Author Question: A client reports that the last time he received nitrous oxide for a procedure he had what felt like ... (Read 18 times)

Zulu123 · **on:** Jul 23, 2018

A client reports that the last time he received nitrous oxide for a procedure he had what felt like a hangover for days afterward. Which intervention should the nurse plan to help avoid this effect?

1. Prehydrate the client with intravenous normal saline.
2. Report this comment to the anesthesiologist so he will change the agent used.
3. Provide the client with caffeine-containing beverages immediately after the procedure.
4. Have the client breathe 100 oxygen for several minutes following the nitrous oxide.

Question 2

A client has received local anesthesia of lidocaine (Xylocaine) with epinephrine for repair of a laceration. The nurse plans care based on the knowledge of which action of the epinephrine?

1. Constrict the blood vessels in the area to dramatically reduce bleeding, thus enhancing the operative field.
2. Constrict the blood vessels to extend the duration of the drug in the operative area.
3. Constrict the blood vessels to make the wound less distressing to the client and to promote relaxation.
4. Constrict the blood vessels in the area to reduce the transmission of pain signals to the central nervous system.

braelync · **Reply #1 on:** Jul 23, 2018

Answer to Question 1

Correct Answer: 4
Rationale 1: There is no evidence to support prehydration causing a change for this effect.
Rationale 2: It is not necessary to change anesthesia agents.
Rationale 3: Administering caffeine with nitrous oxide may exacerbate dysrhythmias.
Rationale 4: Having the client breathe 100 oxygen for several minutes following nitrous oxide use has been shown to prevent alveolar hypoxia. It is the alveolar hypoxia that produces the hangover effect.
Global Rationale: Having the client breathe 100 oxygen for several minutes following nitrous oxide use has been shown to prevent alveolar hypoxia. It is the alveolar hypoxia that produces the hangover effect. There is no evidence to support prehydration causing a change for this effect. It is not necessary to change anesthesia agents. Administering caffeine with nitrous oxide may exacerbate dysrhythmias.

Answer to Question 2

Correct Answer: 2
Rationale 1: The amount of vasoconstriction with a local anesthetic will not significantly decrease bleeding from the injury.
Rationale 2: Epinephrine is a common additive to local anesthetics that is used to constrict the blood vessels and to extend the duration of the drug.
Rationale 3: Vasoconstriction will not promote relaxation in the client.
Rationale 4: Vasoconstriction does not decrease the transmission of pain signals.
Global Rationale: Epinephrine is a common additive to local anesthetics that is used to constrict the blood vessels and to extend the duration of the drug. The amount of vasoconstriction with a local anesthetic will not significantly decrease bleeding from the injury. Vasoconstriction will not promote relaxation in the client nor does it decrease the transmission of pain signals.