Teaching Plan

When a patient has surgery it is important for them to keep their lungs healthy and to take slow deep breaths. After surgery it can hurt too much or they may feel too weak to take the deep breaths, which can cause lung illnesses. A device that can be used is an incentive spirometer. Its important for someone to learn who to use the incentive spirometer as they will not benefit from using it if not used correctly.
A nursing diagnosis for a patient after surgery is ineffective breathing pattern related to surgery as evidenced by patient being short of breath. A short-term goal for this is the patient will use the incentive spirometer for 5 sets 10 times a day.
To teach the patient how to use the incentive spirometer I would take the time and sit with them and explain how to use it and also demonstrate how to use it. Then I would have the patient show it back to me and I would give them feedback. Also when I go in the room again I would ask them to show me how it’s done to make sure they are doing it correctly. The step-by-step outline that will be used to teach the patient includes: 1. I would have the patient to sit in semi-fowler position if they can as this will increase lung expansion. 2. Since they are post op I would place a pillow or folded blanket over chest or abdominal incision for splinting. 3. Show the patient how to steady device with one hand and hold mouthpiece with the other. 4. Instruct the patient to exhale normally and then place lips securely around mouthpiece. 5. Have the patient inhale slowly and as deeply as possible through the mouthpiece without using their nose. 6. Next instruct the patient that when they cannot inhale anymore then they should hold their breath and count to three with keeping an eye on the gauge to see the level and if they are making progress each time. 7. After they will remove their lips from mouthpiece and breath normally. The patient will be encouraged to do this 5 to 10 times every 1-2 hours if they are able.
A couple weeks ago as well as this week at clinical I had patients that were to use an incentive spirometer in which I did this teaching plan with them. Some factors that affected my teaching where the patient was confused, he slept most of the time, he didn’t remember how to use it, he was in too much pain, and refused to use it. All of these factors ended up hindering the teaching. I would try to work with the patient by suggesting the splinting as he had fractured ribs but he would still refuse and several times I went in to try again and he was sleeping. However with the other patient I had a few weeks ago it went very well I was able to show them how to use it and then they would show me they understood and then I went back in the room a few hours later and he was still able to show me he understood which says to me that this teaching plan worked. The only issue he had was he would forget to do it so one thing I thought about was that I could suggest the patient to use it on every commercial of their show.
Before saying if this teaching plan worked or did not I would want to have others try it to see if it works before making changes because it really depends on the patient on how they are going to understand things and you might have to change things as you go to accommodate them so they will understand.

Reference:
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of Nursing: The art and Science of Nursing Care (7th ed.). Philadelphia: Lippincott Williams & Wilkins.