconscious. He is not arousable by painful
stimulation. A stridor is noticed, his O2 Sat drops to 78%, his RR is 4-6/min.
general anesthesia
Questions and Answers with complete solution
Practitioners performing moderate sedation must have all the skills to provide
support to a patient in a state of deep sedation.
TRUE
The Joint Commission standards on sedation and anesthesia apply whenever a
patient receives moderate sedation, deep sedation, or general anesthesia. They
do not apply when patients receive anxiolysis/minimal sedation.
TRUE
The RN giving moderate sedation to the patient should not be scheduled to be
involved in duties other than continuous monitoring of the patient.
TRUE
Case Scenario 1: A 70-year-old 80 kg male is scheduled for cystoscopy and
prostate biopsies for prostatic hypertrophy. He has a long history of hypertension
and intermittent CHF treated with Lasix and Digoxin. He also has an implanted
pacemaker that was placed for his history of heart block. Upon arrival to the clinic
his B/P is 160/90, HR 75, RR14 and O2 Sat 96% on room air. Per physician order
the patient receives Valium 10mg p.o. and is transferred to the procedure room 30
min. later. The patient feels relaxed and he moves to the exam table himself. B/P
150/80, HR 70, O2 Sat 95 Percent on room air.
This case report is an example for:
minimal sedation
A pre-sedation assessment needs to include all of the following except:
hematocrit
A 62-year-old 100 kg man with chronic alcoholism and acute hematemesis is
scheduled for an upper endoscopy. On admission his mental status is described
as alert and oriented. B/P 140/90, HR 110. His Hct is 27. Upon arrival to the GI
suite the patient is placed on all monitors. He receives oxygen at 2 liters/min. by
nasal cannula and is sedated with Demerol 50mg x 2 IV. The patient is sleepy, but
easy to arouse and follows commands. His O2 Sat. is 96% and he shows no signs
of airway obstruction. Ten minutes into the procedure the patients' B/P dropped
briefly to 86/45 and his HR is 110.
moderate sedation
A 66-year-old 62 kg male was admitted to the hospital after a 3-day history of new
onset of hemoptysis. A left upper lobe mass was noted on his chest x-ray. He is
now scheduled for a bronchoscopy. He has a long history of tobacco abuse and
he uses heroin up to three times per day. He has a history of hypertension for
which he takes Clonidine. B/P 140/90, HR 62, RR 24, O2 Sat 96% on 2 liters/min.
nasal cannula. The patient is very anxious. During the first 15 min. the respiratory
therapist and pulmonologist try to talk to the patient. He receives his Lidocaine
INH, a total of 10 mg of morphine IV, and midazolam 3mg IV. The patient's speech
is slurred and he soon becomes unconscious. He is not arousable by painful
stimulation. A stridor is noticed, his O2 Sat drops to 78%, his RR is 4-6/min.
general anesthesia
