Which statement by the nurse when explaining the purpose of positive end-expiratory pressure (PEEP) to the patient's caregiver is accurate?

"PEEP prevents the lung air sacs from collapsing during exhalation."

"PEEP allows the breathing machine to deliver 100% 02 to the lungs."

"PEEP will push more air into the lungs during inhalation."

"PEEP will prevent lung damage while the patient is on the ventilator."

Answer and Explanation

The Correct Answer is A

A.   Positive end-expiratory pressure (PEEP) is applied during mechanical ventilation to prevent alveolar collapse at the end of expiration. It helps maintain the patency of the alveoli, improving oxygenation and preventing atelectasis.
B.   While PEEP can improve oxygenation by recruiting collapsed alveoli and increasing functional residual capacity, it does not directly affect the concentration of oxygen delivered by the ventilator. Oxygen concentration is adjusted separately from PEEP settings.
C.   PEEP is applied at the end of expiration to maintain positive pressure in the airways and alveoli, preventing them from collapsing. It does not directly affect the delivery of air during inhalation.
D.   PEEP can help prevent lung damage by maintaining alveolar recruitment and reducing the risk of atelectasis and barotrauma. However, it is not the sole factor in preventing lung damage, and other ventilator settings and strategies also play a role in protecting the lungs.

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Correct Answer is D

Explanation

D. Assessing the patient's level of consciousness (LOC) is essential to determine their neurological status and assess for any signs of deterioration. Changes in LOC could indicate worsening sepsis, hypoperfusion, or other underlying issues that require immediate attention.

A. Administering amiodarone, an antiarrhythmic medication, is not the first action to take in this situation. While amiodarone may be used to manage certain arrhythmias, its use should be based on a thorough assessment and specific arrhythmia diagnosis. In this case, with only three seconds of PVCs followed by sinus tachycardia, immediate administration of amiodarone is not warranted.

B. Carotid massage is not indicated in this scenario. Carotid massage is typically used to slow down or terminate supraventricular tachycardias (SVTs), such as paroxysmal supraventricular tachycardia (PSVT). However, it is contraindicated in patients with a history of stroke, transient ischemic attack (TIA), carotid artery disease, or recent myocardial infarction (MI). Furthermore, PVCs are not typically responsive to carotid massage.

C. Administering Tylenol (acetaminophen) may be appropriate in this situation. The patient's elevated temperature (101.1°F) suggests the presence of fever, which could contribute to the patient's tachycardia. Lowering the fever with acetaminophen may help reduce the heart rate and alleviate symptoms associated with fever, such as discomfort.

A. The patient's IV infusion site is cool and pale. B. The patient's extremities are warm and dry. C. The patient's urine output is 28 ml, over the past hour. D. The patient's heart rate is 58 beats/min.

Correct Answer is A

Explanation

A. In a patient receiving a dobutamine infusion, which is a vasopressor medication used to increase cardiac output, a cool and pale IV infusion site could indicate inadequate perfusion despite treatment. This finding requires immediate action to assess the patient's hemodynamic status and ensure adequate tissue perfusion.

B. Warm and dry extremities are typically indicative of adequate tissue perfusion. In neurogenic shock, vasodilation can lead to warm extremities due to decreased systemic vascular resistance. While this finding may be expected in neurogenic shock, it does not necessarily indicate a need for immediate action if other parameters are stable.

C. Decreased urine output can be indicative of inadequate renal perfusion and impaired kidney function. In a patient with neurogenic shock, maintaining adequate renal perfusion is crucial to prevent acute kidney injury. While decreased urine output warrants close monitoring and intervention, it may not require immediate action unless other signs of worsening perfusion are present.

D. A heart rate of 58 beats/min may be within the normal range for some patients, especially those who are receiving dobutamine, which can have a chronotropic effect. However, in the context of neurogenic shock, bradycardia may indicate a compensatory response to hypotension and decreased tissue perfusion. While bradycardia alone may not always require immediate action, it should prompt further assessment of the patient's hemodynamic status and response to treatment.

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Which statement by the nurse when explaining the purpose of positive end-expiratory pressure (PEEP) to the patient's caregiver is accurate?

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Naxlex Comprehensive Predictor Exams

A patient admitted with urosepsis and alcohol abuse had three seconds of PVCS and returns to sinus tachycardia. The patient's baseline heart rate ie 116/ min with a temperature of 101.1F, respirations of 22/min and blood pressure is 114/64. What should the nurse anticipate to do first?

Correct Answer is D

Explanation

A patient who has neurogenic shock is receiving a dobutamine infusion through a right forearm IV. Which assessment finding obtained by the nurse indicates a need for immediate action?

Correct Answer is A

Explanation

A nurse in the ICU is caring for a client who has heart failure and is receiving a dobutamine drip. The nurse should identify that which of the following findings indicates that the medication is effective?

A nurse is caring for a client in a critical care unit who suffered a knife wound to the chest. The nurse suspects the client is developing cardiac tamponade. Which of the following assessment findings should the nurse identify as supporting this suspicion?

A nurse is caring for a client who is in the compensatory stage of shock. Which of the following findings should the nurse expect?

A nurse is caring for a client who has pericarditis and reports feeling a new onset of palpitations and shortness of breath. Which of the following assessments should indicate to the nurse that the client may have developed atrial fibrillation?

A nurse is caring for a client with a ventricular pacemaker who is on ECG monitoring. The nurse understands that the pacemaker is functioning properly when which of the following appears on the monitor strip?