Patient Assessment and Preparation Flashcards

Which finding in a patient medical history would most likely require physician consultation BEFORE proceeding with IV sedation?

Answer: Myocardial infarction 4 weeks ago

A myocardial infarction within 6 weeks represents high cardiac risk. Elective procedures should be deferred for at least 4 to 6 weeks (many guidelines say 3 months) with cardiology clearance.

A complete airway examination before IV sedation should include all of the following EXCEPT:

Answer: Radiographic bone density of the cervical spine

Cervical spine radiography is not a routine pre-sedation airway assessment tool. Clinical airway assessment includes Mallampati score, thyromental distance, mouth opening, neck mobility, and dental assessment.

For a 25 kg pediatric patient, if fentanyl is ordered at 1 mcg/kg IV, what is the correct dose?

Answer: 25 mcg

1 mcg/kg x 25 kg = 25 mcg fentanyl. Weight-based dosing is mandatory for all pediatric patients to prevent overdose.

Preoperative anxiolysis with oral midazolam in a pediatric patient is typically administered at which dose?

Answer: 0.5 mg/kg PO maximum 20 mg

Oral midazolam for pediatric premedication is typically 0.5 mg/kg up to a maximum of 20 mg, mixed in flavored syrup for palatability.

A patient reports taking St. John Wort herbal supplement. This is clinically relevant to sedation because it:

Answer: Induces CYP3A4 and CYP2C9 enzymes, reducing plasma levels of many sedative drugs

St. John Wort is a potent CYP3A4 inducer that accelerates metabolism of benzodiazepines, opioids, and other sedatives, potentially leading to inadequate sedation.

Post-sedation discharge instructions MUST include which of the following elements?

Answer: No driving for 24 hours, responsible adult escort required, emergency contact information

Post-sedation instructions must specify no driving for at least 24 hours, mandatory adult escort, dietary guidance, activity restrictions, and emergency contact details.