Do you have a clever way to do IS teaching?

[EGVnurse]

I work on a Med-surg unit with adult patients and I teach all of them how to use incentive spirometry. But you know what I realized, I'm bad at teaching it! I'm such a poor teacher when it comes to IS, sometimes my patients think I'm asking them to blow INTO the IS and way too hard for that matter haha. I think its just too easy that I assume patient's will understand me. Does anyone have any clever teaching method/way to simplify IS teaching for patients?? Thanks!

Also, in nursing school, I never learned that IS can help decrease a patient's elevated temp? If someone could explain why this works to me, I'd appreciate it.

[dah doh, BSN, RN]

For smokers, ask them to take a "drag" from a cigarette. Pot smokers do exceptionally well. For non-smokers, ask them to imagine its a very thick milkshake that needs to be sucked through the straw. Try to get the larger piece as high as you can while keeping the smaller part in the "best" area.

[blackvans1234]

I'm a CNA but am in nursing school, I reinforce IS teaching and love quizzing my patients about their incentive spirometers.

It's funny when they blow into it and nothing happens, then they realize they have to inhale.

Then I realize they haven't been doing it 10X per hour!

[MessyMomma]

I would think that if atelectasis was causing the temp elevation, doing

I.S. could help.

I just try to get my patient to exhale deeply first, then put in the mouthpiece. I tell them to inhale slowly and steadily--often they suck hard and fast. I tell them to make sure the ball drops completely and that they rest a little in between.

Hope some of this helped!

[healthpluscare]

Hello,

i find my patients whom most likely not to use I.S are the smokers!!! Being in AZ, its flu season all year long (ugh). i will teach the method..... but one thing no one wants is to return to the hospital due to money!! I will go into lung sounds and spike temps... but due to the ever shrinking economy? PLUS no discharge education (from AZ we are gehhto).. no one can afford to pay.. its truly sad but people worry about money more than health... mention money... they open their ears..

AT LEAST WHEN I DO VISITS, I GET PAID WHEN THEY DONT LISTEN... sad and true.

[healthpluscare]

with pulmonary patients... I.S is good but side to side laying position while in bed(avoid the back/supine) will expand lungs greater. Most dont like I.S for it makes them cough.

[healthpluscare]

awesome idea.

[Vespertinas]

I would think that if atelectasis was causing the temp elevation, doing

I.S. could help.

It makes perfect sense in my mind and many other clinicians' minds too but apparently atelectasis is not to blame for post-op fever. While it IS important to combat atelectasis to avoid hypoxemia in the first few days after surgery, a fever that is attributed to the pulmonary system is supposed to be from pneumonia which is treated with antibiotics, not incentive spirometry.

"Atelectasis (not causal) — Atelectasis is often used as an explanation for otherwise unexplained postoperative fever. Both atelectasis and fever occur frequently after surgery, but their concurrence is probably coincidental rather than causal.

• In one study of 270 consecutive patients after abdominal surgery, the sensitivity and negative predictive value of fever as a predictor of atelectasis were both less than 50 percent, and the specificity and positive predictive value were 68 and 66 percent respectively [72].
  
• In another study, there was also no association between fever and the presence of, or the degree of, atelectasis [73]. Therefore, ascribing a postoperative fever to atelectasis is probably false reassurance and may mislead the clinician from pursuing the true cause of the fever."
  

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I dunno though...I've been led to believe that all my chest PT and IS encouragement was making a difference in those fevers. So I guess it's just post-op self-limiting fevers from the surgical trauma. In any case, it's good to get that IS habit in early! Scare your patient with a little threat of pneumonia hehe.

My key tricks are:

to use the word 'SUCK' instead of saying 'breathe in' bc it somehow clicks in their minds better

once they have it down, remind them to exhale completely before breathing in to see the maximum result

[Vespertinas]

Most dont like I.S for it makes them cough.

yay, good! cough away. I'll give you plenty of pain medication for that.

[turnforthenurse, MSN, NP]

I tell them imagine that they are sucking something up through a straw...like a very thick milkshake.

For kiddos, have them pretend they are blowing bubbles or a wisp of cotton.

[PinkNBlue, BSN, RN]

I just tell them to suck it like a straw. LOL

[coco317]

I instruct them to suck in, take rests, coughing is good, keep the little bobber in between the arrows ( I call it the strike zone for those into baseball- that works well with men haha).

I then throw out incentives : this will help you get off of oxygen because your lungs will improve ; prevent pneumonia; help you cough up all that gunk. If I hear crackles on assessment I tell them and reinforce IS teaching and tell them I will be reassessing during my shift. Patients really seem to respond to that.