The nurse is caring for a patient on a mechanical ventilator and the low-pressure alarm sounds. Which action by the nurse is most appropriate?
a. Assess for secretions in the airway and suction the patient.
b. Administer a sedative to the patient to prevent coughing.
c. Assess the endotracheal tube cuff to make sure it is deflated.
d. Check the ventilator tubing and reconnect if disconnected.
D
The low-pressure alarm sounds when the ventilator has no resistance to inflating the lung. The patient may be disconnected from the ventilator, or a leak may have developed in the ventilator circuit. The high-pressure alarm sounds when the ventilator has met resistance to delivery of the tidal volume. This may result from coughing, increased secretions, or biting on the endotracheal tube. The cuff of the endotracheal tube is inflated to create a seal for positive-pressure ventilation. A cuff that is leaking could cause the low-pressure alarm to sound.
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