a question about post-op temp and incentive spirometry

[BB8789]

Hi, I am new to this website so if I am in the wrong place please forgive me.

I am in my last 3 months of LPN school and we are going over post-op patients. It is said that when a patient is out of surgery and recovering, if their temperature goes up to have them do the incentive spirometer a few times and their temperature should decrease. I recently saw this with my dad who had surgery a few weeks ago.

I don't quite understand what happens, I understand that it decreases the temperature but I wanted to know what exactly happens that makes the temperature go down. Does anyone have any insight on this? If so, it would be greatly appreciated!

Thank you!

BB

[Stacey1234]

I have been trying to find the answer to this as well. Unfortunately I couldn't find any real evidence or a proper explanation of the mechanism behind the process. I am orienting on a surgery floor and after telling my mentor about my patient with a slightly elevated temp, she asked me what I had done to reduce it. I told her I had given Tylenol and taken off some blankets. She asked me what else I couldn't have done ... I suggested using cold compresses on the neck and chest (I remembered doing that on my peds rotation) she said there was one more obvious answer but I was at a loss. She said that deep breathing and using the spirometer could reduce fever and looked at me puzzled like she was amazed I didn't know that? I had never heard of that before and tried to find it online. She brought it up while discussing my progress and she saw it as me lacking knowledge of nursing interventions. I still don't see how it would work other than improving lung function and reducing chance of infection. But I don't see how it could rapidly reduce a fever!

[nutella, MSN, RN]

I think there is a little bit of a confusion going on.

slightly elevated temp to around 100 F / up to 100.4F for the first 2 days after surgery is not uncommon and happens because of an inflammatory reaction that the body has to the actual surgery. Usually, this temp disappears after the first 2 days.

Another story is high fever or fever that develops after the first 2 days - that can be due to some infection (of course that could be anything from UTI to PNA and wound infection or unrelated fever).

I think some observations and anecdotal evidence come from the fact that nurses forget to give the patient the IS right after surgery. When somebody happens to notice that the temp is 100F they automatically check to see if the patient has an IS (because we want to prevent PNA and atelectasis ). Now the patient gets the IS on the day of surgery late or the second day - and on the 3. or 4. day the increased temp is down - because the normal inflammatory response is going down (and not because an atelectasis opens up...).

Having said that - the IS is very important to prevent atelectasis and PNA after a variety of surgery. PNA of course can cause a fever - but if it is a bacterial PNA usually the MD will prescribe antibiotics because the IS will not fix a bacterial infection.

It is an important tool and very under appreciated !

I worked in thoracic surgery and every patient got an IS right away - to prevent atelectasis and to assist with inflating the lungs. Unfortunately a lot of nurses do not teach it right or at all ...