Red flag to remember
Worsening shortness of breath, decreasing SpO2, fever, or new crackles/diminished breath sounds may signal atelectasis or pneumonia; report.
Before you read
Test yourself first: 1 question
Question 1 of 1
To prevent atelectasis after surgery, the priority nursing intervention is to:
Answer: B. Encourage incentive spirometry and deep breathing/coughing to re-expand alveoli and prevent atelectasis. Early ambulation helps too; strict bed rest worsens it.
0/1
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What is incentive spirometry?
It is especially important after surgery, prolonged bed rest, or with reduced mobility. Key principle: a slow, sustained, deep inhalation, not a fast or forceful breath.
Key points to remember
- It works by promoting sustained maximal inspiration to open alveoli and prevent atelectasis.
- The client sits upright (high-Fowler's) for best lung expansion.
- Technique: exhale normally, seal lips tightly around the mouthpiece, inhale slowly and deeply, hold 3 to 5 seconds, then exhale.
- Typical use is about 10 breaths every 1 to 2 hours while awake, especially post-op.
- Coughing after using the device helps clear loosened secretions.
- It is a key prevention measure for postoperative pneumonia and atelectasis.
Nursing priorities
- Position the client upright and pre-medicate for pain so deep breathing is effective (splint incision with a pillow).
- Demonstrate the technique: slow, deep, sustained inhalation with a 3- to 5-second hold.
- Encourage use about 10 times per hour while awake.
- Have the client cough afterward to clear secretions and assess lung sounds.
- Monitor for improvement in breath sounds and the volume achieved over time.
Labs & values
Pulse oximetry SpO2 95 to 100%
Monitor temperature and WBC for signs of pneumonia
Patient teaching
- Inhale slowly and deeply, hold the breath 3 to 5 seconds, then exhale; do not breathe out into the device.
- Use it about 10 times every hour while awake and cough afterward.
- Splint your incision with a pillow to make deep breathing and coughing more comfortable.
Red flags: report now
- Worsening shortness of breath, decreasing SpO2, fever, or new crackles/diminished breath sounds may signal atelectasis or pneumonia; report.
- Dizziness or lightheadedness during use indicates breaths are too rapid; have the client slow down and rest.
- Never substitute fast, shallow breaths for the slow sustained inhalation the device requires.
References
Clinical references for this topic
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