When discussing the complications of prolonged mechanical ventilation, which should the nurse include?

The correct choice highlights the risk of ventilator-associated pneumonia as a significant complication of prolonged mechanical ventilation. This condition arises due to factors associated with mechanical ventilation, such as the presence of an endotracheal tube, which creates a direct pathway for pathogens to enter the lower respiratory tract. This can lead to an inflammatory response in the lungs and increased infection risk, characterized by the presence of new or progressive pulmonary infiltrates, fever, and increased respiratory secretions.

Prolonged mechanical ventilation can disrupt normal airway clearance mechanisms, allowing secretions to accumulate, which promotes microbial growth. Moreover, the impaired cough reflex due to sedation or neuromuscular blockade can further increase the susceptibility to pneumonia. Addressing the risk of ventilator-associated pneumonia is crucial in managing patients on mechanical ventilation, as early identification and intervention can improve patient outcomes and reduce morbidity associated with prolonged ventilatory support.

In contrast, the other options do not accurately represent the consequences of prolonged mechanical ventilation. Respiratory muscle strength typically diminishes with extended support as patients become reliant on the ventilator, improved airway patency may not occur due to possible complications such as edema or secretions, and sedation requirements often increase rather than decrease as patients may require more sedation to tolerate mechanical ventilation.