Module 9

Question 1

AANA standards say that ventilation should be

Answer 1

Monitored by the use of continuous expired carbon dioxide and alarm should be audible

Question 2

With capnography, there is a

Answer 2

Pressure vs time plot

Question 3

These are the 2 speeds of capnography

Answer 3

High speed- allows for the interpretation of each breath

Slow speed- enables observation of the trend

Calculated with either diverting or non diverting systems

Question 4

Chemical sensitive paper only gives a

Answer 4

Quantitative measurement

Question 5

Carbon dioxide values can be used to estimate

Answer 5

Blood CO2 levels
Pulmonary blood flow
Alveolar ventilation.

Question 6

The evaluation of CO2 waveform allows the identification of

Answer 6

Adequacy of gas sampling
Leaks
Malfunctions

Question 7

What does it mean if there’s No capnography waveform

Answer 7

There’s a failure to ventilate the patients lungs

Due to: esophageal intubation, extubation, disconnect, failure of sampling line, apnea, bronchospasm, cardiac arrest

Question 8

During inspiration or phase 0,

Answer 8

Fresh gas is being inhaled & therefore no CO2 flows by the CO2 sampling site; no rebreathing = concentration is 0

Question 9

If CO2 is greater than 0,

Answer 9

CO2 is being rebreathed

Question 10

What are causes of CO2 rebreathing?

Answer 10

Incompetent expiratory valve
Exhausted CO2 absorbent
Improperly calibrated capnography

Question 11

High respiratory rate may exceed

Answer 11

The responsiveness of the monitor or sampling device

Question 12

Inspiratory segments included phases

Answer 12

1-3 and occasional 4

Question 13

Phase 1 appears as an extension on the horizontal baseline initiated during phase 0, but

Answer 13

It’s the beginning of exhalation when CO2 free gas from dead space is exiting

Question 14

In phase 2, CO2 rich alveolar gas

Answer 14

Begins to appear as the expiratory upstroke appears; should be steep

Question 15

The alpha angle is the transition between

Answer 15

Phase 2 & 3

Correlates with the emptying of the alveoli & thus overall VQ matching

Question 16

Capnography plateaus in

Answer 16

Phase 3 with only a slight increase in slope

Question 17

The beta angle represents

Answer 17

A transition from the expiratory to inspiratory segments

Question 18

What increases the beta angle

Answer 18

Malfunctioning inspiratory valves
Rebreathibg
Low tidal volume

Question 19

Presence of phase 4 is due to

Answer 19

VQ mismatching or air trapping, which is most frequently seen in pregnant & obese patients

Question 20

What is the best measurement of ventilation

Answer 20

Partial pressure or arterial CO2

Question 21

End tidal CO2 & arterial CO2 differ by

Answer 21

5mmHg due to ventilation mismatching & alveolar mixing

Question 22

Increases in CO2 are caused by

Answer 22

PE
Bronchial intubation which causes perfusion without ventilation

Question 23

Deceases in end tidal CO2 are related to

Answer 23

Difference between the measured CO2 level & the try CO2 level in the airway caused by CO2 sampling or problems with the capnography

Question 24

Under normal conditions, the lungs excrete CO2

Answer 24

At the same rate as the body produces it, therefore no change in arterial CO2

Question 25

What increases CO2

Answer 25

Respiratory acidosis
Increased CBF/ICP/PVR
K+ into serum

Question 26

What decreases CO2

Answer 26

Respiratory alkalosis
Decreased CBF/PVR
K+ shift intercellular

Question 27

End tidal CO2 is an important adjunct for predicting

Answer 27

Outcomes of CPR

Reflects quality of chest compressions & pulmonary circulation

CO2 greater than 15 during CPR predicts a greater chance of ROSC

Question 28

What can be used in ARDS to decrease VQ mismatching and minimize Wests Zone 1

Answer 28

PEEP

Question 29

PE can be diagnosed by

Answer 29

Capnography, since a PE will show an increase in alveolar dead space by decreasing perfusion

No definitive diagnosis can be made

Question 30

Is etCO2 a replacement for blood gas

Answer 30

No