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NurseDive Free Nursing Practice Question
A student is caring for a patient with positive end-expiratory pressure (PEEP) at 5 cm H20. The student asks “What is the purpose of PEEP?” which of the following is an appropriate response by the nurse?
A. PEEP deceases the peak respiratory pressures
PEEP decreases the peak respiratory pressures:PEEP may increase peak respiratory pressures, especially during inspiration, but its primary purpose is to prevent alveolar collapse and improve oxygenation.
B. “PEEP increases the number of breaths the patient takes on his own.”
“PEEP increases the number of breaths the patient takes on his own.”:PEEP does not increase the number of breaths the patient takes. It primarily affects the quality of ventilation by preventing alveolar collapse.
C. “PEEP augments the patient’s overall tidal volumes.”
“PEEP augments the patient’s overall tidal volumes.”: PEEP does not necessarily increase overall tidal volumes. It focuses on maintaining positive pressure at the end of expiration to prevent alveolar collapse.
D. “PEEP improves oxygenation by keeping alveoli open after exhalation.”
“PEEP improves oxygenation by keeping alveoli open after exhalation.”Positive end-expiratory pressure (PEEP) is used in mechanical ventilation to maintain positive pressure in the airways and alveoli at the end of the respiratory cycle (expiration). This helps prevent alveolar collapse and improves oxygenation by keeping the alveoli open, particularly in patients with conditions like acute respiratory distress syndrome (ARDS). PEEP is commonly used to increase functional residual capacity (FRC) and improve oxygenation.
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Full Explanation
A. PEEP decreases the peak respiratory pressures:
PEEP may increase peak respiratory pressures, especially during inspiration, but its primary purpose is to prevent alveolar collapse and improve oxygenation.
B. “PEEP increases the number of breaths the patient takes on his own.”:
PEEP does not increase the number of breaths the patient takes. It primarily affects the quality of ventilation by preventing alveolar collapse.
C. “PEEP augments the patient’s overall tidal volumes.”:
PEEP does not necessarily increase overall tidal volumes. It focuses on maintaining positive pressure at the end of expiration to prevent alveolar collapse.
D. “PEEP improves oxygenation by keeping alveoli open after exhalation.”
Positive end-expiratory pressure (PEEP) is used in mechanical ventilation to maintain positive pressure in the airways and alveoli at the end of the respiratory cycle (expiration). This helps prevent alveolar collapse and improves oxygenation by keeping the alveoli open, particularly in patients with conditions like acute respiratory distress syndrome (ARDS). PEEP is commonly used to increase functional residual capacity (FRC) and improve oxygenation.
Similar Questions
A nurse is reviewing the medical records of four clients who have an acid-base imbalance. The nurse should recognize that a clients is at risk for metabolic acidosis?
A. A client who is taking a thiazide diuretic
A client who is taking a thiazide diuretic:Thiazide diuretics can cause loss of potassium and metabolic alkalosis, not metabolic acidosis.
B. A client who is vomiting
A client who is vomiting:Vomiting can lead to the loss of stomach acid (hydrochloric acid) and may result in metabolic alkalosis, not metabolic acidosis.
C. A client who has diarrhea
A client who has diarrhea. Diarrhea can lead to the loss of bicarbonate, an important buffer in the body that helps maintain acid-base balance. The loss of bicarbonate in diarrhea can result in an excess of acid, contributing to metabolic acidosis.
D. A client who is having an acute anxiety attack
A client who is having an acute anxiety attack:Acute anxiety is not typically associated with metabolic acidosis. It is not directly related to changes in acid-base balance.
Full Explanation
A. A client who is taking a thiazide diuretic:
Thiazide diuretics can cause loss of potassium and metabolic alkalosis, not metabolic acidosis.
B. A client who is vomiting:
Vomiting can lead to the loss of stomach acid (hydrochloric acid) and may result in metabolic alkalosis, not metabolic acidosis.
C. A client who has diarrhea.
Diarrhea can lead to the loss of bicarbonate, an important buffer in the body that helps maintain acid-base balance. The loss of bicarbonate in diarrhea can result in an excess of acid, contributing to metabolic acidosis.
D. A client who is having an acute anxiety attack:
Acute anxiety is not typically associated with metabolic acidosis. It is not directly related to changes in acid-base balance.
A nurse is preparing to administer clindamycin 300 mg by intermittent IV bolus over 30 min to a client who has a staphylococci infection. Available is clindamycin premixed in 50 ml 0.90% sodium chloride (NaCl). The nurse should set the IV pump to deliver how many ml/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)
Full Explanation
Clindamycin is an antibiotic that can treat infections caused by staphylococci bacteria. It can be given by intermittent IV bolus, which means injecting the drug into a vein over a short period of time. To calculate the infusion rate for clindamycin, we need to use the formula:
Infusion rate (ml/hr) = Volume (ml) / Time (hr)
In this case, the volume is 50 ml and the time is 0.5 hr (30 min). Plugging these values into the formula, we get:
Infusion rate (ml/hr) = 50 ml / 0.5 hr
Infusion rate (ml/hr) = 100 ml/hr
Therefore, the nurse should set the IV pump to deliver 100 ml/hr of clindamycin.
The nurse is caring for the client following a thoracentesis. (Select the 3 findings that require immediate follow-up.)
A. Decreased lung sounds
Decreased lung soundsA decrease in lung sounds could indicate a pneumothorax, which is a potential complication of thoracentesis. It requires prompt evaluation.
B. Heart rate 110/min and regular
Heart rate 110/min and regularA heart rate of 110/min is within a normal range, and regular rhythm is generally acceptable post-thoracentesis. It may be related to pain or anxiety but is not an immediate concern.
C. Oxygen saturation of 95%
Oxygen saturation of 95%An oxygen saturation of 95% is within an acceptable range. While maintaining adequate oxygenation is important, this finding does not suggest an immediate complication.
D. Subcutaneous emphysema
Subcutaneous emphysemaSubcutaneous emphysema involves the presence of air in the subcutaneous tissues and can indicate a communication between the pleural space and subcutaneous tissues. This requires immediate attention.
E. Trachea midline
The trachea being midline is a normal finding and does not indicate an immediate problem post-thoracentesis.
F. Puncture site dry
A dry puncture site is expected after a thoracentesis. This finding is normal and indicates appropriate wound care. It is included in the list to ensure recognition of normal post-procedure findings.
Full Explanation
A. Decreased lung sounds
A decrease in lung sounds could indicate a pneumothorax, which is a potential complication of thoracentesis. It requires prompt evaluation.
B. Heart rate 110/min and regular
A heart rate of 110/min is within a normal range, and regular rhythm is generally acceptable post-thoracentesis. It may be related to pain or anxiety but is not an immediate concern.
C. Oxygen saturation of 95%
An oxygen saturation of 95% is within an acceptable range. While maintaining adequate oxygenation is important, this finding does not suggest an immediate complication.
D. Subcutaneous emphysema
Subcutaneous emphysema involves the presence of air in the subcutaneous tissues and can indicate a communication between the pleural space and subcutaneous tissues. This requires immediate attention.
E. Trachea midline
The trachea being midline is a normal finding and does not indicate an immediate problem post-thoracentesis.
F. Puncture site dry
A dry puncture site is expected after a thoracentesis. This finding is normal and indicates appropriate wound care. It is included in the list to ensure recognition of normal post-procedure findings.