Incentive Spirometry (Spirometer) NCLEX Review for Nursing with Demonstration

Hey everyone, it's Sarah with RegisteredNurseRN.com and in this video, I'm going to do a quick NCLEX review over the incentive

spirometer and as always over here on the side or in the down in the description below you can access the

resources that goes along with this video. So let's get started. First,

let's talk about the learning objectives of what I want you to learn from this lecture.

I want you to learn what an incentive spirometer is, how to use it so you can educate your patient,

which I'm going to do a demonstration and walk you step-by-step on how to do that and then at the end

I'm going to go over an NCLEX style

question of what you could expect to be asked in your nursing lecture exam or on the NCLEX about an incentive spirometer.

So first, let's talk about the definition of what an incentive spirometer is, also known as an IS.

The definition is that it's a device that encourages slow, long, deep breaths to help pop

open the alveoli sacs, which helps move secretions and keeps the sacs working because the biggest

problem with a lot of patients who need to use an incentive spirometer is that these sacs have become

deflated, which we'll go over the cause here in a second.

So we want to prevent that or help treat that to help get those sacs improving their function.

So it's used with

helping with the prevention or if a patient's experiencing this with a condition called

actilectasis. And a lot of patients who are going for surgery or after surgery,

especially like thoracic or chest or abdominal, we want to encourage them to use this device.

It's a little device that seems like it wouldn't have a significance to it, but it really does and it really works.

Another reason we would use this device is to help patients with breathing disorders, such as

COPD, because this helps increase their lung function. We've had a lot of patients who have severe COPD,

but they regularly use their incentive spirometer every day and they

report that they can breathe better and they can tolerate more activities compared to whenever they're not using their incentive spirometer regularly.

Also, if a patient has

pneumonia, one of the first things I would like to do whenever my patient has pneumonia is get them incentive

spirometer and educate them how to use that. Because what's going on with pneumonia, you have

nasty pus infection going on in these alveolar sacs and the bronchioles and we want to help

move that out, keep that lung function going, and pop those open.

So the big goal with this incentive spirometer is to inflate, get those alveolar sacs working back,

and to keep that patient regularly deep breathing. Now, let's talk about lung anatomy and

specifically what is happening in the lungs whenever a patient is experiencing

actilectasis, because this is one of the main reasons we want to educate a patient to using incentive spirometer.

So what happens is whenever you're breathing, you have air

that you've breathed in go down through your trachea, down through your bronchus,

into your right and left bronchi, which branch off into that, and then you have your bronchioles,

and then it flows down into your alveolar sacs. And this, in those sacs, is where the gas

exchange occurs. And these sacs are constantly inflating and deflating as the air flows in and flows out.

But what can happen, as you see with this little alveolar sac, he's pitiful. He is

collapsed. What's happened is that in these bronchioles, some fluid or a mucous plug or maybe a tumor

can get in there. And the air, as you see with the blue arrow, is trying to flow into there, and it can't. It's stopped by that

blockage, so that sac becomes

deflated. Now, what you want it to look like is this, nice and inflated. The air exchange is

passing through really nicely.

Now, atlectasis, the definition is that you have a lung or part of it has collapsed, and those

alveolar sacs are unable to inflate and deflate and perform the gas exchange. And again, like I said earlier, this is very

common after surgery, especially after abdominal or thoracic surgery.

So, as the nurse, we want to educate our patients before they're going for surgery because they are at risk for this.

Now, let's talk about your role as a nurse with an incentive spirometer.

Okay, big role is that we're going to educate our patient how to use it and stress to them the

importance. Because a lot of times

patients see this little device and they're like, what in the world is that going to do for me?

But like I said at the beginning, it looks insignificant, but it's a very important device.

So, we need to educate them how to use it.

Also, monitoring, we need to monitor the lung sounds and make sure we're having

improvement. For instance, if you're educating your patient how to use this device for pneumonia, monitor those breath sounds.

Like at the beginning of the shift, they sounded really bad, but you encourage them to use an incentive spirometer throughout the day.

And was there improvement? Do those lungs sound better?

Next, observe the patient meeting their goal and make sure they're using it right.

And because a lot of times whenever patients want to use this device, they either want to use it really fast,

which I'll demonstrate for you, or they just want to blow into it and they use it incorrectly and they're not getting the full

usage out of it.

So, it's important you observe that they're using it right and that they're meeting the goal that the

physician has ordered for it to be. And how are goals figured out? Because as you can see on the incentive spirometer, we'll go over

the layout of it.

There's little areas that are measured in milliliters of how much the patient should pull whenever they're sucking in. And it's based on a

patient's height and their age. So, just for comparison, for instance, a male patient who's 5'8",

who's age 30, should pull about

3,150 milliliters. Compared to a female who's the same height, the same age, will pull about

2,900. So, it varies based on patient's age and their height. Now,

let me demonstrate for you how to use an incentive spirometer and go over an NCLEX question with you.

Okay, here we have a basic incentive spirometer.

Every hospital is different on what they carry,

but generally this is the most popular.

And it will come in a little plastic bag and it'll come with the mouthpiece with the flexible tubing and the device.

And what you want to do as the nurse is you want to connect your mouthpiece tubing to

the port of where it plugs in. So, you'll just

push that on there like so.

And

let's go over the parts of it.

Here you have the mouthpiece and it moves, it's flexible. And you have right here this little

yellow marker. And this is where you set how much, what the patient's goal should be. Should they do about

2,000,

1,500, wherever they go. This will just help the patient know, hey,

this is my goal, where I need to get. Then you have the yellow piston. And this thing will

auscultate up and down as the patient breathes in and breathes out.

And you have your hand rail where the patient will hold it while they are breathing in. And you could put this,

this is just a bed rail

holder where you could put it on the bed if you wanted to. And then over here is another very important part.

You have a face that is frowning, a happy face, and then another face that's frowning.

Then you have in the middle this yellow indicator. And whenever the patient breathes in, they don't want to breathe in too fast or too slow.

Just perfect. And this will go up and just stay right in there as the patient breathes.

And this is where the patient wants to stay to get the best

usage out of this. And then on the back, some have this, some don't, there's a little oxygen port. If your patient's on

oxygen, you can plug it in here so they can get it while they're breathing.

Now, let me demonstrate how to use this.

Okay, first let's go over some wrong ways to use an incendium spirometer. A lot of times if patients haven't been educated properly,

they will do what they think you're supposed to do naturally with it by blowing into the device

rather than actually inhaling from the device.

Another wrong way patients may try to use an incendium spirometer is by quickly inhaling and exhaling off the device like this.

Now, let's look at the right way to use an incendium spirometer.

Okay, first what you want to do is you want to set the goal for the patient with the yellow marker

so they know where they need to get whenever using this incendium spirometer.

Then you're going to have the patient set up and exhale completely.

Then have them seal their mouth around the mouthpiece tightly and they will inhale slowly and deeply,

slowly and deeply,

making sure to keep the yellow indicator on the side within normal range.

They don't want that little yellow piece to go too high or too low.

And as they do this, the piston will rise up.

And have the patient keep inhaling as deep as possible until they can't inhale anymore.

And then they'll need to hold their breath for six seconds and then exhale slowly and allow the piston to fall before repeating again.

And record the amount that they were able to get on the incendium spirometer and they will perform this

at least 10 times every hour or two while awake. So this is what it looks like in action.

So

Okay, here's a typical NCLEX question you may see on an exam or the NCLEX about the incendium spirometer.

A lot of these questions like to ask you about patient teaching

or

how you observe the patient using it and are they doing it correctly. So let's look at this question.

You're providing pre-op teaching to a patient who will be having abdominal surgery.

After discussing with the patient how to use an incendium spirometer,

you ask the patient to demonstrate how to use the device.

What action by the patient demonstrates the patient understood your teaching?

A. The patient inhales quickly and rapidly.

B. The patient inhales and then exhales into the mouthpiece.

C. The patient inhales slowly until they're unable

any longer and holds breath for six seconds and then exhales. Or D.

The patient slowly inhales and exhales multiple times and then holds breath for two seconds.

So whenever you're looking at this question, you got to say okay, how do you properly use an incendium spirometer?

And delete from there. So let's look at option A. A. The patient inhales quickly and rapidly.

No, we can mark this off because whenever you're using an incendium spirometer, as you just seen, you do it slowly

over time. You don't do it quickly.

B. The patient inhales and then exhales into the mouthpiece. No.

The patient inhales into the mouthpiece, but does not exhale into the mouthpiece. So that is wrong.

Okay, C. The patient inhales slowly until they're unable any longer and holds breath for six seconds and then

exhales. And this is right. C is our answer because as you've seen with the demonstration,

you have the patient do it until they can no longer do it anymore because they're inhaling,

they're putting all that pressure on those alveolar sacs, and then after they hold their breath for six seconds and then exhale.

Now, let's look at and see why D is wrong. D. The patient slowly inhales and exhales multiple times and then holds breath for two seconds.

No, this is wrong because the patient isn't going to inhale, exhale, inhale, exhale, and then hold breath.

And anyways, they hold it for six seconds instead of two. So our answer is C.

Okay, that's a review over the incendium spirometer. Now,

be sure to go and check out my other videos in this lung series for the NCLEX review.

And thank you so much for watching and please consider subscribing to this YouTube channel.