During a bronchoscopy procedure, what complication should the respiratory therapist prepare for if the patient is alert and breathing spontaneously?

During a bronchoscopy procedure, if the patient is alert and breathing spontaneously, one of the primary concerns is the potential for significant stimulation of the cough reflex. This is due to the irritation caused by the bronchoscope as it passes through the airway, which can trigger the body's natural cough response. An alert patient may cough involuntarily, sometimes violently, which can lead to discomfort or complications such as airway obstruction or bronchospasm.

Being aware of this complication allows the respiratory therapist to prepare adequately, providing reassurance to the patient, employing appropriate airway management techniques, and possibly utilizing sedation if necessary to minimize discomfort and coughing during the procedure. Awareness of the cough reflex is particularly vital since it can significantly affect the outcome and safety of the bronchoscopy, especially in ensuring a clear and unobstructed airway during interventions.

Other complications listed, while they may occur under different circumstances, are less directly related to an alert and spontaneously breathing patient during a bronchoscopy. Hypotension, decreased pulmonary compliance, and an increased risk of nosocomial infection may not be as immediate concerns in this specific situation compared to the need to manage and mitigate coughing.