PEDS CCRN REVIEW Q&A 2023

PEEP is intended to do which of the following? A. Improve ventilation/perfusion matching B. Decrease functional residual capacity C. Increased venous return to the heart D. Increased cardiac output - Answer- A. Improve ventilation/perfusion matching - PEEP increases alveolar volume, thereby improving ventilation/perfusion matching and increasing functional residual capacity. - A detrimental effect of PEEP (especially at high levels) is a decrease in venous return to the heart and a subsequent decrease in cardiac output. In an infant with sepsis, factors that impair the release of oxygen by negatively affecting oxyhemoglobin dissociation include: A. Hyperthermia B. Metabolic acidosis C. Respiratory acidosis D. Hypothermia - Answer- D. Hypothermia - To answer this question, you must consider the factors that would cause a left shift of the oxyhemoglobin curve. - Hypothermia, decreased CO2, and increased pH (alkalosis) would all cause a left shift. - Hyperthermia and acidosis would cause a right shift of the curve In which condition might you observe a decreased V/Q ratio (<0.8)? A. Status asthmaticus B. Sepsis C. Pulmonary emboli D. Tricuspid atresia - Answer- A. Status asthmaticus - A V/Q ratio of <0.8 is indicative of perfusion exceeding ventilation. Air trapping from diseases such as asthma is a common cause of this scenario Factors such as small nostrils, larger tongue, and narrower airways in an infant.... A. Decrease airway resistance B. Make intubation easier C. Increase airway resistance D. Improve airway obstruction - Answer- C. Increase airway resistance