A client has an endotracheal tube for mechanical ventilation. A high-pressure alarm occurs. What are the most likely causes of this alarm for the nurse to assess? (SELECT ALL THAT APPLY)

A. Encourage the use of sunglasses when outside: Sunglasses are useful for reducing glare and light sensitivity, but they do not address the underlying cause of diplopia (double vision) in Multiple Sclerosis (MS). Diplopia is often due to neurological damage affecting the eye muscles or nerve pathways, not from light sensitivity.

B. Assess for conjunctival bleeding: Conjunctival bleeding (bleeding under the eye's clear surface) is not related to diplopia. Diplopia in MS is caused by problems with the nerves or muscles controlling eye movement, and assessing for conjunctival bleeding would not help in managing the double vision.

C. Alternate the use of an eye patch on each eye: Diplopia in MS is commonly caused by eye misalignment due to nerve damage. Using an eye patch on one eye at a time can temporarily help by blocking vision in one eye, allowing the brain to focus and alleviating the perception of double vision. Alternating the patch between eyes is a common strategy to manage diplopia while treating the underlying neurological issues.

D. Apply cool compresses for pain relief: Cool compresses might help with general eye discomfort, but they do not directly address diplopia. Diplopia due to MS is usually caused by muscle or nerve issues rather than discomfort that could be relieved by cool compresses.

A. Decrease activity, increase bronchodilator use, and encourage pursed lip breathing: This is not the most appropriate intervention for bacterial pneumonia. While bronchodilators and pursed-lip breathing can help in certain conditions (like chronic obstructive pulmonary disease), bacterial pneumonia primarily requires treatment with antimicrobials to address the infection. Decreasing activity may be necessary based on the patient’s condition, but it does not directly address the pneumonia or intrapulmonary shunting.

B. Increase fluid intake, administer antimicrobials & facilitate adequate coughing: Increasing fluid intake helps to thin secretions and improve expectoration. Administering antimicrobials is essential to treat bacterial pneumonia. Facilitating adequate coughing allows the patient to clear mucus from the airways, improving ventilation and reducing intrapulmonary shunting (which occurs when blood is diverted to areas of the lung that are not ventilated). This is the most appropriate set of interventions.

C. Place in prone position, begin steroid therapy & check peak flow monitor use: The prone position and steroid therapy are more commonly used in conditions like acute respiratory distress syndrome (ARDS), not bacterial pneumonia. Checking a peak flow monitor is more appropriate for asthma or other obstructive lung diseases, not bacterial pneumonia.

D. Increase oxygen, administer a cough suppressant, and place client on bedrest: While increasing oxygen is important to support oxygenation in pneumonia, administering a cough suppressant would be inappropriate as it would prevent the patient from clearing secretions effectively. Bedrest may be appropriate but should not be the primary focus when treating bacterial pneumonia.