A client diagnosed with adult respiratory distress syndrome has positive end expiratory pressure (PEEP) added to the treatment.
A nurse should understand that PEEP has been ordered to promote what client outcome?
To increase the shunting effect of oxygen.
To improve oxygenation of the client.
To assist with weaning the client off the ventilator.
To decrease the amount of oxygen in the alveoli.
The Correct Answer is B
Choice A rationale
PEEP, or positive end-expiratory pressure, is applied to increase functional residual capacity and prevent alveolar collapse. It does not increase the shunting effect of oxygen; rather, it aims to reduce physiological shunting by recruiting collapsed alveoli, improving ventilation-perfusion matching, and thus enhancing gas exchange. Increasing shunting would be a detrimental outcome, not a therapeutic goal.
Choice B rationale
PEEP improves oxygenation by maintaining positive pressure in the airways at the end of exhalation, which prevents alveolar collapse and recruits previously collapsed alveoli. This increases the surface area available for gas exchange, allowing for more efficient diffusion of oxygen into the pulmonary capillaries and subsequently into the bloodstream, thus enhancing arterial oxygen saturation.
Choice C rationale
While PEEP is a component of ventilatory support, its primary purpose is not to directly assist with weaning the client off the ventilator. PEEP optimizes lung mechanics and oxygenation, which can indirectly contribute to a client's readiness for weaning by improving their overall respiratory status. However, weaning protocols involve reducing ventilator support, not necessarily increasing PEEP.
Choice D rationale
PEEP actively works to increase, not decrease, the amount of oxygen in the alveoli by preventing their collapse and ensuring they remain open for gas exchange throughout the respiratory cycle. By maintaining alveolar patency, PEEP facilitates a higher residual volume of oxygen in the lungs, improving the driving pressure for oxygen diffusion across the alveolar-capillary membrane.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
This choice suggests a socioeconomic or access issue, which while possible, is not the primary physiological reason for weight loss specifically linked to advanced COPD. The core problem in COPD impacting nutrition is often directly related to the physiological demands of the disease itself.
Choice B rationale
In advanced COPD, increased respiratory effort leads to dyspnea, making it difficult to coordinate breathing with the act of eating. This results in reduced oral intake because clients become breathless during meals, leading to caloric deficit and subsequent weight loss due to decreased energy intake.
Choice C rationale
While depression and loss of appetite can occur in chronic illnesses, the primary mechanistic link between advanced COPD and weight loss is often the physical inability to consume adequate calories due to exertional dyspnea and the high metabolic demands of increased work of breathing.
Choice D rationale
Fatigue certainly contributes to overall debility in COPD, but the specific mechanism for weight loss is often directly tied to the physiological challenge of eating. The energy expenditure for breathing significantly increases, diverting energy from other functions and making the act of eating itself exhausting.
Correct Answer is B
Explanation
Choice A rationale
Furosemide, a loop diuretic, primarily affects the ascending limb of the loop of Henle, inhibiting sodium, potassium, and chloride reabsorption. While it can cause some calcium excretion, hypocalcemia is not its most prominent or common electrolyte imbalance compared to potassium. Normal serum calcium is 8.5-10.2 mg/dL.
Choice B rationale
Furosemide works by inhibiting the Na-K-2Cl cotransporter in the thick ascending limb of the loop of Henle, leading to increased excretion of sodium, potassium, and chloride. This significant loss of potassium in the urine frequently results in hypokalemia, a common and critical adverse effect. Normal serum potassium is 3.5-5.0 mEq/L.
Choice C rationale
Furosemide promotes potassium excretion, making hyperkalemia an unlikely and rare occurrence. In fact, it is sometimes used to treat hyperkalemia in specific clinical situations due to its kaliuretic effect. Normal serum potassium is 3.5-5.0 mEq/L.
Choice D rationale
Furosemide causes increased excretion of sodium, leading to a risk of hyponatremia, not hypernatremia. The diuretic effect reduces total body water and sodium, potentially causing a dilutional or depletional hyponatremic state. Normal serum sodium is 135-145 mEq/L. .
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