MODERATE SEDATION CERTIFICATION EXAM QUESTIONS WITH CORRECT ANSWERS ALL VERIFIED BY AN EXPERT A+ GRADED (LATEST UPDATE)

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MODERATE SEDATION
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CERTIFICATION EXAM
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QUESTIONS WITH CORRECT
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ANSWERS ALL VERIFIED BY
AN EXPERT A+ GRADED
(LATEST UPDATE)

,Moderate "Conscious" Sedation - ANS A minimally depressed level of consciousness induced
by the administration of pharmacologic agents in which the patient retains continuous and
independent ability to maintain protective reflexes and a patent airway and to be aroused by
physical or verbal stimulation.

Levels of Sedation Analgesia - ANS 1. Minimal Sedation
2. Moderate Sedation/Analgesia




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3. Deep Sedation/Analgesia
4. General Anesthesia




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Minimal Sedation - ANS 1. Patient is able to respond normally to verbal stimulation.
2. Airway and Spontaneous Ventilation is not affected and thus "normal"
3. Cardiovascular function is not affected




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Moderate Sedation/Analgesia - ANS 1. Patient responds to verbal or tactile stimulation
2. No intervention to maintain patent airway
3. Spontaneous ventilation is adequate
4. Cardiovascular function is usually maintained
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Deep Sedation/Analgesia - ANS 1. Patient responds to repeated or painful stimulation
2. May require intervention to maintain patent airway
3. Spontaneous ventilation may be inadequate
4. Cardiovascular function is usually maintained
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General Anesthesia - ANS 1. Patient cannot be aroused, even with painful stimuli
2. Intervention required to maintain patent airway
3. Spontaneous ventilation is frequently inadequate
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4. Cardiovascular function may be impaired

Goals of Safe Sedation - ANS 1. Maintain adequate ventilation, homeostasis, and circulation
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2. Maintenance of appropriate level of consciousness
3. Promote comfort by elevating pain threshold
4. Patient Safety-be knowledgeable about possible consequences of respiratory depression,
airway obstruction, apnea, hypoxia, hypercapnia, bradycardia, asystole, brain injury/death
5. Using the essential components required to conduct safe sedation
6. Understand the importance of a systematic approach to sedation that promotes safety and
efficacy.

Role of the Sedation Nurse - ANS 1. Pre-op Nursing Assessment
2. Intra-op Nursing Actions: medication administration; patient monitoring; patient safety;
procedure specific

,3. Post-op monitoring during recovery
4. Follow post-op d/c criteria
5. Explain post-d/c written instructions
6. Follow-up

JCAHO Care Standard: Qualified Individuals conducting sedation must possess education,
training, and experience in? - ANS 1. Evaluating patients prior to moderate or deep sedation
2. Rescuing patients who slip into a "deeper than desired" level of sedation or anesthesia
3. Managing a compromised airway during a procedure
4. Handling a compromised CV system during a procedure.




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Pre-Operative Nursing Assessment Steps - ANS 1. Chart Review
2. Patient Interview




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3. Physical Exam and Review of Systems

Pre-sedation Assessment Overview: Parts of the Assessment - ANS 1. NPO Status




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2. Chief complaint
3. Current medications
4. Drug allergies
5. H/O substance abuse
6. Concurrent medical problems
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7. Communication Ability

How is Aspiration Risk Reduced - ANS 1. Pre-procedure fasting--Defined as no food for 6
hours prior to procedure. May have clear fluids until 2h prior to procedure.
2. Medication is titrated to maintain reflexes
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What conditions place patient's at enhanced risks for aspiration with sedation? - ANS 1.
Obesity
2. DM
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3. Pregnancy
4. Bowel Dysfunction
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Patient history to consider during pre-op preparation - ANS 1. Smoking- PPD and years
2. Drug allergies and reaction
3. Alcohol Abuse
4. Menstrual Hx and Urine HCG for fertile women
5. Height and Weight to dose medications
6. Drug Abuse
7. Daily Medications
8. Post Facial/Neck Trauma or Surgery
9. Dentures or any removable items in mouth

Elements of Pre-operative Preparation - ANS 1. Patient counseling

, 2. Rapport
3. Verbal reassurance
4. Patient expectations
5. IV Access
6. EKG/BP
7. Pulse Ox
8. Informed Consent

Pre-Sedation Assessment: Chart Review - ANS 1. Past medical illnesses
2. Prior Surgical Procedures




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3. Allergies
4. Drug reactions and intra-anesthetic complications
5. Lab Studies




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6. Current medications
7. Compliance of medication regimen




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Pre-Sedation Assessment: Ancillary Studies - ANS 1. Recent EKG (<1year)
2. Patients at risk for myocardial injury (anti-hypertensive)
3. Pregnant, must have OB consult
4. <5 years old require a consult with anesthesia
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ASA Physical Status - ANS American Society of Anesthesiologists Physical Status System
helps qualify the relative risk to patients sedative medications pose

ASA 1 - ANS -Normal, healthy adult
-No chronic illness
-No regular medications
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-Excludes very young and very old
-Good exercise tolerance
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ASA 2 - ANS Mild systemic disease:
-Controlled HTN
-Type II DM
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-H/O tobacco use
-Obesity
-Non-metastatic carcinoma
-Well controlled asthma
-Child with underlying cerebral palsy
-Child with well-controlled seizure disorder

ASA 3 - ANS *Severe systemic disease that is not incapacitating:
-Poorly controlled HTN
-Multiple medications for cardiac, respiratory, and/or metabolic disorders
-Metastatic dz with some interference with function