A nurse is making her 4-hour rounds on her patient who is on a ventilator. Up until this time the patient has been doing well with no complications but now alarms are sounding. The nurse knows that alarms should never be ignored. On closer inspection, he/she notices that it is the high-pressure alarm that is sounding. Select the following that would signify why the high-pressure alarm would be sounding. (Select all that apply)

Rationale: A. A kink or obstruction in the ventilator tubing increases resistance to airflow. The ventilator is pressure-triggered and senses that it must generate higher pressure than normal to deliver the set tidal volume. This triggers the high-pressure alarm. Nurses should inspect the tubing immediately, straighten any kinks, and ensure the circuit is free from obstruction. B. A leak causes a loss of delivered volume or pressure, which usually triggers a low-pressure alarm rather than a high-pressure alarm. Leaks allow air to escape, so the ventilator cannot build the necessary pressure to deliver a full breath. C. Secretions or mucus plugs obstruct airflow in the endotracheal or tracheostomy tube, making it harder for the ventilator to push air into the lungs. This obstruction increases airway pressure, resulting in a high-pressure alarm. Nurses should assess lung sounds, suction the airway if needed, and ensure proper humidification to prevent thick secretions. D. Changing the circuit may temporarily trigger an alarm, but this is usually brief and procedural, not a physiologic cause of a high-pressure alarm. Once the circuit is connected properly, the alarm should resolve. E. In modes that rely on spontaneous breathing, apnea or lack of patient effort usually triggers an apnea or low tidal volume alarm, not a high-pressure alarm. The high-pressure alarm reflects resistance or obstruction, not absence of breathing effort.