Definition
An incentive spirometer is a simple yet powerful respiratory device used to help patients improve lung function, especially after surgery or during recovery from respiratory illness. It encourages deep, sustained inhalation, which helps prevent complications like atelectasis (lung collapse), pneumonia, and mucus buildup.
Assisting the patient for voluntary deep breathing by providing visual feedback about inspiratory volume by using specially designed apparatus called spirometer.
Purposes for incentive spirometer
- To improve pulmonary ventilation.
- To counteract the effects of anaesthesia or hypoventilation.
- To loosen respiratory secretions.
- To facilitate respiratory gaseous exchange.
- To expand collapsed alveoli.
- To prevent postoperative respiratory complications
Indications for incentive spirometer
- Patients on long term bed rest.
- Patients with chronic obstructive and restrictive lung diseases
- Patients on medications that depress respiration
- Postoperative patients
Types of incentive spirometer
- Volume-oriented incentive spirometry (VIS): The tidal volume of the spirometer is set according to the manufacturer’s instructors. It ensures that the volume of air initiated is increased gradually as the patient takes deeper and deeper breaths.
- Flow-oriented incentive spirometry (FIS): There is no preset volume. The spirometer contains a number of movable balls that are pushed up by the force of breath and held suspended in the air while the patient inhales. The amount of air inhaled and the flow of the air estimated by how long and how high the balls are suspended.
Articles
- Stethoscope
- Incentive spirometer with appropriate mouthpiece
- Flow-oriented.
- Volume-oriented.
3.Tissue paper
4. Emesis basin.
5.Pillow, if needed.
Procedure for incentive spirometer
| Nursing Actions | Rationale |
| Before procedure 1. Explain the reason and objective for the therapy that the inspired air helps to inflate the lungs. The ball or weight in the spirometer will rise in response to the intensity of the intake of air. The higher the ball rises, the deeper the breath. 2 Assess the patient’s respiratory status by general observation, auscultation of breath sounds, and percussion of thorax. 3. Review medical record for recent arterial blood gas. 4 Remove dentures During procedures 5. Wash hands 6.Instruct patient to assume a semi-Fowler’s or high Fowler’s position. 7. Set pointer on incentive spirometer at appropriate level or point to level where disk or ball should reach. 8. For the postoperative patient try as much as possible to avoid discomfort with the treatment. Coordinate treatment with administration of pain relief medications. Instruct and assist the patient with splinting of incision. 9 Demonstrate the technique to the patient. a) Hold or place the spirometer in an upright position. A tilted flow-oriented device requires less effort to raise the balls or disks. A volume-oriented device will not function correctly unless upright. b) Demonstrate how to steady device with one hand and hold mouthpiece with the other hand. c) instruct the patient to exhale normally and then place lips securely around mouthpiece. d) Instruct to take a slow, deep breath to elevate the balls or cylinder and then hold the breath for 2 seconds initially increasing to 6 seconds to keep the balls or cylinder elevated if possible. e) Instruct patient not to breathe through his or her nose. Use a nose clip if necessary. f) Tell patient to remove lips from mouthpiece and exhale normally. 10.Instruct patient to relax and repeat the procedure several times and then four or five times hourly. 11.Instruct patient to cough after the procedure. After procedure 12. Clean the mouthpiece with water and shake it dry. Change disposable mouthpieces every 24 hours. 13 Record lung volume in cubic centimetres. Respiratory assessment (rate and depth of respiration, the amount of secretions expectorated). | Helps in obtaining cooperation of patient. Helps in comparison after procedure. Determines need for using incentive spirometer. Dentures interfere with performance of procedure. Reduces the transmission of microorganisms. Promotes optimal lung expansion. Encourage patient to reach appropriate goal. More likely to have best results in using incentive spirometry when patient has as little pain as possible. Practice increases inspiratory volume, maintains alveolar ventilation, and prevents atelectasis. Deep ventilation can loosen secretions, and coughing can facilitate their removal. Act as a communication between staff members. |
Special Considerations
Patient should take several normal breaths before attempting another one with the incentive spirometer.
Usually, one incentive breath per minute minimizes patient fatigue. No more than four or five maneuvers should be performed per minute to minimize hypocarbia.
REFERENCES
- Annamma Jacob, Rekha, Jhadav Sonali Tarachand: Clinical Nursing Procedures: The Art of Nursing Practice, 5th Edition, March 2023, Jaypee Publishers, ISBN-13: 978-9356961845 ISBN-10: 9356961840
- Omayalachi CON, Manual of Nursing Procedures and Practice, Vol 1, 3 Edition 2023, Published by Wolters Kluwer’s, ISBN: 978-9393553294
- Sandra Nettina, Lippincott Manual of Nursing Practice, 11th Edition, January 2019, Published by Wolters Kluwers, ISBN-13:978-9388313285
- Adrianne Dill Linton, Medical-Surgical Nursing, 8th Edition, 2023, Elsevier Publications, ISBN: 978-0323826716
- Donna Ignatavicius, Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care, 11th Edition ,2024, Elsevier Publications, ISBN: 978-0323878265
- Lewis’s Medical-Surgical Nursing, 12th Edition,2024, Elsevier Publications, ISBN: 978-0323789615
- AACN Essentials of Critical Care Nursing, 5th Ed. Sarah. Delgado, 2023, Published by American Association of Critical-Care Nurses ISBN: 978-1264269884
- Ernstmeyer K, Christman E, editors. Nursing Fundamentals [Internet]. 2nd edition. Eau Claire (WI): Chippewa Valley Technical College; 2024. PART IV, NURSING PROCESS. Available from: https://www.ncbi.nlm.nih.gov/books/NBK610818/
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