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The patient will be too sedated to be aware of the details of care. This is incorrect because paralytics are not sedatives or analgesics. Sedation and pain control must be provided separately; assuming the patient is unaware risks causing distress and harm.

Caregivers should be encouraged to provide stimulation and diversion. While emotional support is important, excessive stimulation may be frightening when the patient cannot respond. Calm, clear verbal reassurance and minimal unnecessary stimulation are preferred.

Communication will not be possible with the use of neuromuscular blocking agents. Verbal communication is impossible, but alternative communication methods (e.g., explanation, yes/no signals if possible, communication boards when feasible) and ongoing verbal interaction remain crucial because the patient may still comprehend.

Hypoxemia: While hypoxemia can result from pneumonia or poor ventilation, it is typically a symptom of the patient’s overall condition, not the root cause of prolonged recovery.

Enteral feeding: This method provides essential nutrients and supports healing. It aids recovery rather than delays it, provided it meets the patient’s metabolic needs.

Decreased activity level: Though physical inactivity contributes to muscle weakness, the primary factor in this scenario is malnutrition, which underlies both fatigue and impaired muscle function.

Auscultation reveals an air leak around the ET tube cuff: An air leak may cause loss of tidal volume or poor pressure delivery, but it does not directly confirm alveolar hypoventilation unless accompanied by abnormal ABG values.

ABG results show a PaCO₂ of 32 mm Hg and a pH of 7.47: These findings indicate alveolar hyperventilation, not hypoventilation, because CO₂ levels are low and pH is alkalotic.

The patient tries to breathe faster than the ventilator setting: This suggests anxiety, pain, or ventilator dyssynchrony, not alveolar hypoventilation. The patient may actually be hyperventilating, decreasing CO₂ levels instead.

Decrease the delivered FiO₂ concentration: Oxygen concentration should be reduced only if oxygenation remains stable; it is not the primary strategy for ventilator weaning.

Substitute ventilator support with a manual resuscitation bag if the patient becomes hypoxemic: This is an emergency measure, not a weaning technique. Manual ventilation is used only during equipment failure or acute decompensation.

Implement weaning procedures around the clock until the patient does not experience ventilatory fatigue: Continuous weaning can cause severe fatigue and respiratory failure. Rest periods are essential to allow recovery and prevent exhaustion of respiratory muscles.

Help the caregiver to plan for placement of the patient in a long-term care facility: This may be an option if home care is not feasible, but it is not appropriate if the goal is to discharge the patient home.

Stress the advantages for the patient in being cared for in the home environment: Although beneficial, discussing advantages does not ensure the caregiver’s readiness or competence to manage home ventilation.

Have the caregiver arrange for around-the-clock home health nurses for the first several weeks: Continuous nursing care is not always available or necessary; the focus should be on training and empowering the primary caregiver to handle daily care safely.