Capnography & Ventilation Waveforms Quiz
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What is the primary purpose of setting the trigger sensitivity in Pressure Support Ventilation (PSV)?

  • To lower the peak and mean airway pressures compared to Volume Control Ventilation (VCV)
  • To compensate for leaks in the ventilator circuit
  • To control the rate, volume, and inspiratory time of the patient's breathing
  • To ensure the ventilator responds to inspiratory effort without auto-cycling due to artifactual changes in airway pressure (correct)

    • Which of the following is NOT a key advantage of Pressure Support Ventilation (PSV)?

  • Patient controls rate, volume, and inspiratory time
  • Synchrony between patient and ventilator
  • Can compensate for leaks in the ventilator circuit
  • Delivers a consistent minute ventilation regardless of changes in respiratory drive (correct)

    • What is the recommended approach to setting the pressure support level in PSV?

  • Decrease the pressure support level until the desired tidal volume is achieved
  • Increase the pressure support level until the desired tidal volume is achieved
  • Adjust the pressure support level based on the patient's exhaled tidal volume (correct)
  • Maintain a constant pressure support level throughout the ventilation

    • Which patient population is Pressure Support Ventilation (PSV) particularly useful for?

    <p>Patients with morbid obesity</p> Signup and view all the answers

    Which of the following is a key disadvantage of Pressure Support Ventilation (PSV)?

    <p>High inspiratory flow can cause patient discomfort</p> Signup and view all the answers

    Which of the following is a common cause of patient-ventilator asynchrony during Pressure Support Ventilation (PSV)?

    <p>Increased airflow obstruction (e.g., COPD)</p> Signup and view all the answers

    What is the primary purpose of using Pressure Support Ventilation (PSV) during procedures like MAC, inhalation induction, and fiber-optic intubation?

    <p>To improve patient comfort and tolerance of the procedure</p> Signup and view all the answers

    Which of the following is NOT a potential cause of inappropriate triggering during Pressure Support Ventilation (PSV)?

    <p>Changes in lung compliance</p> Signup and view all the answers

    What is the primary advantage of Pressure Support Ventilation (PSV) compared to Volume Control Ventilation (VCV)?

    <p>Allows the patient to control their own rate, volume, and inspiratory time</p> Signup and view all the answers

    Which of the following is NOT a potential benefit of using Pressure Support Ventilation (PSV) in obese patients?

    <p>Decreases the functional residual capacity (FRC)</p> Signup and view all the answers

    Which of the following statements about capnography is correct?

    <p>Capnography can detect airway obstruction, apnea, extubation, and incompetent valves.</p> Signup and view all the answers

    What is the primary factor that determines the resistance to airflow during mechanical ventilation?

    <p>The ratio of the change in driving pressure to the change in flow rate (cm H2O/L/s).</p> Signup and view all the answers

    Which of the following statements about pressure-volume loops is correct?

    <p>The slope of the pressure-volume loop represents the compliance of the respiratory system.</p> Signup and view all the answers

    In volume control ventilation (VCV), what happens if the inspiratory flow rate is set too high?

    <p>The TV is reached before the end of inspiration.</p> Signup and view all the answers

    Which of the following statements about pressure control ventilation (PCV) is correct?

    <p>PCV is used when the goal is to avoid high airway pressures.</p> Signup and view all the answers

    What is the primary advantage of synchronized intermittent mandatory ventilation (SIMV)?

    <p>It ensures a minimum amount of ventilation without requiring manual ventilation.</p> Signup and view all the answers

    In mandatory minute ventilation, how does the ventilator adjust the amount of ventilatory support?

    <p>By monitoring the exhaled volume and adjusting the tidal volume accordingly.</p> Signup and view all the answers

    Which of the following statements about pressure support ventilation (PSV) is correct?

    <p>In PSV, the patient's spontaneous breaths are supported by a preset inspiratory pressure.</p> Signup and view all the answers

    Which of the following statements about flow-volume loops is correct?

    <p>Expiration is an active process that reflects the elastic recoil of the lung and chest wall.</p> Signup and view all the answers

    What factor should trigger sensitivity in Pressure Support Ventilation (PSV) respond to?

    <p>Inspiratory effort</p> Signup and view all the answers

    Why is Pressure Support Ventilation (PSV) considered useful in obese patients?

    <p>It improves gas exchange and ventilation</p> Signup and view all the answers

    What can be a consequence of setting the pressure support level too low in PSV?

    <p>Decreased delivered volume</p> Signup and view all the answers

    Which characteristic of PSV distinguishes it from Volume Control Ventilation (VCV)?

    <p>Patient-controlled inspiratory time</p> Signup and view all the answers

    What situation can lead to asynchrony during Pressure Support Ventilation (PSV) in patients with COPD?

    <p>Airflow obstruction</p> Signup and view all the answers

    What is one of the disadvantages of Pressure Support Ventilation (PSV) related to respiratory drive?

    <p>Unpredictable delivered minute ventilation</p> Signup and view all the answers

    Why can high inspiratory flow in PSV cause patient discomfort?

    <p>It leads to unpredictable tidal volumes</p> Signup and view all the answers

    What is a feature that PSV shares with synchronized intermittent mandatory ventilation (SIMV)?

    <p>Patient-controlled rate</p> Signup and view all the answers

    What is a potential consequence of PSV inappropriately triggered by cardiac contractions?

    <p>Dangerous changes in minute ventilation delivery</p> Signup and view all the answers

    How does PSV compensate for leaks according to the text?

    <p>To an extent, but not completely</p> Signup and view all the answers

    What is the primary factor that determines the inspiratory time during Pressure Control Ventilation (PCV) when the respiratory rate is increased?

    <p>The inspiratory to expiratory (I:E) ratio</p> Signup and view all the answers

    Which of the following statements regarding the flow-volume loop is correct?

    <p>The expiratory limb reflects the elastic recoil of the lung and chest wall</p> Signup and view all the answers

    In Mandatory Minute Ventilation (MMV), how does the ventilator adjust the tidal volume and respiratory rate to achieve the set minute ventilation?

    <p>Adjusts both tidal volume and respiratory rate based on the exhaled volume</p> Signup and view all the answers

    Which of the following statements about capnography is correct?

    <p>Capnography can assess the patient's metabolism, circulation, and ventilation</p> Signup and view all the answers

    In Pressure Control Ventilation (PCV), what is the primary reason for setting a maximum inspiratory flow rate when lung compliance is poor?

    <p>To avoid overshooting the target pressure</p> Signup and view all the answers

    Which of the following statements regarding Synchronized Intermittent Mandatory Ventilation (SIMV) is correct?

    <p>The ventilator adjusts the mandatory breaths to achieve the set respiratory rate</p> Signup and view all the answers

    Which of the following statements about the pressure-volume loop is correct?

    <p>The slope of the loop represents the compliance of the respiratory system</p> Signup and view all the answers

    In Pressure Support Ventilation (PSV), what is the primary purpose of setting the trigger sensitivity?

    <p>To prevent auto-triggering and ensure patient synchrony</p> Signup and view all the answers

    Which of the following statements regarding the resistance to airflow during mechanical ventilation is correct?

    <p>Resistance is calculated as the ratio of driving pressure to flow rate</p> Signup and view all the answers

    Which of the following statements about Pressure Support Ventilation (PSV) is correct?

    <p>The inspiratory pressure is maintained throughout the entire inspiratory phase</p> Signup and view all the answers

    Study Notes

    Capnography & Ventilation Waveforms

    • Capnometry measures CO2 in a gas mixture to monitor correct placement of ETT or LMA and until airway is removed.
    • It is standard of care for every patient receiving anesthesia, or moderate to deep sedation.
    • Used during MAC & sedation to assess metabolism, circulation, ventilation, and detect airway obstruction, apnea, extubation, and incompetent valves.
    • ETCO2 is usually 2-5 torr < PaCO2.

    Resistance

    • Resistance is the ratio of change in driving pressure to change in flow rate (cm H2O/L/s).
    • Raw = (PIP-Pplat)/Flow.
    • Total airway resistance is peak – plateau pressure, normally 2-5 cm H2O.
    • May differ between inspiration & expiration due to tube diameter, secretions, and bronchoconstriction.

    Spirometry Loops

    • Graphic representation of the dynamic relationship of 2 variables during inspiration & exhalation.
    • Types of loops: Pressure-Volume Loop, Flow-Volume Loop.
    • Pressure-Volume Loop: Volume on vertical axis, pressure on horizontal; Slope = compliance.
    • Flow-Volume Loop: Volume on horizontal axis, flow on vertical axis; TV is point where flow returns to zero.

    Ventilation Modes

    • Volume Control Ventilation (VCV)
      • Most common mode.
      • Preset TV delivered.
      • CRNA controls TV, RR, MV independent of patient.
      • Flow rate is constant during inspiration.
    • Pressure Control Ventilation (PCV)
      • Used to avoid high airway pressure.
      • Provides ventilation at lower pressures than VCV.
      • Fixed I:E ratio.
      • examples: obese patients, lung injuries, single-lung ventilation, airway leak.
    • Synchronized Intermittent Mandatory Ventilation (SIMV)
      • Synchronizes ventilator-delivered breaths with patient’s spontaneous respirations.
      • Provider sets RR and Vt.
      • I:E ratio not required.
      • Helps transition from controlled to spontaneous ventilation.
    • Mandatory Minute Ventilation
      • Method of mechanical ventilation.
      • Amount of ventilatory support automatically adjusted to reach set MV.
      • Ventilator monitors exhaled volume.
    • Pressure Support Ventilation (PSV)
      • Provides pressure support throughout inspiratory phase.
      • Pressure waveform has a square shape.
      • In pure PSV mode, patient can become apneic.
      • Provider sets trigger sensitivity and inspiratory pressure (usually from 5 to 10 cm H2O).

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    Related Documents

    Capnography & Ventilation Waveforms PDF

    Description

    Test your knowledge on the use of capnography for analyzing carbon dioxide levels and ventilation waveforms in patients under anesthesia or sedation. Learn about the importance of monitoring CO2 levels for airway placement and respiratory status.

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