NCLEX-PN

5.​ Initiate a cough after the third deep breath. 6.​ Repeat the cycle of coughing and deep breathing as required to effectively clear the airways. An incentive spirometer is an effective tool to guide clients in mastering deep breathing and coughing techniques . This device comprises a plastic chamber with a ball, a mouthpiece, and tubing . The Client, in a semi-upright position or seated, places the mouthpiece securely and deeply inhales using diaphragmatic breathing. This action prompts the ball to rise to the designated goal level. Clients are encouraged to perform this process at least every two hours while awake, aiming for ten breaths per session. Postural drainage involves specific positioning of the client to facilitate the drainage of respiratory secretions from various lung regions. Gravity aids in this process. For example, the client may be positioned prone and at a 45-degree Trendelenburg angle to drain the posterior bronchus. Similarly, lying on the left side helps drain the lateral bronchus. Percussion is performed by the nurse or certified respiratory therapist . It entails cupping the hand and gently tapping the lung areas for about a minute while the client performs a deep inhalation, holding their breath when possible. This technique is often combined with postural drainage and requires the same positions mentioned earlier. Vibration , akin to percussion, involves rapidly vibrating the lung area using the palm of the hand. This is done while the client is positioned for postural drainage. Inspiratory respiratory exercises focus on strengthening the inspiratory muscles . The Client lies supine , comfortably relaxing, and takes deep breaths using a mouthpiece with progressively smaller lumens. This challenges the client to engage the diaphragm more forcefully, overcoming the resistance of the narrowing mouthpiece. The goal is to enhance respiratory muscle strength. Applying, Maintaining, and Removing Orthopedic Devices for Client Care Orthopedic care encompasses various devices, including traction devices, splints, braces, and casts, which nurses are responsible for applying, maintaining, and removing. These devices play a crucial role in managing fractures and promoting proper healing. Traction: Enhancing Alignment and Alleviating Discomfort Traction involves applying a pulling force to a body part. Its purposes include external fixation of fractures, maintaining anatomical alignment, reducing pain, and decreasing muscle spasms . There are two main categories of traction forces: inline (running) traction and balanced traction. Balanced traction utilizes the client's bodily weight to exert force, while inline traction exerts force along the bone's long axis and a single plane. Three fundamental traction techniques include: ●​ Manual Traction : This technique involves manually applying force to align a fractured bone correctly before casting.

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