This is an NCLEX review on the incentive spirometer. In this review I will cover the most important material you need to know about the incentive spirometer for the NCLEX exam and give you a practice NCLEX style question at the end.
An incentive spirometer is a device used to help improve lung function and prevent atelectasis. Atelectasis is where the lung or part of it, has collapsed and the alveoli sacs are unable to perform gas exchange. This is a very common complication for patients after surgery.
An incentive spirometer encourages the patient to regularly deep breath which helps keep the alveoli sacs open. The alveoli sacs are responsible for gas exchange and if they become affected, gas exchanged will be significantly decreased.
What do you need to know for the NCLEX exam about the Incentive Spirometer?
- How to properly use it (exams LOVE to give you a scenario and ask which of the following is the correct or incorrect way to use an incentive spirometer)***most common
- The nurse’s role with the incentive spirometer
- What type of patients benefit from using an incentive spirometer
- How an incentive spirometer works and why it is used
Video NCLEX Lecture on the Incentive Spirometer
What Type of Patients Benefit from an Incentive Spirometer?
- Pre-opt and post-opt patients
- Patients with breathing disorders: COPD (strengthen lung function)
- Patients with respiratory illnesses: Pneumonia (helps keep lungs healthy while sick and move fluid/pus affecting the alveoli sac)
How often should a patient use and incentive spirometer? 10 times every 1 to 2 hours while awake
Nurse’s role with an Incentive Spirometer:
- Educate patient how to use it and the importance of using it regularly
- Observing and encouraging patient to use it often
- Monitoring lung sounds for improvement: For example, if the patient has atelectasis the lungs will sound diminished or bronchial breath sounds may be heard in the peripheral lung fields, or crackles. LISTEN TO ABNORMAL LUNG SOUNDS
Wrong Ways to use an Incentive Spirometer?
- Blowing into the device (most devices will not work if this is done)
- Rapidly inhaling and exhaling off of the device
- Inhaling too fast or too slow off of the device and not allowing the piston to completely fall to baseline before repeating
- Not using it often (less than 2 -3 times per day)
- Not using the device in sets of 10
Steps on How to Use an Incentive Spirometer
- Attach the flexible tubing to port
- Set goal for patient with the yellow marker
- Have patient sit-up and exhale completely
- Seal lips around mouthpiece tightly
- Have patient inhale deeply and slowly…making sure to keep yellow indicator within normal range (not too fast or too slow)…Piston will rise
- Patient needs to keep inhaling as deep as possible. …until unable to hold breath any longer and then hold breath for 6 seconds
- Exhale slowly and allow piston to fall before repeating again
NCLEX style question about an Incentive Spirometer:
You are providing pre-opt teaching to a patient who will be having abdominal surgery. After discussing with the patient how to use an incentive spirometer, you ask the patient to demonstrate how to use the device. Which action by the patient demonstrates that the patient understood your education about how to use the device?
A. The patient inhales quickly and rapidly off of the device.
B. The patient inhales and then exhales into the mouthpiece.
C. The patient inhales slowly until unable and holds breath for 6 seconds and then exhales.
D. The patient slowly inhales and exhales multiple times and then holds breath for 2 seconds.
Answer: C….this option is the only correct explanation of how to correctly use an incentive spirometer.
A is wrong because the patient should SLOWLY inhale from the device not quickly and rapidly.
B is wrong because the patient never exhales into the mouthpiece.
D is wrong because the patient should inhale and exhale one time each time (not multiple) and hold breath for 6 seconds…not two.
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