The nurse is caring for a patient with myasthenia gravis who is on a ventilator. The high-pressure alarm sounds. What is the most likely cause of this?
a. The tubing is disconnected.
b. The electricity is interrupted.
c. The patient is fatigued.
d. The patient needs to be suctioned.
ANS: D
High-pressure alarms sound for higher-than-normal resistance to air flow. This might occur if the patient needs to be suctioned; if the patient is biting on the tube, coughing, or trying to talk; if tubing is kinked or otherwise obstructed; or if worsening respiratory disease causes decreased lung compliance. Disconnected tubing causes a low-pressure alarm. Loss of power causes its own alarm. Fatigue should not cause an alarm.
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