A client diagnosed with a pulmonary embolism is placed on a continuous Heparin infusion. A nurse should notify the health care provider for which of the following findings?

A. Supportive feedback: This term refers to positive, constructive input that aims to help a colleague improve their practice or decision-making. Nurse Taylor's behavior does not reflect supportive feedback; rather, it is negative and undermining, contributing to a hostile work environment.
B. Lateral violence: This term describes aggressive or bullying behavior exhibited by colleagues at the same hierarchical level. Nurse Taylor's sarcastic remarks and belittling comments toward Nurse Jordan are clear examples of lateral violence, as they create a toxic atmosphere and negatively impact team dynamics. This behavior can lead to increased stress and decreased morale among team members.
C. Workplace violence: While Nurse Taylor's behavior can be considered a form of workplace violence in a broader sense, it is more specifically classified as lateral violence. Workplace violence generally encompasses physical threats or harm, while lateral violence focuses on verbal and emotional abuse among coworkers.
D. Constructive criticism: Constructive criticism involves providing feedback aimed at improving performance while maintaining respect and professionalism. Nurse Taylor's sarcastic remarks do not meet this definition, as they are not aimed at helping Nurse Jordan but rather serve to belittle and undermine her. Therefore, this behavior is not constructive and instead falls into the category of lateral violence.

A. To facilitate weaning off the mechanical ventilator. While PEEP is an important component of mechanical ventilation, its primary function is not to facilitate weaning. Instead, it improves oxygenation by preventing alveolar collapse. Weaning involves gradually reducing ventilatory support, but PEEP is typically adjusted based on oxygenation needs rather than as a direct step in weaning.
B. To decrease trapped oxygen in the alveoli. PEEP does not decrease trapped oxygen; instead, it maintains alveolar patency and prevents atelectasis. In conditions like ARDS, alveoli tend to collapse due to fluid accumulation and inflammation, and PEEP helps counteract this collapse to improve gas exchange. Reducing "trapped" oxygen is not a function of PEEP.
C. To promote independent breathing efforts. PEEP itself does not promote spontaneous breathing; instead, it provides positive pressure at the end of exhalation to improve oxygenation. In fact, high levels of PEEP can suppress spontaneous breathing by increasing intrathoracic pressure, requiring careful adjustment to balance oxygenation and ventilatory effort.
D. To keep the airways and small lung spaces open. PEEP prevents alveolar collapse by maintaining positive pressure in the lungs at the end of expiration. This improves oxygenation and gas exchange, which is critical in ARDS, where alveoli are prone to collapse due to inflammation and fluid accumulation. Keeping alveoli open reduces shunting and improves oxygen delivery to tissues.