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Checking for proper connections in a patient's PEP (Positive Expiratory Pressure) device is essential when the device fails to generate pressure. This failure may indicate that the device is not functioning as intended, which could be due to loose or disconnected components. If the connections are not secure, it can lead to inadequate pressure generation, rendering the therapy ineffective. Ensuring all connections are tight and properly seated is crucial for the correct operational functioning of the device, as any gaps could lead to significant air leaks and compromise the therapy.

While heightened resistance, excessive noise, and erratic breathing patterns are all concerns that could arise during PEP therapy, they do not directly signal a lack of pressure generation in the same way. Heightened patient resistance may suggest a need for an assessment of the patient's condition or technique but does not automatically imply a connection issue. Similarly, excessive noise might indicate a need for maintenance or adjustment of the device rather than simply checking connections. Erratic breathing patterns could be indicative of several underlying issues but do not specifically point to whether the device is generating the required therapeutic pressure.