What is the purpose of positive end-expiratory pressure (PEEP) in a mechanically ventilated patient?
To provide a certain volume of air to patient
To increase volume of air left in lungs at the end of expiration in order to help open up collapsed alveoli
To increase patient's respiratory rate
To decrease patient's respiratory rate
The Correct Answer is B
A. To provide a certain volume of air to patient: Delivering a specific tidal volume is controlled by the ventilator’s volume settings, not by PEEP. PEEP functions to maintain alveolar pressure after expiration rather than to regulate the amount of air delivered with each breath.
B. To increase volume of air left in lungs at the end of expiration in order to help open up collapsed alveoli: PEEP prevents alveolar collapse by maintaining positive pressure in the lungs at the end of expiration. This helps improve gas exchange, increase functional residual capacity, and enhance oxygenation, especially in conditions like ARDS or pulmonary edema.
C. To increase patient’s respiratory rate: The respiratory rate is controlled by ventilator frequency settings, not by PEEP. Increasing PEEP does not alter the number of breaths delivered per minute but rather the pressure maintained after exhalation.
D. To decrease patient’s respiratory rate: PEEP does not directly influence respiratory rate; it affects oxygenation and alveolar stability. Any change in respiratory rate must be adjusted through the ventilator’s rate settings or sedation management, not by altering PEEP levels.
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Related Questions
Correct Answer is A
Explanation
A. We can control amount of pressure going into lungs, decreasing risk of barotrauma: Pressure-control ventilation delivers breaths to a preset inspiratory pressure, limiting peak airway pressure. This reduces the risk of alveolar overdistension and barotrauma, making it particularly useful in patients with stiff or non-compliant lungs.
B. A patient will only need to be on the ventilator for a short period of time: The duration of mechanical ventilation depends on the patient’s underlying condition and recovery, not the mode itself. Pressure-control ventilation does not inherently shorten ventilation time.
C. The patient is more comfortable on this mode: Comfort may vary depending on sedation and ventilator settings. Pressure-control ventilation does not automatically make the patient more comfortable than other modes.
D. Patient is at lower risk of ventilator associated pneumonia: Ventilator-associated pneumonia risk is influenced by factors such as oral care, suctioning, and positioning, not by the choice of pressure-control ventilation mode.
Correct Answer is D
Explanation
A. Hyperoxemia: Excess oxygen in the blood usually does not cause anxiety, confusion, or tachypnea. In fact, patients with hyperoxemia are typically asymptomatic unless oxygen toxicity develops over a prolonged period, which is not consistent with these acute symptoms.
B. Hypercapnia: Elevated CO2 levels typically cause symptoms such as headache, flushed skin, drowsiness, and eventually lethargy. Although confusion can occur, hypercapnia usually leads to hypoventilation rather than tachypnea.
C. Alkalosis: Alkalosis, particularly respiratory alkalosis, can cause lightheadedness and paresthesia but rarely leads to confusion and significant anxiety unless it is severe. The described symptoms more strongly suggest low oxygen levels rather than an altered pH state.
D. Hypoxemia: Low oxygen levels in the blood stimulate the respiratory center, resulting in tachypnea as the body attempts to increase oxygen intake. Anxiety and confusion occur as cerebral oxygenation decreases, making hypoxemia the most likely cause of these findings.
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