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CNOR Operating Room Nursing

Category - Intraoperative

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A patient’s ventilator continues to alarm of increased peak airway pressure. What nursing interventions are most appropriate in this situation?

Notify the physician immediately.
Suction the endotracheal tube.
Prepare the patient for insertion of a chest tube.
Call the respiratory therapist to change out the ventilator.

Explanation

Answer: B-In this situation, the nurse should initially suction the endotracheal tube. Increased peak airway pressure may occur due to tube occlusion, which may be the result of excess secretions. The tube could also have become kinked, and suctioning will help the nurse to determine if the tubing is occluded because it is twisted. The nurse may need to assess for other sources of increased pressure, such as poor lung compliance or a pneumothorax, if suctioning does not resolve the problem.

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CNOR Operating Room Nursing

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