The first step in the assessment and documentation of patient-ventilator interaction following placement of a patient on a mechanical ventilator is which of the following?

• A. Verifying ventilator settings with patient charts
• B. Checking cuff pressures
• C. Recording tidal volumes
• D. Verifying physician orders

Answer: (D)

Verifying the physician’s orders is the first step because it establishes the intended plan for the patient’s ventilation, including the mode, target tidal volume, FiO2, PEEP, respiratory rate, and any alarm settings or weaning strategy. Having the orders confirmed ensures that the ventilator is configured to the clinician’s prescribed plan and provides a baseline to document and compare actual settings against. Once the orders are verified, you can proceed to confirm that the ventilator matches those orders and document any deviations. Other tasks like checking cuff pressures or recording tidal volumes are important for ongoing care, but they hinge on having a correct, active set of orders to guide what the ventilator should be doing in the first place.