The nurse responding to a low-pressure alarm on the ventilator should assess for which condition?
Disconnection of tubing.
Patient self-extubation.
Patient laying on the tubing.
Patient coughing.
Excessive airway secretions and mucous plugs.
Correct Answer : A,B
Choice A rationale
A disconnection of the ventilator tubing from the patient's airway or from another part of the circuit directly leads to a loss of positive pressure within the system. The ventilator detects this rapid drop in circuit pressure, triggering a low-pressure alarm. This physical separation prevents effective delivery of the set tidal volume and positive end-expiratory pressure, resulting in insufficient ventilation for the patient.
Choice B rationale
Patient self-extubation refers to the accidental or intentional removal of the endotracheal or tracheostomy tube. When this occurs, the connection between the ventilator circuit and the patient's airway is severed. Consequently, the positive pressure generated by the ventilator escapes into the atmosphere, causing a sudden and significant decrease in the circuit pressure, which activates the low-pressure alarm.
Choice C rationale
While a patient laying on the tubing might cause a temporary increase in resistance, it would more likely trigger a high-pressure alarm due to an obstruction or kink in the circuit, which impedes gas flow and increases proximal airway pressure. A low-pressure alarm indicates a leak or disconnection, not an obstruction.
Choice D rationale
Patient coughing can cause a transient increase in intrathoracic pressure and a brief spike in airway pressure within the ventilator circuit. This temporary increase in pressure is more likely to trigger a high-pressure alarm rather than a low-pressure alarm, as it represents a momentary resistance to airflow or expulsion of air.
Choice E rationale
Excessive airway secretions and mucous plugs create an obstruction within the patient's airway or the endotracheal tube. This obstruction increases the resistance to airflow, leading to a build-up of pressure within the ventilator circuit. Therefore, this condition would typically trigger a high-pressure alarm, indicating increased resistance to ventilation, rather than a low-pressure alarm, which signifies a leak or disconnection.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Albuterol is a selective beta-2 adrenergic agonist and does not directly suppress the immune response. Corticosteroids are known for their immunosuppressive effects, but Albuterol's primary action is bronchodilation by acting on airway smooth muscle receptors, leading to relaxation and improved airflow without affecting immune cells.
Choice B rationale
While some beta-agonists can have a minor effect on glucose metabolism, leading to slight increases in blood sugar in some individuals, this is not a common or significant side effect associated with typical Albuterol use, especially compared to corticosteroids. Albuterol's primary mechanism involves adenyl cyclase activation, leading to bronchodilation.
Choice C rationale
Mouth sores are not a typical side effect of Albuterol. Oral candidiasis (thrush) can occur with inhaled corticosteroids due to localized immunosuppression and altered oral flora, but Albuterol, being a bronchodilator, does not have this effect. Mouth irritation is possible with any inhaled medication, but not true sores.
Choice D rationale
Albuterol is a beta-2 adrenergic agonist, and while it primarily targets beta-2 receptors in the lungs, it can have some systemic absorption and stimulate beta-1 receptors in the heart, especially with higher doses. This stimulation can lead to an increased heart rate (tachycardia) due to enhanced cardiac contractility and conduction.
Correct Answer is ["B","C"]
Explanation
Choice A rationale
Dexamethasone is a corticosteroid, primarily used for its anti-inflammatory and immunosuppressive effects. While it may be used in certain respiratory conditions, it is not routinely co-administered with vecuronium to mitigate direct effects of neuromuscular blockade. Its use would be based on the underlying disease process rather than as an adjunct to neuromuscular blockade.
Choice B rationale
Fentanyl is a potent opioid analgesic. It is essential to administer an opioid like fentanyl concurrently with vecuronium because neuromuscular blocking agents induce paralysis without affecting consciousness or pain perception. Paralyzing a patient without providing adequate analgesia would be profoundly distressing and unethical, leading to severe anxiety and suffering.
Choice C rationale
Midazolam is a benzodiazepine, primarily used for sedation and anxiolysis. It is crucial to administer a sedative like midazolam concurrently with vecuronium because patients who are paralyzed by neuromuscular blockers are still fully conscious and aware of their surroundings. Sedation prevents psychological distress and ensures patient comfort during mechanical ventilation.
Choice D rationale
Furosemide is a loop diuretic, used to promote diuresis and reduce fluid overload. While fluid management is often critical in critically ill patients, especially those with ARDS, furosemide is not a medication that is routinely administered *with* vecuronium as a direct adjunct to its action. Its use would depend on the patient's fluid status and renal function.
Choice E rationale
Famotidine is a histamine H2 receptor antagonist, primarily used to reduce gastric acid production and prevent stress ulcers. While stress ulcer prophylaxis is common in critically ill patients, famotidine is not administered concurrently with vecuronium to mitigate direct effects of neuromuscular blockade. Its use is prophylactic and unrelated to the paralytic's action.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.