Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Medical Surgical Nursing
Easy
Positive end expiratory pressure (PEEP) is:
Appeared in: Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Explanation
- Positive End-Expiratory Pressure (PEEP) is defined as the application of pressure into the lungs that is maintained at the end of expiration.
- This pressure is 'positive' because it is set above the surrounding atmospheric pressure.
- The primary purpose is to prevent the collapse of alveoli (air sacs) at the end of exhalation, which increases the functional residual capacity of the lungs.
- By keeping the alveoli open, PEEP improves the surface area available for gas exchange, leading to better oxygenation.
- This mechanism is crucial in treating conditions like Acute Respiratory Distress Syndrome (ARDS) where alveoli are prone to collapsing.
Why Other Options Were Wrong
- Option B: This describes a state where the pressure outside the lungs is greater than inside. This negative pressure gradient is what drives inspiration (air flowing into the lungs), not the principle of PEEP, which applies pressure at the end of expiration.
- Option C: This option incorrectly links atmospheric pressure with osmotic pressure. Osmotic pressure is related to the movement of water across cell membranes due to solute concentration and is not a principle of respiratory mechanics.
- Option D: This option is incorrect because a correct definition is provided in the options.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain The definition and principle of Positive End-Expiratory Pressure (PEEP) in mechanical ventilation as background academic context rather than a clinical decision trigger.
- PEEP is a fundamental setting in mechanical ventilation used to treat hypoxemia by preventing alveolar collapse and improving oxygenation, especially in patients with ARDS.
- Nurses are responsible for monitoring patients on PEEP for both therapeutic effects (improved SpO₂, decreased work of breathing) and potential complications.
- Complications of PEEP include barotrauma (lung injury from pressure, e.g., pneumothorax) and hemodynamic instability (hypotension due to decreased venous return to the heart).
How to Approach the Question
- First, identify the key term in the question: 'Positive end expiratory pressure (PEEP)'.
- Break down the term itself for clues: 'Positive' implies a pressure above a baseline (usually atmospheric), and 'End-Expiratory' specifies the timing—at the end of exhalation.
- Evaluate each option against this breakdown.
- Option A states 'Alveolar pressure above atmospheric pressure'. This aligns perfectly with the meaning of 'positive pressure' in a respiratory context.
- Option B describes the opposite, which is characteristic of inspiration.
- Option C introduces 'osmotic pressure', which is a different physiological concept related to fluid balance, not ventilation mechanics.
Concept Tested & Keywords
- Concept Tested: The definition and principle of Positive End-Expiratory Pressure (PEEP) in mechanical ventilation.
- Stem keywords: Positive end expiratory pressure, PEEP
- Lead-in keywords: is
Question ID
Qp10eI0cyZjnI-nrJif7BP
Reference Book
E6 Nursing Fundamentals Potter Perry 12e Part 5 p. 1-3
E6 Medicine Harrison 22e Part 2 p. 206-208
E6 Nursing Brunner Adult Health 3SA Vol 2 Part 2 p. 34-36
Practise the full Combined AIIMS - 2020 (Jodhpur, Bhopal, Patna, Raipur)
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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