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DH: Principles I > Exam 1 Capnography (6/11/24) > Flashcards

Exam 1 Capnography (6/11/24) Flashcards

1
Q

What are the effects of hypercarbia?

A
  • Respiratory Acidosis
  • ↑ CBF
  • ↑ PVR
  • K⁺ shift intravascularly
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2
Q

What are the effects of hypocarbia?

A
  • Respiratory alkalosis
  • ↓ CBF
  • ↓ PVR
  • K⁺ shift intracellulary
  • Blunts respiratory drive
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3
Q

What is the Bohr equation?
What is it used for?

A

Used to calculate physiologic dead space

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4
Q

Conditions that increase alveolar dead space (V/Q mismatching):

A
  • Hypovolemia
  • Pulmonary hypotension
  • Pulmonary embolus
  • Ventilation of nonvascular airspace
  • Obstruction of precapillary pulmonary vessels
  • Obstruction of the pulmonary circulation by external forces
  • Overdistension of the alveoli
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5
Q

This is the Measurement and quantification of inhaled or exhaled CO2 concentrations:

A

Capnometry

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6
Q

What is the best method to confirm endotracheal tube placement?

A

Capnography

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7
Q

Differentiate high-speed (real-time) and low speed (trend capnography).

A

High-speed – user can interpret information about each breath
Slow-speed – appreciation of the expired and inspired trend

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8
Q

How much gas do side-stream analyzers utilize?

A

50-200 mL/min sample rate

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9
Q

What is the most common method for capnographic sampling, side-stream or main-stream sampling?

A

Side-stream

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10
Q

Which type of sampling analyzes the gas sample directly in the breathing circuit?

A

Main-Stream

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11
Q

What are the benefits of main-stream sampling?

A
  • No time delay
  • quicker rise time
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12
Q

At what “Phase” do we measure ETCO2?

A

End-point of phase 3

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13
Q

Why might the patient’s Phase 1 not be 0mmHg?

A

Rebreathing CO2

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14
Q

Increased or Decreased ETCO2?

Hypothermia
Hypotension
Bicarb Administration
Hemorrhage
Sepsis
CPR
Cardiac Arrest
Seizures

A

Hypothermia: Decreased
Hypotension: Decreased
Bicarb Administration: Increased
Hemorrhage: Decreased
Sepsis: Increased
CPR: Increased
Cardiac Arrest: Decreased
Seizures: Increased

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15
Q

What approximate difference is there between PaCO₂ and EtCO₂ ?

A

5 mmHg

ex. PaCO₂ will be 40 mmHg vs EtCO₂ at 35 mmHg

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16
Q

True or False:
The greater the CO2 in the sample, the more IR light that reaches the detector?

A

False:

The greater the CO2 in the sample, the LESS IR light that reaches the detector

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17
Q

What color is the CO₂ chemical indicator?
What color does it change to in the presence of CO₂ ?

A

purple → yellow

18
Q

When using a capnograph, how close must a CO₂ reading be to the actual value?

A

+/- 12%

19
Q

What are the inspiratory phases of the capnograph?

A

Phase 0

20
Q

What are the expiratory phases of the capnograph?

A

Phases I, II, and III

21
Q

When would the CO₂ reading of a capnograph be 0 mmHg ?

A

Phase I

22
Q

Which phase of the capnograph represents the beginning of expiration?

A

Phase II

23
Q

What is a phase IV in the capnograph? Why does it occur?

A

Upstroke at the end of Phase III resulting from collapse of alveoli.

24
Q

What patient populations might exhibit a Phase IV on their capnograph?
Why?

A
  • Obese
  • Pregnant

Decreased FRC and TLC

25
Q

What phases are separated by the β angle?

A

Phase III and 0

26
Q

What degree should the α angle have?
What occurs with increase to the angle’s degree?

A
  • 100 - 110°
  • Increased angle occurs with expiratory airflow obstruction (COPD, ETT, bronchospasm, etc)
27
Q

What degree should the β angle have?

A

90°

28
Q

What situations/conditions would cause an increase in the β angle?

A
  • Bad inspiratory valve
  • Rebreathing
  • Low VT w/ tachypnea
29
Q

What type of capnograph is depicted below?

A

Mechanical Ventilation

30
Q

What type of capnograph is depicted below?

A

Spontaneous Ventilation

31
Q

What is occurring with the capnograph below?

A

Inadequate ETT seal

32
Q

What might be occurring based on the two capnographs below?

A

Faulty Inspiratory Valve

33
Q

What is occurring with the capnograph below?

A

Sample line leak

34
Q

What is occurring with the capnograph below?

A

Hyperventilation (resulting in a ↓ EtCO₂)

35
Q

What is occurring with the capnograph below?

A

Hypoventilation (resulting in steady ↑ EtCO₂)

36
Q

What is occurring with the capnograph below?

A

Airway obstruction or breathing circuit obstruction

37
Q

What is occurring with the capnograph below?

A

Cardiac oscillations

38
Q

What is occurring with the capnograph below?

A

Rebreathing (note the increasing baseline)

39
Q

What is occurring with the capnograph below?

A

Curare Cleft (NMBDs are wearing off)

40
Q

What is occurring with the capnograph below?

A

Ventilator overbreathing

41
Q

What is occurring with the capnograph below?

A

Esophageal Intubation (You tubed the goose ya dummy)

DH: Principles I (50 decks)

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