Page 488 - Saunders Comprehensive Review For NCLEX-RN

2. Provide written instructions to the client and family
regarding the specifics of care.
3. Instruct the client and family about postoperative
complications that can occur.
4. Provide appropriate resources for home care support.
5. Instruct the client not to drive, make important
decisions, or sign any legal documents for 24 hours
after receiving general anesthesia.
6. Instruct the client to call the surgeon, ambulatory
center, or emergency department if postoperative
problems occur.
7. Instruct the client to keep follow-up appointments
with the surgeon.

Box 15-1

Client Teaching

Deep-Breathing and Coughing Exercises

Instruct the client that a sitting position gives the best lung expansion for
coughing and deep-breathing exercises.
Instruct the client to breathe deeply 3 times, inhaling through the nostrils and
exhaling slowly through pursed lips.
Instruct the client that the third breath should be held for 3 seconds; then the
client should cough deeply 3 times.
The client should perform this exercise every 1 to 2 hours.

Incentive Spirometry

Instruct the client to assume a sitting or upright position.
Instruct the client to place the mouth tightly around the mouthpiece.
Instruct the client to inhale slowly to raise and maintain the flow rate indicator,
on the device as prescribed.
Instruct the client to hold the breath for 5 seconds and then to exhale through
pursed lips.
Instruct the client to repeat this process 10 times every hour.

Leg and Foot Exercises

Gastrocnemius (calf) pumping: Instruct the client to move both ankles by
pointing the toes up and then down.
Quadriceps (thigh) setting: Instruct the client to press the back of the knees
against the bed and then to relax the knees; this contracts and relaxes the thigh
and calf muscles to prevent thrombus formation.
Foot circles: Instruct the client to rotate each foot in a circle.

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