The respiratory therapist is assessing a mechanically ventilated patient for whom the high pressure alarm is active and the flow-volume loop shows the following:

The action that could alleviate this problem is which of the following?
A) Place a bite block into the patient's mouth.
B) Perform a recruitment maneuver and increase PEEP.
C) Administer a fast-acting bronchodilator and suction the ET tube.
D) Insert a 14-gauge needle into the second intercostal space, midclavicular line, and right side.

Question

The respiratory therapist is assessing a mechanically ventilated patient for whom the high pressure alarm is active and the flow-volume loop shows the following:

The action that could alleviate this problem is which of the following?
A) Place a bite block into the patient's mouth. 
B) Perform a recruitment maneuver and increase PEEP. 
C) Administer a fast-acting bronchodilator and suction the ET tube. 
D) Insert a 14-gauge needle into the second intercostal space, midclavicular line, and right side.

Quizplus · Accepted Answer

The flow-volume loop shows increased expiratory resistance; this plus activation of the high pressure alarm indicates increased airway resistance.Increased airway resistance can be caused by bronchospasm,which can be alleviated by a bronchodilator and suctioning.Although a patient biting the tubing would cause a high pressure alarm,no or very little volume would enter the patient,and the flow-volume loop would not be as large.The flow-volume loop is not indicative of low compliance,which would necessitate a recruitment maneuver and increased PEEP.The expiratory flow would not be "scooped out" if low compliance were a problem.Because the signs indicate increased airway resistance,needle decompression is not appropriate.

The Respiratory Therapist Is Assessing a Mechanically Ventilated Patient for Whom