The high-pressure alarm activates on a patient receiving mechanical ventilatory support. The pa-tient is tachycardic and tachypnic with absent breath sounds on the right side. Which of the fol-lowing condition(s) could be the cause?
1. Pneumothorax
2. Pulmonary edema
3. Disconnection from the ventilator
4. Increased airway resistance
a. 1 only
b. 4 only
c. 1, 2, and 3 only
d. 1 and 4 only
ANS: A
Pneumothorax is another possible problem that must be detected during positive pressure ventila-tion (PPV) and treated quickly. Pneumothorax can be recognized as increased WOB if a patient is conscious. For example, the patient may demonstrate nasal flaring, use of accessory muscles, uneven chest wall movement, and absence of breath sounds on the affected side. Auscultation and percussion of the chest, cardiovascular assessment, and ventilating pressure evaluations usu-ally can distinguish a pneumothorax from other problems.
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