Patient Teaching - Incentive Spirometer

The incentive spirometer is a medical plastic device that allows you when taking deep breath and exhaling, it expands your lungs. It consists of a mouthpiece, a flexible tubing, a piston, a breathing coach indicator, a yellow indicator and a barrel. It uses to assist patient after surgery or any person who want to improve their lungs function especially patient or any person who is restricted to be in bed for many days. It fortifies and exercises lungs and keeps them pure and dynamic. It helps with lung expansion after taking steady deep

Throughout my clinical rotation, the only concern for this patient was pain management and discomfort from the chest tube site. The patient was given Ketorolac for a pain of 4/10 using the numeric pain sale. The patient was also at risk for pneumonia and pressure ulcers from immobility and not coughing/deep breathing. Nursing interventions were getting the patient up to the chair and using the incentive spirometer ten-times per hour. Another concern was SOB and fatigue with activities.

The patient may have a hard time breathing because she is in pain after having surgery. Since they patient doesn’t want to breath due to the pain it can cause atelectasis and later sepsis if not treated in time. It would be important to teach the patient about splinting and to use an incentive spirometry in order to help her be able to breath. Another risk factor for the patient not being able to oxygenate would be hypovolemia since there is less blood volume which can also lead to less oxygen being able to travel in the blood or able to perfuse throughout the body.

On the early morning of August 17, 2002, James C., a patient in one of the wards under the supervision of Ellen Hughes Finnerty, RN, went into respiratory depression. Between 3:00 and 4:00 a.m., Ann Mugi, the patient’s primary nurse, sought the assistance of a respiratory therapist, Hiran Obeyesekere, to help her care for the patient. As Obeyesekere suctioned the patient airway, Mugi called the service of the patient’s primary care physician, Dr. Jackson, to report the changes in the patient’s respiratory status, e.g., respiratory rate of 40 breaths per minute and low urine output.

interrupted and so the number of rotations can be measured. The frequency of rotations depends on the flow of air so a flow signal can be generated.

Mr. Joseph is a 56-year-old has 30 smoking pack years. He was diagnosed 10 years ago with asthma/chronic bronchitis, arthritis of the knees, and congestive heart failure (CHF). Mr. Joseph weighs 350 pounds with a height of 6 feet, making his body mass index (BMI) of 47.5, much more than the recommended 25, and in fact his BMI places him in the morbid obesity classification. He takes medicines for his pulmonary conditions, along with a diuretic.

Ineffective breathing pattern related to bronchoconstriction as evidenced by decreased SpO2 of 91% and increased respirations of 28 breaths per minute (Pillitteri, 2014, p. 1224).

Both rapid, shallow breathing patterns and hypoventilation effect gas exchange. Arterial blood gases will be monitored and changes discussed with provider. Alteration in PaCO2 and PaO2 levels are signs of respiratory failure. Patient’s body position will be properly aligned for optimum respiratory excursion, this promotes lung expansion and improved air exchange. Patient will be suctioned as needed to clear secretions and maintain patent airways. The expected outcome is that the patient’s airway and gas exchange will be maintained as evidence by normal arterial blood gases (Herdman,

The second nursing concern is impaired gas exchange for patient with COPD, this may be related to; alter oxygen supply, alveoli destruction and alveolar capillary membrane changes. The nursing intervention of this would be, to elevate the head of the bed up to help the patient breathe easier, to assess the skin and the membrane for color changes and to encourage the patient to cough to help clear secretion, as well as, to monitor the level of consciousness and mental status. The expected outcomes would be that the patient shows improvement of ventilation and oxygenation of their tissues and by assessing the ABGs and to be free of respiratory distress (Vera, 2013).

A range of emotional factors including fear, stress, anxiety, and pain can affect a person’s ability to breathe correctly and efficiently. The healthcare environment involves a considerable amount of stress and anxiety. Patients often demonstrate fear for their own well- being or

The nursing role in pulmonary rehabilitation includes one on one sessions with patients to cover more in-depth education of the disease process including actual anatomy and physiology of the pulmonary system. After that has been covered then the nurses can focus on causes of COPD, symptoms of the disease and management of them, diet, pulmonary exercise, medications for COPD and compliance issues, and most importantly smoking cessation. The nurses will likely require the patient to give return demonstrations of the medication use and pulmonary exercises such as pursed lip breathing (Mohammadi, Jowkar, Khankeh & Tafti, 2013).

Inform patient about using incentive spirometer every 2 hours to practice for deep breath and cough.

I stayed close to the patient during this whole period, but I was not paying enough attention to her low oxygen level. The patient was a healthcare aid and she kept telling me that, “It’s ok, I am always a shallow breather”. However, I should have my own judgement ability and provide more competent care with timely evaluation of the effectiveness of the interventions.

Respiratory therapists have one of the most exciting and gratifying careers within the medical field. Unfortunately as with any other job or career, it doesn’t come without having challenging times. Respiratory therapists work along-side physicians and are highly trained to treat patients with any sort of lung concern or breathing complications. This job requires hands on care, and deals with life and death daily. One specific scope of this field involves caring for patients (of all ages) attached to mechanical ventilation. It is the respiratory therapists’ responsibility to remove assistive ventilation to patients with written order from the doctor; which ultimately results in death of the patient (Keene, Samples, Masini, Byington).

Jane’s asthma was acute severe. Initially to alleviate some of Jane’s breathlessness she was sat up right in the bed and supported with pillows to improve air entry. Due to her low oxygen saturations she was placed on 40% oxygen via Hudson mask (BTS 2006), as Jane was mouth breathing the mask was the appropriate device to use to ensure adequate oxygenation (Walsh 2002). According to Inwald et al (2001) hypoxemia is frequently a primary cause in numerous asthma related deaths. By administering oxygen promptly, for acute severe asthma, serious hypoxemia