While working in the neonatal intensive care unit, a respiratory therapist notices that a baby with an apnea monitor is not breathing, but the apnea alarm is not ringing. Which of the following might cause this failure?
1. Tachypnea
2. Bradycardia
3. Excessive movement
4. Upper airway obstruction
a. 1 and 2 c. 1 and 3
b. 2 and 4 d. 3 and 4
ANS: B
Bradycardia and upper airway obstruction can cause apnea monitors to fail to signal apnea, be-cause with bradycardia, cardiac oscillations and intrathoracic blood-volume changes cause an in-crease in impedance, which is sensed as part of the respiratory cycle. Continued respiratory ef-forts in the presence of upper airway obstruction are sensed as normal respiratory efforts.
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