A nurse in a provider's office is caring for a client.

For each potential provider's prescription, click to specify if the potential prescription is anticipated, nonessential, or contraindicated for the client

Incentive spirometry is a respiratory therapy technique used to promote lung expansion, prevent atelectasis, and improve oxygenation, especially after surgery or periods of immobility. It encourages sustained, deep inhalation to fully inflate the alveoli and enhance ventilation. Proper technique is essential for maximizing effectiveness and preventing postoperative pulmonary complications. Client education focuses on slow, controlled inhalation and regular use.

A. Placing the mouthpiece in the mouth and inhaling slowly is the correct technique for incentive spirometry. A slow, deep inhalation allows full expansion of the lungs and helps open collapsed alveoli, improving gas exchange. The client should aim to raise the indicator to the prescribed target level while maintaining a steady breath.

B. Removing the mouthpiece and exhaling quickly is incorrect because the primary goal of incentive spirometry is deep inspiration, not forceful exhalation. Rapid exhalation does not promote alveolar expansion and may reduce the effectiveness of the therapy. Controlled breathing in through the device is the key therapeutic action.

C. Using the incentive spirometer every 4 hours is less frequent than recommended for most clients. Typically, clients are encouraged to use it 5 to 10 times every hour while awake, especially in the postoperative period. Frequent use is necessary to maintain lung expansion and prevent complications.

D. Avoiding coughing during and after the session is incorrect because coughing is encouraged after using the incentive spirometer. Coughing helps mobilize and clear secretions that are loosened during deep breathing. This combination improves airway clearance and enhances lung function.

Postoperative care following a partial colectomy with ostomy formation focuses on maintaining stoma function, preventing complications, and promoting patient independence in self-care. Clients must be educated on normal stoma appearance, pouch management, and expected return of bowel function. Proper ostomy care helps prevent leakage, skin breakdown, and infection. Nurses play a key role in reinforcing safe and practical self-management strategies before discharge.

A. While notifying the provider about stoma color is important, a "dark red" stoma is actually a healthy finding. A healthy stoma should be moist and range in color from bright red to dark red. The nurse should instruct the client to notify the provider if the stoma becomes pale pink indicating anemia or purple/black indicating ischemia or necrosis, which is a surgical emergency.

B. Placing an aspirin in the ostomy pouch to control odor is incorrect and unsafe because aspirin is not used for odor control and may cause chemical irritation or damage to the pouch system. Proper odor management includes dietary modifications and use of commercially available deodorizing agents designed for ostomy care.

C. Emptying the ostomy pouch when it becomes one-third to halfway full is correct because it prevents excessive weight on the appliance, reduces the risk of leakage, and maintains a secure seal. Regular emptying also promotes comfort and helps protect the peristomal skin from breakdown due to prolonged contact with effluent.

D. Stating that the ostomy should start functioning in five days is incorrect because bowel function typically returns within 24 to 72 hours after surgery, depending on the type of colectomy and anesthesia effects. Delayed output beyond expected timeframes may indicate complications such as ileus and should be reported.