Capnography and Ventilation Assessment Quiz
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Questions and Answers

What should be done for a patient whose ETCO2 is greater than 45mmHg?

  • Hyperventilate the patient to increase CO2 levels (correct)
  • Introduce supplemental oxygen only
  • Maintain current ventilation rate
  • Decrease ventilation to lower CO2 levels

    • What does a sudden loss of waveform in capnography indicate?

  • Reinforced tube placement
  • Stable circulatory function
  • Possible tube disconnection or obstruction (correct)
  • Initial alveolar exhalation

    • What is the role of capnography in assessing a patient's ventilation status?

  • It records heart rate fluctuations
  • It displays patient oxygen saturation levels
  • It provides ETCO2 as an indicator of ventilation (correct)
  • It measures blood PH levels directly

    • Which phase of the capnogram represents the inspiratory baseline?

    <p>Phase 1 (A-B)</p> Signup and view all the answers

    What condition is indicated by a shark fin appearance in the wave form of capnography?

    <p>Bronchospasm related to asthma or COPD</p> Signup and view all the answers

    What are the typical values for ETCO2 in a healthy individual?

    <p>35-45mmHg</p> Signup and view all the answers

    What should be performed during CPR to ensure effective ventilation?

    <p>Maintain a minimum ETCO2 of 10mmHg</p> Signup and view all the answers

    What does a decrease in ETCO2 levels during ventilation suggest?

    <p>Hypoventilation or possible apnea</p> Signup and view all the answers

    What does EtCO2 measure?

    <p>The partial pressure of CO2 at the end of exhalation</p> Signup and view all the answers

    Which process primarily describes the movement of air in and out of the lungs?

    <p>Ventilation</p> Signup and view all the answers

    How is the total physiological dead air space calculated?

    <p>Anatomic Dead Space + Alveolar Dead Space + Mechanical Dead Space</p> Signup and view all the answers

    What is the normal range of CO2 levels measured in capnography?

    <p>35-45 mmHg</p> Signup and view all the answers

    Which term refers to the body’s process of regulating oxygen levels to the tissues?

    <p>Oxygenation</p> Signup and view all the answers

    What condition can lead to low ETCO2 levels?

    <p>Pulmonary embolus</p> Signup and view all the answers

    What happens to the respiratory rate as CO2 levels rise in the blood?

    <p>It increases to expel CO2</p> Signup and view all the answers

    What is the main function of pulse oximetry?

    <p>Determine the percentage of oxygen saturation in the blood</p> Signup and view all the answers

    Which factor can cause high CO2 levels due to hypoventilation?

    <p>Sedation</p> Signup and view all the answers

    In which situation does ETCO2 reflect cardiac output rather than ventilation?

    <p>During cardiac arrest</p> Signup and view all the answers

    What constitutes external respiration?

    <p>Gas exchange across the respiratory membrane in the lungs</p> Signup and view all the answers

    What is a possible complication related to flow rate in IV administration?

    <p>Infiltration</p> Signup and view all the answers

    Which gauge size is most appropriate for administering large amounts of fluid to adolescents and adults?

    <p>18 Gauge</p> Signup and view all the answers

    What factor contributes to decreased flow rate due to phlebitis or thrombi?

    <p>Position of the patient’s extremity</p> Signup and view all the answers

    What complication occurs when fluid leaks into surrounding tissue during IV therapy?

    <p>Infiltration</p> Signup and view all the answers

    Which of the following can affect the flow rate due to viscosity?

    <p>Dextrose concentration</p> Signup and view all the answers

    What is a common characteristic of chronic obstructive pulmonary disease (COPD)?

    <p>Irreversible damage to lung tissue</p> Signup and view all the answers

    Which symptom is typically associated with cystic fibrosis?

    <p>Chronic cough</p> Signup and view all the answers

    What is a potential complication of aspiration?

    <p>Complete airway obstruction without sound</p> Signup and view all the answers

    Which factor can trigger an asthma episode?

    <p>Exposure to cold air</p> Signup and view all the answers

    What symptom is NOT typically associated with secondary infections?

    <p>Weight gain</p> Signup and view all the answers

    What characterizes stable angina?

    <p>Predictable pain, location, and severity that is relieved by rest</p> Signup and view all the answers

    What causes unstable angina?

    <p>Ruptured plaque leading to significant coronary artery obstruction</p> Signup and view all the answers

    Which of the following is not a typical sign of angina?

    <p>Severe headache</p> Signup and view all the answers

    What is the most common cause of an acute myocardial infarction?

    <p>Ruptured plaque and thrombus formation</p> Signup and view all the answers

    What typically differentiates a STEMI from a Non-STEMI?

    <p>The ECG findings revealing elevated ST segments</p> Signup and view all the answers

    What happens to the area of ischemic tissue surrounding an infarcted zone?

    <p>It remains viable but is deprived of oxygen</p> Signup and view all the answers

    Which of the following best describes the pain experienced during an acute myocardial infarction?

    <p>Heavy, squeezing, crushing, or tight, often with a clenched fist</p> Signup and view all the answers

    Which condition represents a high risk of imminent myocardial infarction?

    <p>Unstable angina with longer lasting severe pain</p> Signup and view all the answers

    What happens during total obstruction of the bronchioles?

    <p>Mucus plugs completely block airflow.</p> Signup and view all the answers

    Which sign or symptom is commonly associated with Status Asthmaticus?

    <p>Cough with thick tenacious mucus.</p> Signup and view all the answers

    What characterizes the condition known as emphysema?

    <p>Destruction of the alveolar walls.</p> Signup and view all the answers

    In emphysema, what occurs due to the breakdown of elastic fibers?

    <p>Altered V/Q ratios and air trapping.</p> Signup and view all the answers

    What is the primary cause of dyspnea in a patient with bronchial obstruction?

    <p>Increased residual volume.</p> Signup and view all the answers

    How does the respiratory center adapt in patients with hypercapnia from emphysema?

    <p>It loses sensitivity to high CO2 levels.</p> Signup and view all the answers

    What can result from the formation of large alveolar air spaces in emphysema?

    <p>Increased likelihood of pulmonary hypertension.</p> Signup and view all the answers

    Which respiratory symptoms signify a worsening asthma exacerbation?

    <p>Silence in breath sounds and no respiratory rate.</p> Signup and view all the answers

    What is a common sign that may indicate a secondary infection?

    <p>Malaise and fatigue</p> Signup and view all the answers

    What is a potential consequence of aspiration in the lungs?

    <p>Obstruction with no sound</p> Signup and view all the answers

    What characterizes the onset of asthma episodes?

    <p>Hypersensitivity to environmental factors</p> Signup and view all the answers

    What is a common indicator of chronic obstructive pulmonary disease (COPD)?

    <p>Progressive tissue degeneration</p> Signup and view all the answers

    What is a characteristic sign of chronic bronchitis?

    <p>Constant productive cough</p> Signup and view all the answers

    Which condition is commonly referred to as 'blue bloaters'?

    <p>Chronic bronchitis</p> Signup and view all the answers

    What causes the thickening of bronchial walls in chronic bronchitis?

    <p>Chronic irritation and inflammation</p> Signup and view all the answers

    Which symptom is indicative of polycythemia in a patient with chronic bronchitis?

    <p>Clubbing of fingers</p> Signup and view all the answers

    What is a typical respiratory behavior of patients to facilitate breathing in chronic bronchitis?

    <p>Sitting upright in tripod position</p> Signup and view all the answers

    What is the primary role of pulmonary ventilation in the respiratory process?

    <p>To allow air to enter and exit the alveoli</p> Signup and view all the answers

    What measurement does capnography primarily provide?

    <p>The amount of CO2 in the exhaled air</p> Signup and view all the answers

    Which type of dead space includes areas ventilated without blood flow?

    <p>Alveolar Dead Space</p> Signup and view all the answers

    Which statement about EtCO2 is true?

    <p>It is unaffected by motion and circulatory status</p> Signup and view all the answers

    What occurs to the respiratory rate as carbon dioxide levels decrease in the blood?

    <p>It decreases to retain CO2</p> Signup and view all the answers

    What happens when a patient's ETCO2 drops below 35mmHg?

    <p>The patient is hyperventilating and should be hypoventilated.</p> Signup and view all the answers

    What could indicate a sudden increase in ETCO2 levels?

    <p>Return of spontaneous circulation (ROSC).</p> Signup and view all the answers

    How is oxygenation primarily defined in respiratory physiology?

    <p>The addition of oxygen to the body's tissues</p> Signup and view all the answers

    Which phase of the capnogram is characterized by the end tidal value?

    <p>Phase 4</p> Signup and view all the answers

    Which components are essential to the equation of gas exchange?

    <p>Ventilation + Circulation + Metabolism</p> Signup and view all the answers

    What role does external respiration play in the body?

    <p>Gas exchange across the respiratory membrane in the lungs</p> Signup and view all the answers

    What is indicated by a 'shark fin appearance' in a capnogram waveform?

    <p>Asthma or COPD.</p> Signup and view all the answers

    How does the shape of the capnogram waveform change during hyperventilation?

    <p>It becomes short and quick.</p> Signup and view all the answers

    What is a potential cause of decreased ETCO2 levels during ventilation?

    <p>Apnea.</p> Signup and view all the answers

    What should be maintained during CPR to assess ventilation effectiveness?

    <p>A minimum ETCO2 value of 10mmHg.</p> Signup and view all the answers

    What does a semi-quantitative capnography device measure?

    <p>A qualitative range of CO2 levels.</p> Signup and view all the answers

    Which sign is most commonly associated with acute respiratory failure?

    <p>Restlessness</p> Signup and view all the answers

    Which factor indicates the need for placing a supraglottic airway?

    <p>Prolonged extrication</p> Signup and view all the answers

    What is a contraindication for using the King LT airway?

    <p>Intact gag reflex</p> Signup and view all the answers

    Which method is NOT used to confirm proper placement of a supraglottic airway?

    <p>Direct visual inspection</p> Signup and view all the answers

    What is a potential complication when using the King LT airway?

    <p>Laryngospasm</p> Signup and view all the answers

    What primarily causes chronic diseases affecting the coronary arteries?

    <p>Plaque buildup</p> Signup and view all the answers

    Which symptom is commonly associated with unstable angina?

    <p>Prolonged duration of pain</p> Signup and view all the answers

    What is the most significant risk associated with unstable angina?

    <p>High risk of imminent myocardial infarction</p> Signup and view all the answers

    Which of the following describes the typical duration of stable angina pain?

    <p>1 to 5 minutes</p> Signup and view all the answers

    What process leads to the pain experienced during an acute myocardial infarction?

    <p>Plaque rupture and thrombus formation</p> Signup and view all the answers

    Which of the following is NOT a common characteristic of angina symptoms?

    <p>Mild discomfort easily ignored</p> Signup and view all the answers

    What term describes angina that does not follow the usual pattern and is more severe?

    <p>Unstable angina</p> Signup and view all the answers

    Which term best describes the area of heart tissue surrounding the infarcted zone?

    <p>Ischemic tissue</p> Signup and view all the answers

    Study Notes

    EtCO2

    • The process by which oxygen and carbon dioxide diffuse in and out of the blood
    • Also referred to as gas exchange occurring in two areas of the body—external and internal
    • External Respiration: gas exchange across respiratory membrane in the lungs
    • Internal Respiration: gas exchange across the respiratory membrane in metabolizing tissues (e.g., skeletal muscles).

    Ventilation

    • Pulmonary Ventilation: the process by which oxygen enters and carbon dioxide exits the alveoli
    • Ventilation is the act of inhaling and exhaling.

    Oxygenation

    • Refers to the act of adding oxygen to the body.
    • It explains how oxygen reaches the tissues.

    SPO2

    • Saturation of peripheral capillary oxygenation
    • Pulse oximetry measures oxygen saturation levels
    • Noninvasive measurement using a finger probe
    • Indicates the percentage of oxygen bound to red blood cells
    • Note: changes in ventilation can take minutes to be detected; motion and circulatory status might cause artifacts/influence results; nail polish can also cause artifacts.

    EtCO2

    • Measures ventilation status
    • Noninvasive measurement of patient's ventilatory status
    • Provides results within seconds
    • Not affected by motion or circulatory status
    • 100% sensitive and 100% specific

    Dead Air Space

    • Ventilated areas not involved in gas exchange.

    Capnography

    • Represents CO2 in exhaled air
    • Partial pressure of CO2 at exhalation
    • Normal range: 35-45 mmHg
    • Used with nasal prongs or attachment to BVM

    Respiratory Effort

    • Healthy lungs: brain responds to CO2 levels controlling ventilation
    • Assessed through chest rise and fall, respiratory effort, breath sounds, and counting respiratory rate
    • As CO2 increases, respiratory rate should increase to blow off CO2
    • As CO2 decreases, respiratory rate should decrease to retain CO2

    General Considerations

    • ETCO2 below 35mmHg indicates hyperventilation/hypocapnia. Hypoventilation is required to increase CO2 levels.
    • ETCO2 above 45mmHg indicates hypoventilation/hypercapnia. Hyperventilation is required to decrease CO2 levels.

    Why use Capnography?

    • To assess when a patient is ventilated (e.g., with a SGA or ETT), using two primary and one secondary criteria.
    • Primary: Visualization, Auscultation, and Chest rise
    • Secondary: EtCO2, and EDD (other secondary criteria).

    Other Considerations

    • PaCO2: Partial pressure of carbon dioxide in arterial blood gases (ABGs). Correlates with PetCO2 when ventilation and perfusion are stable.
    • Waveform: Capnogram begins before and ends with inspiration (A-E phases).
      • Phase 1 (A-B)—inspiratory baseline (low CO2)
      • Phase 2 (B-C)—exhalation upstroke (dead space gas mixes with lung gas)
      • Phase 3 (C-D)—continuation of exhalation (alveolar gas now rich in CO2)
      • Phase 4 (D-E)—start of inspiration.
    • Abnormal Values/Waveforms: Sudden loss of waveform could indicate disconnection or obstruction, a loss of circulatory function, and decreasing ETCO2 indicates potential issues such as a cuff leak, the tube being in the hypopharynx, or partial obstruction of the airway.
    • Sudden Increase in ETCO2: Indicates the return of spontaneous circulation (ROSC) or possible bronchospasm (Shark Fin Appearance).
    • Causes of Decreased ETCO2: Apnea and sedation are common causes.
    • Causes of Increased ETCO2: Hyperventilation and hypoventilation are possible causes.

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    Description

    Test your knowledge on capnography and its importance in assessing ventilation status in patients. This quiz covers key concepts such as ETCO2 levels, capnogram phases, and the implications of various waveform appearances. Perfect for healthcare professionals and students in respiratory science.

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