Post-op incentive spirometry: Why, when, & how

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Excerpt

SURGICAL PATIENTS who develop pulmonary complications postoperatively not only have extended hospitalizations, but also higher morbidity and mortality.1,2 Complications can include atelectasis, pneumonia, bronchospasm, exacerbations of underlying respiratory diseases, respiratory failure, and even death.2 Initiation of a respiratory therapy regimen that includes optimal pain control and early mobilization can decrease the risk of these complications as well as help patients recover from them.2–4
Incentive spirometry, designed to encourage deep breathing and lung expansion, gives the patient visual feedback during the exercise and measureable results for tracking the patient's progress.4,5 Although it's traditionally been a part of post-op care, the American Association of Respiratory Therapists has found little evidence to support routine use and no longer recommends using incentive spirometry routinely to prevent complications (see When to ACT?). However, it may still be employed for select patients, such as those who develop atelectasis with retained airway secretions.6,7 This article discusses how nurses can teach correct spirometry techniques and promote the best possible outcomes in appropriately selected adult patients.
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