During nitrous oxide administration, monitoring should include adjusting the settings as needed.

• A. True
• B. False
• C. Only at the start
• D. Never adjust

Answer: (A)

Continuous monitoring and titration are essential when using nitrous oxide. Its effects can change rapidly as the patient’s anxiety, pain, and breathing pattern shift, so you don’t set the mixture once and stop watching. The aim is to maintain a comfortable level of analgesia and sedation while ensuring adequate oxygenation, which means adjusting the nitrous oxide concentration (typically alongside a constant oxygen delivery) as needed. Clinically, you assess vital signs, oxygen saturation, respiratory rate and pattern, and, if available, capnography to gauge ventilation. If the patient becomes too sedated, you lessen nitrous oxide or increase oxygen; if analgesia or anxiolysis is insufficient, you titrate up carefully. Don’t forget to administer 100% oxygen at the end to prevent diffusion hypoxia and to reassess the patient before discharge.