Deck 7: Waveform Analysis and Application

Question 1

The respiratory therapist is taking care of a trauma patient with bilateral chest tubes for pneumothoraces. The inability to sustain adequate ventilation may be related to which of the following situations?

A) Obstructed chest tube
B) Increased airway resistance
C) Air trapping
D) Air leak

Answer 1

D

Question 2

The scalars below are consistent with the presence of:

A) gas trapping.
B) slow rise time.
C) flow asynchrony.
D) positive response to bronchodilator.

Answer 2

A

Question 3

Based on the scenario displayed on the scalars below, which of the following maneuvers is indicated at this point?

A) Remove the expiratory filter to determine gas trapping
B) Inspiratory hold to measure plateau pressure
C) Expiratory hold to measure auto-PEEP
D) Increase the rise time

Answer 3

C

Question 4

How do you typically identify a patient-triggered breath (except when flow compensation is used)?

A) When the waveform changes to a different color
B) A pressure rise without a pressure deflection below the baseline
C) When the ventilator displays the letter "S" with the breath displayed
D) A pressure deflection below baseline right before a rise in pressure

Question 5

What happens to the waveform, PIP, and P_plat when compliance decreases?

A) Waveform size increases; difference in PIP and P_plat remains the same.
B) Waveform size increases; difference in PIP and P_plat decreases.
C) Waveform size decreases; difference in PIP and P_plat remains the same.
D) Waveform size increases; difference in PIP and P_plat increases.

Question 6

The P-T and the F-T (with brief inspiratory hold) of a patient admitted for COPD exacerbation confirm the presence of:

A) air leak.
B) cycling asynchrony.
C) air trapping.
D) increased airway resistance.

Question 7

The P-T of a patient displays a bump at the beginning of the initial inspiratory tracing. This change is consistent with:

A) increased airway resistance.
B) fast rise time.
C) decreased lung compliance.
D) air trapping.

Question 8

The FVL of a patient with tracheoesophageal fistula indicates a leak of at least:

A) 50 mL.
B) 100 mL.
C) 150 mL.
D) 200 mL.

Question 9

When inspiratory flow takes longer to return to baseline, what does this indicate on a flow waveform?

A) Airway obstruction
B) Decreased alveolar compliance
C) Gas trapping
D) Air leak

Question 10

When expiratory flow takes longer to return to baseline, what does this indicate on a flow waveform?

A) Airway obstruction
B) Decreased alveolar compliance
C) Gas trapping
D) Air leak

Question 11

In order to assess improvement after administration of a bronchodilator, you should see:

A) lower mean airway pressures.
B) improved PEFR and shorter expiratory time.
C) decrease in P_plat.
D) improved PIFR and shorter inspiratory time.

Question 12

On the first round of the evening, a critical care fellow is asking the respiratory therapist what mode of ventilation these scalars are more consistent with. The RT should answer:

A) VAC.
B) PAC.
C) PRVC.
D) APRV.

Question 13

On a pressure-volume loop, what does beaking suggest?

A) Overdistention
B) Airway obstruction
C) Presence of airway secretions
D) Insufficient PEEP

Question 14

An increase in airway resistance causes the pressure-volume loop to do what?

A) It causes it to widen.
B) It causes it to narrow.
C) It causes a shift upward.
D) It causes a shift to the middle.

Question 15

What does a shift downward indicate on a PVL?

A) Decreased resistance
B) Decreased compliance
C) Trigger asynchrony
D) Overdistention

Question 16

Which mode of ventilation is more consistent with the scalars below?

A) SIMV
B) APRV
C) PS
D) PAC

Question 17

What do you do if the pressure deflection is greater than normal?

A) Change the mode of ventilation.
B) Increase the PEEP.
C) Decrease the sensitivity to make it easier to trigger.
D) Decrease the rise time.

Question 18

What type of PVA does this P-T waveform represent?

A) Trigger asynchrony
B) Flow asynchrony
C) Delayed cycling
D) Premature cycling

Question 19

Which waveform is most likely to determine a sensitivity setting problem?

A) Pressure-time
B) Flow-time
C) Volume-time
D) FVL

Question 20

Which waveform is most likely to determine the beneficial effects of a bronchodilator treatment?

A) Pressure-time
B) Flow-time
C) Volume-time
D) PVL