Cannulation Pre and Post Procedures

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Questions and Answers

What is the first step in the pre-procedure of cannulation?

Assess patient’s level of consciousness and anxiety

Provide privacy

Greet and explain procedures to patient

Check for doctor’s order (correct)

What is a potential complication of IV therapy?

Allergic reaction

Anaphylaxis

Infection

Hematoma (correct)

What is a characteristic of the vein selected for cannulation?

Deep in the skin

Small and fragile

Big enough, straight, soft and visible through the skin (correct)

Broken or damaged

What is the threshold for PaO2 that indicates a drop in oxygen saturation?

less than 60 mmHg Signup and view all the answers

What should be done with disposable items and sharps after the procedure?

Discard them appropriately Signup and view all the answers

Why may patients receiving anticoagulant therapy be more prone to hematoma?

Because they are taking anticoagulant therapy Signup and view all the answers

Which of the following is NOT a cause of decreased oxygen in the bloodstream?

Gastroparesis Signup and view all the answers

What is ecchymosis?

A bigger hematoma Signup and view all the answers

What is a possible clinical manifestation of decreased oxygen in the bloodstream?

Cyanosis of mucous membranes Signup and view all the answers

What should be done after washing hands during the procedure?

Select the site and vein Signup and view all the answers

Which of the following can increase the risk of aspiration?

Gastroparesis Signup and view all the answers

What is the threshold for SpO2 by pulse oximeter that indicates a drop in oxygen saturation?

less than 90% Signup and view all the answers

When is hematoma more likely to occur?

When using a large bore cannula Signup and view all the answers

Which of the following is a possible cause of decreased oxygen consumption?

Hypothermia Signup and view all the answers

What is another term for decreased oxygen in the bloodstream?

Hypoxia Signup and view all the answers

Which of the following conditions can delay gastric emptying?

All of the above Signup and view all the answers

What was the occupation of Dr. John Riggs?

Dentist Signup and view all the answers

What was Horace Wells trying to achieve in his experiment?

To test the effect of nitrous oxide on pain Signup and view all the answers

What is the term for the type of sedation where an inhaled drug is used?

Inhalation sedation Signup and view all the answers

What is the advantage of inhalation sedation over oral, rectal, or intramuscular sedation?

It has a more rapid onset of action Signup and view all the answers

What is the main advantage of IV drug administration?

Only it and inhalation sedation provide peak clinical actions in a time span permitting titration Signup and view all the answers

What is the risk of overly deepening the penetration of the needle?

It may hit the femur Signup and view all the answers

Who administered nitrous oxide to Horace Wells?

Professor Gardner Quincy Colton Signup and view all the answers

What was the effect of nitrous oxide on Horace Wells during the procedure?

He was unaware of the procedure and experienced absolutely no pain Signup and view all the answers

What is the primary concern when injecting in the upper outer quadrant of the gluteal region?

Avoiding the sciatic nerve Signup and view all the answers

Why is the ventrogluteal region preferred for IM injections in certain patients?

Because the patients are bedridden and unable to lie face down Signup and view all the answers

What is the advantage of submucosal sedation over IM administration?

A more rapid onset of action Signup and view all the answers

In which region is the submucosal sedation technique used?

Maxillary or mandibular buccal fold Signup and view all the answers

Why is the gluteal region injection method avoided by pediatric doctors?

Because of the slow rate of absorption Signup and view all the answers

What are the three bony landmarks used to locate the ventrogluteal region?

Anterior superior iliac spine, iliac crest, and greater trochanter of the femur Signup and view all the answers

What is the disadvantage of using the gluteal region for injection?

All of the above Signup and view all the answers

What type of drug is used in submucosal sedation?

CNS-depressant Signup and view all the answers

What is the primary goal of modifying the patient's state of mind with inhalation sedation?

To maintain communication and respond to verbal command Signup and view all the answers

What is the advantage of using N2O in inhalation sedation?

It is not metabolized by the body Signup and view all the answers

What is the equivalent analgesic effect of a 20% concentration of N20?

10 to 15 mg of morphine Signup and view all the answers

What is the recovery time from inhalation sedation with N2O-O2?

3-5 minutes Signup and view all the answers

What is the effect of N2O on the liver, kidneys, brain, and cardiovascular and respiratory systems?

It has no adverse effects on these systems Signup and view all the answers

At what concentration of N20 does it produce analgesia?

30% to 40% Signup and view all the answers

What is the advantage of using inhalation sedation with N2O-O2 in certain procedures?

It can be used instead of local anesthesia Signup and view all the answers

What is the significance of the margin of safety in inhalation sedation?

It prevents unintended loss of consciousness Signup and view all the answers

Study Notes

Pre-Procedures

Check doctor's order and greet patient
Assess patient's level of consciousness and anxiety
Provide privacy
Wash hands

During Cannulation

Wash hands
Select the site and vein:
- No wound or rashes
- Vein is big enough, straight, soft, and visible through the skin

Complications of Intravenous Therapy

Hematoma

Resulting from infiltration of blood into tissues at the venipuncture site
Related to venipuncture technique
Use of large bore cannula: Trauma to the vein during insertion
Patients receiving anticoagulant therapy and long-term steroids

Hypoxia

Present when PaO2 is less than 60 mmHg or SpO2 by pulse oximeter is less than 90%
Causes:
- Hypoventilation
- Low inspired oxygen
- Increased oxygen consumption (e.g., shivering, sepsis, pain)
- Low cardiac output
- Anatomic shunt: refractory to oxygen therapy
Clinical conditions that may delay gastric emptying and increase risk of aspiration:
- Anxiety
- Autonomic dysfunction (gastroparesis)
- Hiatal hernia / GERD
- Morbid obesity
- Pregnancy
- Bowel obstruction
- Head trauma / increased intracranial pressure
- Multi-trauma

IM Injections

Deltoid muscle injection technique:
- Injection given between upper and lower portions of the deltoid muscle
Ventrogluteal Region:
- Lies in close proximity to the gluteal region
- Primary use is for IM injection in patients who are bedridden and unable to lie face down
Sciatic nerve:
- One of the longest nerves in the body
- Risk of paralysis if hit during injection

Submucosal Sedation

Used in pediatric dentistry
CNS-depressant drug is injected into the mucous membrane in either the maxillary or mandibular buccal fold
Advantage over IM administration: slightly more rapid onset of clinical action

Inhalation Sedation

Form of conscious sedation
Inhaled drug:
- Depresses the central nervous system (CNS) to an extent that allows operative treatment with minimal physiological and psychological stress
- Modifies the patient's state of mind such that communication is maintained and the patient can respond to verbal command
- Carries a margin of safety wide enough to render the unintended loss of consciousness and loss of protective reflexes unlikely
Advantages:
- Onset of action is more rapid than oral, rectal, intranasal (IN), or intramuscular (IM) sedation
- Peak clinical action in a time span permitting titration
- Recovery time is rapid
- No adverse effects on liver, kidneys, brain, or cardiovascular and respiratory systems
N2O-O2 can be used instead of local anesthesia in certain procedures
Analgesia produced by a 20% concentration of N20 is equivalent to that of 10 to 15 mg of morphine

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Description

This quiz covers the pre and post procedures for cannulation, including checking doctor's orders, assessing patient consciousness, and proper disposal of sharps.