Question

Case 2 (typed please) this scenario for fundamentals about Culturally Competent Care, Teaching, Learning, and Therapeutic Communication

You are the nurse caring for Ashley, a patient recovering from an ORIF after breaking her right femur. You have the following orders:

Activity: toe-touch weight bearing only on right leg

Incentive spirometer, q1hr while awake

You listen to her lungs and hear crackles in the bases. You notice Ashley’s incentive spirometer isn’t within her reach. You decide to educate Ashley on the use of her incentive spirometer.

Read the following statements and decide if the nurse is exhibiting good use of the teach back technique and an awareness of health literacy. Explain your answer. If the nurse isn’t exhibiting good teach back and health literacy, note what the nurse could say instead.

Statement by Nurse	Is the nurse exhibiting good technique? Why or why not? If not, what could the nurse say instead?
(Instructs patient on proper IS technique) “I’ve just instructed you on how to use your IS. Do you understand what you are going to do with it?”	Good technique by nurse? Why or why not? What could be said instead?
“To use your spirometer, breathe out first. Then put your mouth up to the mouthpiece and take a slow, long exhale in. Keep this floating piece in the ‘smiley face’ section. Hold your breath for as long as you can, then you can take your mouth off the mouthpiece and breath out. Can you show me how to do this?”	Good technique by nurse? Why or why not? What could be said instead?
“You are going to use this IS ten times every hour you are awake to help decrease the amount of atelectasis you have bibasilarly.”	Good technique by nurse? Why or why not? What could be said instead?
“This is your spirometer. After surgery, a lot of patients don’t take as big of a breath as they normally do, which can cause the tiny parts of their lung to collapse. The spirometer will help you keep these tiny parts of your lungs open. Keeping your lungs open will help prevent pneumonia. To make sure I did a good job teaching you, could you explain back to me why using your spirometer is so important?”	Good technique by nurse? Why or why not? What could be said instead?
“Before I review your incentive spirometer with you, I see in your chart you have used this before, tell me what you remember about using this equipment, why you would use it and what are the benefits for your breathing.”	Good technique by nurse? Why or why not? What could be said instead?

Answer 1

1, instead of that nurse could have asked the patient After instructions about spirometer..do you have any doubt about spirometer now??

2, After instructions about spirometer nurse should not ask patient to demonstrate immediately..I will guide you with spirometer when you do next time..

3, no patient should not use spirometer 10times every hour..5-10times per day it is enough for patient to inflate their lungs..

4, yes..this is the good techniques..always feedback will be effective in patient teaching..

5, instead of asking all this information from patient it is better to review the chart and get to know all the information..we must explain clearly the use of incentive spirometer..