Final answer:
The nurse should first instruct the patient with emphysema on mechanical ventilation to allow the machine to breathe for them to address their anxiety, restlessness, and the high-pressure alarm. Further assessment and potential manual ventilation may follow based on the patient's synchrony with the ventilator.
Step-by-step explanation:
A patient with emphysema who is receiving mechanical ventilation and is experiencing anxiety and restlessness with the high-pressure alarm sounding, should be managed by the nurse first by assessing the patient. The first action should be to instruct the patient to allow the machine to breathe for him. This is crucial in ensuring that the patient does not fight the ventilator, which can cause the high-pressure alarm to sound due to increased airway resistance or decreased lung compliance. If the patient is unable to synchronize with the machine, then the nurse should assess the need to manually ventilate the client or adjust the ventilator settings. It's also important to observe for potential causes such as secretions, kinks in the tubing, or pneumothorax. Obtaining arterial blood gases (ABGs) and administering sedatives like PROPOFOL might be necessary as subsequent steps once the immediate issue is addressed and based on the patient's condition.