Certified Ambulatory Perianesthesia Nurse (CAPA) Practice Exam

What vital signs should prompt a nurse to consider reversing sedation with flumazenil?

1. Hypertension and tachycardia

2. Bradycardia and hypotension

3. Respiratory rate below 8 breaths per minute

4. Elevated blood glucose

The correct answer is: Respiratory rate below 8 breaths per minute

The choice of respiratory rate below 8 breaths per minute is particularly significant in the context of sedation reversal. This is because a decreased respiratory rate indicates a potential respiratory depression, which is a critical concern with sedative medications. When patients are sedated, their central nervous system may be inhibited to the extent that it affects respiratory drive. A respiratory rate below 8 breaths per minute suggests that the patient is not adequately ventilating, which can lead to hypoxia and other serious complications. Flumazenil is a specific antagonist of benzodiazepines and is used to reverse the effects of sedation caused by these medications. In cases where a patient demonstrates severe respiratory depression—evidenced by a very low respiratory rate—administering flumazenil can help restore normal respiratory function by reversing the sedative effects. Other conditions, such as hypertension and tachycardia, bradycardia and hypotension, or elevated blood glucose, do not necessarily indicate the need for sedation reversal. While they are important vital signs that require monitoring, they are not specifically linked to the acute respiratory issues that necessitate the use of flumazenil for resuscitating a patient's respiratory drive.