Deck 27: Wave Form Analysis

Question 1

Peak pressure is which of the following?

A) The highest point on the flow-time display
B) The highest point of the baseline pressure
C) The pressure recorded at the point of no airflow
D) The highest pressure reached during inspiration.

Answer 1

The highest pressure reached during inspiration.

Question 2

Which of the following wave forms would be most useful in detecting changes in airway resistance especially after delivery of a bronchodilator?

A) Pressure versus volume
B) Pressure versus time
C) Flow versus volume
D) Volume versus time

Answer 2

Flow versus volume

Question 3

Which of the following wave form would be most useful in assessing lung compliance?

A) Pressure versus volume
B) Pressure versus time
C) Flow versus volume
D) Flow versus time

Answer 3

Pressure versus volume

Question 4

The practitioner states to the nurse that she is concerned about "beaking." The practitioner is referring to

A) a condition of cyanosis that changes the shape of the finger nail beds.
B) a hemodynamic problem caused by excessive PEEP.
C) overdistention of the lungs caused by excessive ventilation pressure.
D) a slight squeaking sound caused by a cuff leak.

Question 5

Two scalar wave forms are combined to ___________________

A) identify presence of PEEP.
B) eliminate autoPEEP.
C) create a loop graphic.
D) demonstrate ventilation mode.

Question 6

Which of the following can be assessed using the pressure-time display?
I.Patient negative pressure trigger effort
II.Peak and plateau pressure
III.Adequacy of inspiratory flow
IV.Mode of ventilation

A) I, II, III and IV
B) I, II and III
C) II, III and IV
D) I and II

Question 7

Combinations of ventilator wave forms can indicate __________________

A) Airway resistance
B) Air trapping
C) Increased work of breathing
D) All of the above

Question 8

The wave form variables of flow,volume and pressure are most often plotted against ______________

A) SpO₂.
B) mode.
C) time.
D) FIO₂.

Question 9

Which of the following are true regarding ventilator air trapping"
I.It is also called AutoMode.
II.It is detected when expiratory flow does not return to baseline prior to next inspiration.
III.It can be reduced by allowing more expiratory time.

A) I, II and III
B) I and II
C) II and III
D) II only

Question 10

The respiratory care practitioner wants to use the graphic display to determine the ventilator's tidal volume.Which of the following should he do?

A) Read the Vt from the horizontal axis of the pressure time display
B) Read the Vt from the vertical axis of the volume time display
C) Read the Vt from the horizontal axis of the volume time display
D) Read the Vt from the vertical axis of the flow volume display

Question 11

The respiratory care practitioner is unable to determine by watching the chest if a patient has spontaneous breath efforts.On the graphic display,the practitioner can note that ___________________

A) mandatory breaths are often smaller and inconsistent.
B) spontaneous breaths have square wave pressure curves.
C) spontaneous breaths are more variable and have smaller pressures.
D) mandatory breaths have an oscillating wave form.

Question 12

With the pressure versus volume loop,which of the following are true?
I.Volume is displayed on the vertical axis.
II.Positive pressure is on the right of the vertical axis
III.With ventilator inspiration,the graph moves from zero upward and to the right

A) I, II and III
B) I and II
C) II and III
D) I and III

Question 13

The respiratory care practitioner wants to check the airway resistance with an asthmatic patient on a ventilator.She can check airway resistance by which of the following?

A) Checking the inspiratory pressure time display for peak pressure.
B) Evaluating the volume time tracing for evidence of unevenness of filling
C) Dividing frequency by tidal volume in liters
D) Observing the slope of the expiratory flow tracing

Question 14

The respiratory care practitioner notices the pressure vs time display rises slowly and shows a concave appearance on inspiration.The practitioner should determine whether _____________

A) excessive volume is being delivered.
B) inspiratory hold is turned on.
C) flow is insufficient for patient demand.
D) the ventilator is malfunctioning.

Question 15

A steeper slope of the pressure versus volume loop indicates ________________

A) overdistention.
B) increased compliance.
C) increased resistance.
D) increased work of breathing.

Question 16

Positive end expiratory pressure is identified on a pressure-time display by _______________

A) noting the amount below the baseline pressure.
B) the rise in the baseline pressure.
C) using inspiratory hold.
D) checking the amount on the ventilation record.

Question 17

Wave form graphically displays which of the following?
I.Arterial blood gas values
II.Gas flowrates
III.Inspiratory and expiratory volumes
IV.Airway pressures

A) I, II, III and IV
B) I, II and III
C) II, III and IV
D) II and III

Question 18

Wave forms description of rectangular,accelerating,decelerating,sinusoidal and oscillating is associated with ________________

A) pressure.
B) flow.
C) volume.
D) rate.

Question 19

If the volume wave form does not reach zero on exhalation,the practitioner can determine which of the following?

A) Air trapping is present
B) PEEP has been turned on
C) There are secretions in the airway that should be suctioned
D) Tidal volume control is set too low

Question 20

The respiratory care practitioner is assessing a pressure versus volume loop and notices that it starts at zero and moves upward and to the left in a clockwise direction.Which of the following statement is true?

A) This is normal for a positive pressure breath
B) This is normal for a spontaneous breath
C) This is abnormal. The therapist should manually ventilate the patient
D) This occurs when there is a leak in the endotracheal tube cuff

Question 21

A mechanical breath that rises and then remains at the same cmH₂O pressure for the same length of time is which type of mechanical breath?

A) SIMV
B) Volume control
C) Pressure support
D) Pressure control

Question 22

An asthmatic patient has been placed on a mechanical ventilator.The ventilating pressures have increased and wheezes are heard on auscultation over both lung fields.How can the practitioner assess improvement from aerosolized bronchodilator therapy?

Question 23

You have just place a patient with early ARDS onto a mechanical ventilator.Using ventilator graphics how will you monitor the patient's changing lung compliance?

Question 24

Which of the following is true of the flow-volume loop?
I.Flow is plotted on the vertical axis.
II.It is commonly used in PF spirometry evaluation.
III.It is done only after bronchodilator administration.

A) I, II and III
B) I and II
C) I and III
D) II and III

Question 25

As the respiratory care practitioner assigned to a ventilator patient,how would you use ventilator graphics to identify patient effort?

Question 26

A breath that rises and then remains at a specific cmH₂O pressure for varying lengths of inspiratory is which type of breath?

A) Spontaneous
B) Volume control
C) Pressure support
D) Pressure control

Question 27

The respiratory care practitioner determines that a patient has increased airway resistance.How was this identified?

A) On the flow-volume loop by evaluating the shape of the curve
B) On the flow-volume loop by identifying the maximum delivered volume
C) On the pressure-volume loop by the amount of beaking
D) On the pressure-volume loop by the amount of bowing

Question 28

Static pressure is determined by which of the following methods?

A) Adding an inspiratory pause and stopping air flow
B) Adding an expiratory pause and waiting for slight rise in baseline pressure
C) Assessing pressure generated in tubing at 100-200 mL volume
D) Dividing rate by tidal volume

Question 29

Which graphic displays can indicate adequacy of inspiratory flow during a ventilator inspiration and how are they used?

Question 30

You are concerned that the ventilator patient you are assessing may have autoPEEP.How would you use ventilator graphics to identify whether or not this problem exists?