Wavefrom Quiz Study

Front 1

purposes of monitoring graphics?

Back 1

Allows users to interpret, avaluate, and troubleshoot the ventilator and the patients response to the ventilator.
Monitor patients disease status (C and Raw).
Asses patients reponse to therapy.
Monitor proper vent function.
Allow fine tuning of the vent to decrease WOB, optimoze ventilationa and patient comfort.

Front 2

What are the scalars and loops?

Back 2

Scalars- waveforms that plot pressure, flow, or volume against time. Time is the x-axis.
Loops- waveforms that plot pressure or flow against volume. (P/V or F/V). There is no time component.

Front 3

What are the three basic shapes of waveforms?

Back 3

Square
Ramp
Sine

Front 4

Describe a Square wave.

Back 4

Represents a constant or set parameter.
For example, pressure setting in PC mode or flowrate setting in VC mode.

Front 5

Describe a Ramp wave.

Back 5

Represents a variable parameter.
Will vary with changes in lung characteristics.
Can be accelerating or decelaerating.

Front 6

When the square waveform is found in the middle of the graphic screen, what mode does it indicate?

Back 6

Volume mode

Front 7

When the square waveform is located on the top of the graphic screen, what mode is indicated?

Back 7

Pressure mode

Front 8

What are the three types of wave forms?

Back 8

Pressure
Flow
Volume

Front 9

What is the shape of a Pressure waveform in volume modes?

Back 9

The shape of the pressure wave will be a ramp for mandatory breaths.

Front 10

What is the shape of a Pressure waveform in pressure modes?

Back 10

Tha shape of the pressure wave will be square shape.
this means that pressure is constant during inspiration or pressure is a set parameter.

Front 11

Pressure wavefrom is used to asses:

Back 11

Air trapping (auto-peep)
Airway obstruction
Bronchodilator response
Respiratory mechanics (C/Raw)
Active exhalation
Breath type (Pressure vs Volume)
PIP, Pplat
CPAP, PEEP
Asynchrony
Triggering effort

Front 12

In Pressure waveform volume control, increased Raw causes PIP to increase, What happens to Pplat pressure?

Back 12

remains normal

Front 13

In Pressure waveform volume control, decreased lung compliance causes the entire waveform to increase in size, What happens to the difference between PIP and Pplat?

Back 13

Remains normal

Front 14

True or False
In volume control, pressure waveform, the area under the entire curve represents the mean airway pressure (MAP).

Back 14

True

Front 15

In volume control, what will cause the pressure waveform to rise above the baseline while performing an expiratory hold??

Back 15

trapped air

Front 16

What is considered acceptable amount of auto-PEEP ?

Back 16

< 5cmH2O

Front 17

An increase in Raw causes ______to increase and ________to remain the same?

Back 17

PIP, Pplat

Front 18

Flow waveform can be used to asses:

Back 18

Air trapping (auto-PEEP)
Airway obstruction
Bronchodilator response
Active exhalation
Breath type (Pressure vs Volume)
Inspiratory flow
Asynchrony
Triggering effort

Front 19

In volume mode, What is the shape of a flow waveform?

Back 19

Square
This means that flow remains constant or flowrate is a set parameter

Front 20

In pressure mode, what is the shape of a flow waveform?

Back 20

Ramp

Front 21

To asses improvement after a breathing treatment, you should see what?

Back 21

Improved PEF and Shorter E-times.

Front 22

Volume waveforms generally have what shape regardless of what mode of ventilation?

Back 22

Mountain peak appearance

Front 23

Volume waveforms can be used to asses:

Back 23

Air trapping (auto-PEEP)
Leaks
Tidal volume
Active exhalation
Asynchrony

Front 24

True or False
If the exhalation side of the volume waveform doesn't return to baseline, this indicates airtrapping or a leak.

Back 24

True

Front 25

The volume waveform is most commonly used to asses what?

Back 25

Leaks and air trapping

Front 26

How are Pressure/volume loops Plotted?

Back 26

Volume is plotted on the y axis.
Pressure is plotted on the x- axis.

Front 27

Which way does the inspiratory curve go on P/V loops?

Back 27

upwards

Front 28

Which way does the expiratory curve go on P/V loops?

Back 28

Downwards

Front 29

On P/V loops , which direction do Spontaneous breaths go?

Back 29

clockwise

Front 30

On P/V loops , which direction do Positive pressure breaths go?

Back 30

counter clockwise

Front 31

True or false
On P/V loops, the bottom of the loop will be at the set PEEP level and at 0 if no PEEP is set.

Back 31

True

Front 32

True or False If an imaginary line is drawn down th middle of the loop, the area to the right represents expiratory resistance and the are to the left represents inspiratory resistance.

Back 32

False: its opposite

Front 33

P/V loops are used to asses:

Back 33

Lung overdistention
Airway obstruction
Bronchodilator response
Respiratory mechanics (C/Raw).
WOB
Flow starvation
Leaks
Triggering effort

Front 34

P/V loop that is totally shifted to the left indicates what?

Back 34

Increased compliance:
Emphysema or surfactant therapy

Front 35

P/V loop that has totally shifted to the right indicates waht?

Back 35

Decreased compliance:
ARDS, CHF, Atelectasis

Front 36

P/V loops with with a bird beak , indicates what?

Back 36

overdistention
Fixed by reducing the amount of tidal volume delivered.

Front 37

P/V loops that doesn't return to baseline indicates what?

Back 37

Leak

Front 38

Lung protection strategies suggest setting PEEP at what point?

Back 38

Just above the lower inflection point

Front 39

P/V loops, if there is increased expiratory resistance caused by secretions and brochospasms, what happens to the P/V loop?

Back 39

The expiratory (left side)side of the P/V loop will become wider.

Front 40

In P/V loops, What causes inspiratory resistance to increase?

Back 40

ETT size too small
Kinked tube
Patient biting the tube

Front 41

Flow/ Volume Loops are plotted how?

Back 41

Flow is plotted on the y axis
Volume is plotted on the x axis

Front 42

F/V loops are used to determine what?

Back 42

PIF
PEF
Vt

Front 43

F/V loops are used to asses:

Back 43

Air trapping
Airway obstruction
Airway resistance
Bronchodilator response
Insp/Exp flow
Flow atravtion
Leaks
Water or secretion accumulation
Asynchrony

Front 44

In F/V loops, How are leaks indicated?

Back 44

The loop will not meet at the starting point where inhalation starts and exhalation ends.

Front 45

F/V loops, Scooping are indicative of what?

Back 45

The expiratory part of the curve looks like a scoop.
indicates small airway obstruction.(high expiratory resistance).
It is indicates asthma or emphysema

Front 46

What causes air trapping?

Back 46

Insufficient expiratory time.
Early collapse of unstable alveoli/ airways during exhalation.

Front 47

How do you identify Air trapping on the graphics?

Back 47

Pressure wave: while performing expiratory hold, the waveform rises above baseline.
Flow wave: The expiratory flow doesnt return to baseline before the next breath begins.
Volume wave: The expiratory portion doesnt return to baseline.
F/V lopp: The loop doesnt meet at base line.
P/V lopp: the loop doesnt meet at the baseline.

Front 48

What causes Airway resistance changes?

Back 48

Bronchospam
ETT too small
High flow rate
Secretions
Damp or blocked expiratory valve or filter
Water in HME

Front 49

How do you fix Air trapping?

Back 49

increase flow
Give a treatment
adjust I time
add peep

Front 50

How do you identify Airway resistance changes on the graphics?

Back 50

Pressure wave: PIP increases, but Plateau stays the same.
Flow wave: It take longer for the expirtory side to reach the baseline or exp flow rate is reduced.

Front 51

How do you fix Airway resistance changes?

Back 51

Give treatment
Suction patient
Drain water
Change HME
Change ETT
Add a bite block
Reduce PF rate
Change exp filter

Front 52

What causes decreased Compliance?

Back 52

ARDS
Atelectasis
Abdominal Distension
CHF
Consolidation
Fibrosis

Front 53

What causes increased compliance?

Back 53

Emphysema
Surfactant therapy

Front 54

How do you identify Compliance changes on the graphics?

Back 54

Pressure wave: PIP and Pplat both increase.
P/V Loop: Lays more horizontal.