Can you please make the Scenario beginning from Step 1 to step 25?…

Can you please make the Scenario beginning from Step 1 to step 25?… Can you please make the Scenario beginning from Step 1 to step 25? I made for every step.  A 38-year-old white woman came for dental treatment and during dental treatment, decided to administer a nitrous oxide-oxygen sedative for patient comfort. The oxygen tank you will use = 2000 psi and the nitrous tank you will use = 750 psi. Step1)Disinfect all components and Check for tears or leaks.Check all 4 thanks are closed and gauge “0” PSI, then Open the Valve all the way Check which tanks have the most amount of gas.Do this for ALL 4 tanks, to determine which tanks you will use for tx.Close tanks until the patient arrives  Step2) Review RMH.Check for contraindications/indications to nitrous oxide-oxygen sedation.”After reviewing my patent’s medical history there are no contraindications to today’s treatment.” Step3)Introduce patient to Nitrous oxide-oxygen Sedation.” I will be administrating Nitrous oxide-oxygen Sedation for your comfort during the tx. You should feel more relaxed. I will put a nasal hood on your nose, and please breathe through the nose only.” Step4) Take baseline vital signs and Document vitals. Step5) Ask Pt to use the restroom.” Before we start, can you please use the restroom?” Step6) Check patient position (supine and Legs/ankles not crossed)Step7) Set up and secure ScavengingStep8) Start the flow of O2 at 6L, before placing the nasal hood. Step9) Place the nasal hood over the Pt’s nose”I will place the nasal hood over your nose, and please breathe through the nose only. if you breathe through the mouth, Nitrous Gas comes out of your mouth and someone else can inhale it.” Step10) Secure nasal hood and Let Pt adjust it.- Check hoses and slip ring adjusted. The nasal hood is gently placed and fitted over the patient’s nose so there are no leaks of gas into the surrounding environment. Step11) Attention is now drawn to the reservoir bag- Check the reservoir bag for Overly inflated, or Under-inflated.- Adjust the vacuum on the scavenging system and the reservoir bag till Correctly inflated.”Are you comfortable breathing right now?” Step12) Check Pt’s Tidal volume start at adult 6L/min and Adjust flow higher or lower, depending on the movement of the reservoir bag. Step13) Begin titration of N2O.- Increase by 1L/min of N2O, then decrease by 1L/min O2.- Wait for 1min.Step14) Observe the patient and stay with the patient. Step15) Check the level of sedation and how Pt feels.After 1min, Observe the patient. Ask Pt ” How do you feel?” or ” What are you feeling now?”Pt says ” I feel relaxed and warmth” If they feel relaxed enough to begin tx, this will be their sedation level.  (1L/min of N2O, and 5L/min O2). Step16) Continue titration of N2O by 0.5L/min (if needed)First, increase N20 by 0.5L/min then deceased O2 by 0.5L/min.Observes the Patient for one minute.Step17) Observe the Patient for one minute and ask pt ” How do you feel?” or ” What are you feeling now?”.See if the patient’s body is relaxed.If they feel relaxed enough to begin tx, this will be their sedation level.If they do not feel relaxed, continue titration and increase N20 by 0.5L/min. Observe the patient’s clinical signs and symptoms to Inquire about the level of sedation.- Lightheadedness (dizziness), Tingling sensation of arms, legs, or oral cavity, Feeling warmth, floating, or heaviness. If over sedation is observed, determines the urgency of terminating or reducing nitrous oxide.- Persistently close the mouth.- Spontaneously begins mouth breathing.- Complain of nausea and sedation felt too intense or uncomfortable.- Not responsive or sluggish responses.- Sleepy.- Dreaming.- Uncooperative.- Laughs, cries and becomes giddy.- Uncoordinated movement. Step18) Continue to observe the patient for signs of sedation or oversedation.If they feel relaxed enough to begin tx, this will be their sedation level. Begins dental treatment  (1L/min of N2O, and 5L/min O2) Step19) Begins dental treatment- Observes the patient and inhalation sedation unit during the treatment. When sedation is not working anymore- Increase N20 by 0.5L/min then deceased O2 by 0.5L/min.When the patent is over sedated- Increase O2 by 1L/min then deceased N2O by 1L/min. * Deciding when to stop the sedation.- Continue to observe the patient. Step20) Terminating N2O.- Increase O2 flow to tidal volume 6L/min, Shut off N2O completely.- Have the patient inhale 100% Oxygen for at least 5 minutes, or more if necessary.- Ask Pt, “How do you feel?” and “Do you feel back to normal?”.- Until Pt is back to normal, do not remove O2.- When Pt is back to normal, remove the nasal hood and then terminate O2 and shut down the unit. Step 21) Retakes vital signs and if vitals are normal discharges the patient.- Slightly lower BP is normal. Step22) Record Data on the SOAP notes.- Record pre- and post-vital signs. S: Pt presents for dental hygiene service cc: noneO: RMH, No change per pt. No contraindications to tx. Completed LACCD Covid test screening form: no symptoms per pt. Negative covid test dated: 05/13/2022. BP: 118/76 P:72 R:14 Temp: 97.1F O2: 99%A: ASAIP: The patient received 16.7% N2O and 83.3% O2 at a total liter flow of 6L/min. The procedure lasted approximately 45minutes. At the termination of the procedure. the patient received 100% O2 for 5 minutes at a flow of 6L/min. Post vital signs were taken. BP: 114/72 P:70 R: 12 O2: 99%. The patient tolerated the procedure well and was dismissed from the office in a good condition.NV: continue dental hygiene serviceCaroline Sone #2340 Step23) Disinfect Equipment.- Close Tanks- Nasal hood (plastic connectors must remain with the hose, not on the nasal hood) is one that should be sterilized.- Wipe down with disinfect all components (knobs, tubes, reservoir bag, tanks, etc.) Step24) Record remaining gas in the tanks used on the tank sheet or tag.- Turn the unit on.- Slowly and slightly open the cylinder knob, and opening the cylinder, let the pressure gauge rise to maximum level.- Record take level on tank tag.(The oxygen tank = 1500 psi and the nitrous tank = 750 psi.)- Close tanks- Oxygen flush the unit.- Turn the unit off(Empty tanks should be replaced at this time) Step25) Replace unit to the storage area.  Health Science Science NursingNURSING 434Share QuestionEmailCopy link Comments (0)

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