Incentive Spirometer NCLEX Review Study Guide

Introduction

  • Presenter: Sarah from registerednursern.com

  • Purpose: Conduct a quick NCLEX review on the incentive spirometer (IS)

  • Video resources available in the description

Learning Objectives

  • Objective 1: Define what an incentive spirometer is.

  • Objective 2: Demonstrate the usage of the spirometer to educate patients.

  • Objective 3: Provide an NCLEX-style question relevant to the spirometer.

Definition of an Incentive Spirometer

  • Definition: An incentive spirometer, also known as an IS, is a device that promotes slow, long, deep breaths.

    • Purpose: To open alveolar sacs, help move secretions, and maintain their functionality.

  • Clinical Importance: A primary concern for patients needing to use the spirometer is deflated alveolar sacs, which can lead to respiratory complications.

Conditions Treated with Incentive Spirometer

  • Atelectasis:

    • Definition: A condition where part or all of a lung collapses, preventing alveolar sacs from inflating and deflating properly, disrupting gas exchange.

    • Common in patients after thoracic or abdominal surgery.

  • Chronic Obstructive Pulmonary Disease (COPD):

    • Using the spirometer can enhance lung function.

    • Patients with severe COPD report improved breathing and activity tolerance when using the spirometer regularly.

  • Pneumonia:

    • The device aids in clearing pus from alveolar sacs and keeps lungs functional during infection.

Lung Anatomy and Atelectasis

  • Breathing Process:

    • Air travels from the environment down the trachea and bronchi into bronchioles and finally into alveolar sacs.

    • Gas exchange occurs in these sacs, which inflate and deflate with every breath.

  • Atelectasis Mechanism:

    • Blockages (fluid, mucus plugs, or tumors) can prevent air from reaching alveolar sacs, resulting in collapse.

    • A collapsed alveolar sac (depicted in a visual) prevents adequate gas exchange.

Nursing Role with the Incentive Spirometer

  • Patient Education:

    • Importance: Patients may not understand the significance of the spirometer; therefore, education is crucial.

    • Demonstrate proper usage of the spirometer.

  • Monitoring:

    • Assess lung sounds pre- and post-intervention, comparing improvement.

    • Confirm correct usage of the device by observing the patients.

  • Goal Setting:

    • Goals are set based on the patient’s age and height.

    • Example: A 30-year-old male at 5'8" should pull approximately 3,150 mL; a female of the same age and height should pull about 2,900 mL.

Components of an Incentive Spirometer

  • Description of Device Parts:

    • Mouthpiece: Adjustable and flexible, connects to the spirometer.

    • Yellow Marker: Sets the patient’s inhalation goal.

    • Yellow Piston Indicator: Rises with inhalation and provides feedback on breathing technique.

    • Handrail: For patient grip during usage.

    • Faces Indicator: Shows correct inhalation levels (frowning vs. happy face).

    • Oxygen Port: Option for patients on supplemental oxygen to use the device simultaneously.

Proper Usage of Incentive Spirometer

  1. Set the Patient Goal: Adjust the yellow marker to the patient's target volume.

  2. Preparation: Have the patient exhale completely.

  3. Seal Mouthpiece: Ensure a tight seal around the mouthpiece.

  4. Inhale: Instruct the patient to inhale slowly and deeply, maintaining the indicator within the desired range.

  5. Hold Breath: Instruct the patient to hold their breath for 6 seconds before exhaling.

  6. Repeat: Exhale slowly and allow the piston to fall, repeat the process at least 10 times every hour.

Common Mistakes in Usage

  • Incorrect Actions:

    • Blowing into the spirometer instead of inhaling.

    • Rapid inhalation and exhalation, rather than slow and sustained inhalation.

NCLEX Example Question

  • Scenario: Teaching pre-operative patient care for abdominal surgery, assessing understanding of the spirometer.

  • Question: What action by the patient demonstrates understanding of the spirometer use?

    • Options:

    • A. Inhales quickly and rapidly.

    • B. Inhales then exhales into the mouthpiece.

    • C. Inhales slowly until unable, holds breath for 6 seconds, then exhales. (Correct Answer: C)

    • D. Inhales and exhales multiple times then holds breath for 2 seconds.

  • Explanation of Choices:

    • A is incorrect due to rapid inhalation not being suitable.

    • B is incorrect; the patient should not exhale into the spirometer.

    • C is correct as it follows the appropriate inhalation method.

    • D is incorrect due to misunderstanding the required breath-holding duration.

Conclusion

  • Review of the incentive spirometer's role, methods, and implementations in clinical settings.

  • Encourage further learning through additional videos in the lung series.

  • Closing remarks: Thanking viewers and suggesting subscription for more educational content.