medium · NCLEX-RN Physiological Adaptation

Riley, who has severe left-sided heart failure and cardiogenic shock, is being intubated. The provider orders 10 cm H_2O of Positive End-Expiratory Pressure (PEEP).

Why should the RN monitor the blood pressure especially closely after this setting is applied?

  1. PEEP stimulates the vagus nerve, causing sudden profound bradycardia, for this client.
  2. High PEEP levels increase the risk of developing metabolic alkalosis
  3. PEEP increases intrathoracic pressure, which can decrease venous return and BP
  4. PEEP causes systemic vasodilation through the release of nitric oxide.

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