A newly licensed nurse is caring for a mechanically ventilated client in the intensive care unit. The high pressure alarm becomes triggered. Which of the following interventions is appropriate for this alarm?

A. Placing the client in a negative pressure room is not necessary because the client is suspected to have community-acquired pneumonia, which requires droplet precautions, not airborne precautions. Negative pressure rooms are reserved for diseases like tuberculosis, measles, or varicella, which are truly airborne infections.
B. Requesting a prescription for famotidine is not a priority because it is a gastrointestinal medication used for acid suppression or stress ulcer prophylaxis. The client’s presentation does not indicate gastrointestinal bleeding or acute GI issues requiring famotidine urgently.
C. Placing the client on supplemental oxygen is essential because the signs of respiratory distress, tachypnea, and low SpO₂ 90%-93%) require immediate intervention to maintain adequate oxygenation and prevent respiratory deterioration.
D. Obtaining a chest x-ray is a priority to confirm the diagnosis of pneumonia, assess the extent of lung involvement, and guide antibiotic and respiratory management. Radiographic imaging helps identify complications such as consolidation, pleural effusion, or worsening infection.
E. Requesting a prescription for dexamethasone is a priority intervention because steroids help control lung inflammation and reduce airway swelling, especially important for this client who has underlying asthma and signs of significant respiratory involvement.
F. Preparing the client for intubation is not immediately necessary because the client, although tachypneic, is able to maintain oxygen saturation above critical levels with supportive oxygen therapy. Intubation would be considered only if oxygenation worsens despite non-invasive measures.

A. Respiratory alkalosis, uncompensated would show an elevated pH with a decreased PaCO₂, typically due to hyperventilation. However, the PaCO₂ here is normal, and the elevated bicarbonate indicates that the cause of alkalosis is metabolic, not respiratory, making this an incorrect choice.
B. Metabolic alkalosis, uncompensated is the correct answer because the pH is elevated above 7.45, and the bicarbonate level is also elevated at 31 mEq/L. The PaCO₂ remains within the normal range, indicating that there has been no respiratory compensation yet, thus fitting the pattern of uncompensated metabolic alkalosis.
C. Respiratory acidosis, partially compensated would present with a low pH and a high PaCO₂, which is not the case here. The client’s pH is elevated and PaCO₂ is normal, eliminating respiratory acidosis from consideration.
D. Metabolic acidosis, partially compensated would show a low pH with a low bicarbonate level, typically accompanied by a compensatory decrease in PaCO₂. This client has an elevated pH and elevated bicarbonate, ruling out metabolic acidosis as a possibility.