Deck 11: Ventilator Waveform Analysis

Question 1

Approximately 5 to 6 ml/cm H₂O of compressible volume lost is common for disposable adult circuits even when the ventilator offers volume compensation.

Answer 1

False

Question 2

In constant flow and descending ramp flow ventilation, the rise in alveolar pressure (P_ALV) is directly related to the compliance and inversely related to the volume delivered.

Answer 2

False

Question 3

In PCV CMV the rate, T_I or I:E ratio are set by the operator.

Answer 3

True

Question 4

A slow rise time during PSV is more comfortable for the patient.

Question 5

When looking at the pressure-volume loop, a decrease in C_LT will not affect the P_TA.

Question 6

During pressure-controlled ventilation, a ____ may present an exponential decay or concave pattern depending on lung characteristics and patient effort.

A) CFW
B) DRFW
C) ascending ramp flow waveform
D) sine waveform

Question 7

When looking at a flow-time waveform, which of the following is always to the lower side of baseline or zero flow?

A) inspiration
B) change from inspiration to expiration
C) expiration
D) peak expiratory flow rate

Question 8

Constant Peak Flow *I Time = ____

A) PIP
B) P_TA
C) TCT
D) V_T

Question 9

____ is a major concern and reason for performing the pause pressure measurement during ventilator management.

A) P_ALV
B) C_LT
C) P_AO
D) PIP

Question 10

In CPAP, airway pressure is above _____ cm H₂O and all breaths are ____.

A) 0; controlled
B) 0; spontaneous
C) 5; controlled
D) 5; spontaneous

Question 11

Which of the following is not affected by changes in compliance?

A) P_ALV
B) PIP
C) P_AO
D) P_TA

Question 12

During time-limited ventilation, the I time is unchanged when the flow pattern is changed from constant flow to descending ramp flow. The same volume can only be maintained if the peak flow of the descending ramp flow is ____.

A) increased
B) decreased
C) halved
D) doubled

Question 13

During time-limited ventilation (constant T_I), a decrease in flow causes a ____.

A) higher V_T and P_TA
B) lower P_TA and P_ALV
C) higher V_T, P_TA, and P_ALV
D) lower V_T, P_TA, and P_ALV

Question 14

In IRPCV, the patient is often sedated and paralyzed to prevent ____.

A) barotrauma
B) hyperventilation
C) hypercapnia
D) patient-ventilator dyssynchrony

Question 15

During PSV, the ____ are under the patient's control.

A) pressure support level and flow
B) flow, volume, and inspiratory time
C) V_T and inspiratory effort
D) pressure support level and volume

Question 16

During pressure-controlled ventilation, a(n) ____ airflow resistance or a(n) ____ compliance would reduce the delivered flow and tidal volume.

A) increased; increased
B) increased; decreased
C) decreased; decreased
D) decreased; increased

Question 17

The first physical sign of increased WOB is ____ and a general appearance of agitation.

A) intercostal retractions
B) active expiration
C) tachypnea
D) the use of accessory respiratory muscles

Question 18

Gas trapping can easily be recognized by examining the ____.

A) volume-time waveform
B) constant flow waveform
C) DRFW
D) pressure-volume loop

Question 19

Volume waveforms are primarily used to ensure accurate V_T delivery, but they can also be used to check for ____.

A) decreased C_LT
B) increased airway resistance
C) air trapping
D) air leaks

Question 20

A decrease in C_LT causes the pressure-volume loop to shift to the ____.

A) left toward the volume axis
B) right toward the pressure axis.
C) left toward the pressure axis.
D) right toward the pressure axis

Question 21

The ideal _______________ waveform that is created under passive conditions of constant flow ventilation is a step ascending ramp.

Question 22

During descending ramp flow ventilation, a(n) _______________ end-flow raises the P_TA at end-inspiratory.

Question 23

_______________ is used only under conditions of severe hypoxemia and lung injury.

Question 24

During _______________, either in the CMV or spontaneous modes, the pressure target is sustained while the flow and volume vary when there are changes in pulmonary mechanics.

Question 25

The _______________ can be used to determine whether a patient has excessive airway resistance (asthma), obstructive, or restrictive disease (ARDS).

Question 26

How has the advent of waveform analysis improved ventilator-patient management for respiratory care professionals?

Question 27

Describe the waveform characteristics of controlled mandatory ventilation.

Question 28

Describe which variables are set by the operator and how the other variables are set in pressure-controlled ventilation in the CMV mode.

Question 29

What are the signs of patient-ventilator dyssynchrony?

Question 30

Describe when ascending ramp and sine waveforms are used.