Week 4: Evaluate and apply the facts and principles of biological, psychological,

sociological, cultural and spiritual functioning while providing nursing care to

clients with needs resulting from altered states of wellness throughout the lifespan.
a.

Evidence Based Practice

This week I had a patient that was post op day from a hip fracture repair. Due to
the patients surgery, pain, medication, and impaired mobility I knew she would be
resting in bed most of the day. A combination of all these factors can have an effect on
your lungs and respiratory status. Pain medication such as oxycodone and morphine that
are commonly prescribed after surgery can cause respiratory depression and cns
depression therefore the use of an incentive spirometer is very important to keep the
lungs strong and to prevent them from collapsing. Also general anesthesia that is used
during surgery puts the patient at risk for impaired respiratory. This week I thought my
patient about the importance of using an incentive spirometer. I provided her with
instructions on how to use an incentive spirometer and how offer she should be using it.
After I informed the patient about an ICS I asked the patient to demonstrate how she will
use to make sure she is doing it correctly and it is effective. I documented the amount she
was able to blow and how many breaths she was able to take. I am glad she performed
the ICS because her number was pretty low proving the ICS would be very effective for
her overtime help improve her lung function and prevent complications. According to
(Ignatavicius, 256) the purpose of the incentive spirometer is to promote complete lung
expansion and to prevent pulmonary problems. The incentive spirometer mimics the
same mechanics of yawning. The incentive spirometer show how well you are taking
deep breaths and expanding lungs. Incentive spirometers make you breath deeply
therefore improving you ability to excrete mucus from your lungs and increasing the

amount of oxygen that gets into your lungs. With all types of incentive spirometers the
patient must be able to seal their lips tightly around the mouthpiece, inhale spontaneously
and hold their breath for 3-5 seconds for effective lung expansion. Thorough out this
clinical rotation I have been making it a priority to teach and encourage my patient to use
the incentive spirometer. The article I read was based on 60 post op patients that were
divided into two groups one groups used the incentive spirometer post op and the other
group used deep breathing excersizes. The patient in group A were encouraged to use the
IS 10 times in each waking hour the patients in group B were encouraged deep breath 10
times with each waking hour. The results showed the incentive spirometer group showed
better improvement and prevention of post op pulmonary complications.

Ignatavicius , D. (2013). Management of Perioperative Patients.

Medical Surgical Nursing (7 ed., p. 25). Elsevier.

Kumar, K. (2013, March ). Efficiency of incentive spirometer in improving pulmonary

Function after upper abdominal surgery. Retrieved October 31, 2016, from
http://ijbamr.com/pdf/PDF%20DECEMBER%2013%20%20328-334.pdf.pdf