Which of the following actions would prevent Atelectasis following abdominal surgery?

AIIMS Rishikesh & Jodhpur NO - 2017

Medical & Surgical Nursing

Easy

Appeared in: AIIMS Rishikesh & Jodhpur NO - 2017

Explanation

Incentive spirometry is a core nursing intervention to prevent or treat atelectasis in postoperative patients, especially after abdominal or thoracic surgery.
It works by encouraging voluntary deep breathing, which provides visual feedback to the patient about their inspiratory volume.
This sustained maximal inspiration helps to inflate the alveoli, improve lung expansion, and prevent them from collapsing.
Regular use (e.g., 10-15 breaths every 1-2 hours while awake) is essential for its effectiveness.

Option A: Providing oxygen by face mask treats the symptom of hypoxemia but does not resolve the underlying cause of atelectasis, which is alveolar collapse. The lungs must be physically expanded to correct the problem.
Option C: The Sims' position is used for procedures involving the rectum or for pregnant women to relieve pressure on the vena cava. It does not promote optimal lung expansion.
Option D: Early cessation of NPO (nothing by mouth) status is related to the assessment and recovery of gastrointestinal function after surgery. It has no direct effect on respiratory function or preventing atelectasis.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Prevention of postoperative atelectasis as background academic context rather than a clinical decision trigger.
Preventing atelectasis is a critical nursing responsibility as it is a common postoperative complication that can lead to pneumonia if not addressed.
Patient education before surgery is key. The nurse should teach the patient how to use the incentive spirometer, how to splint their incision while coughing, and the importance of early mobility.
What if? The patient has severe incisional pain and refuses to use the incentive spirometer. The nurse's priority is to assess the pain and administer prescribed analgesics. Effective pain control is essential to allow the patient to breathe deeply and participate in pulmonary exercises.

How to Approach the Question

First, identify the core clinical problem in the question: preventing atelectasis after abdominal surgery.
Recall the pathophysiology of postoperative atelectasis: pain from the incision leads to shallow breathing (splinting), which causes the alveoli (tiny air sacs in the lungs) to collapse.
Evaluate each option based on whether it directly counteracts this mechanism.
Option A (O2 mask) treats a symptom (low oxygen), not the cause (collapse).
Option B (Incentive spirometry) directly forces deep breathing to keep alveoli open.
Option C (Sims' position) is for a different purpose (rectal procedures).

Concept Tested & Keywords

Concept Tested: Prevention of postoperative atelectasis
Stem keywords: Atelectasis, abdominal surgery, prevent
Lead-in keywords: Which
Clinical cues: The context is 'following abdominal surgery', which points to pain-related shallow breathing as a primary risk factor.
Negative lead-in flag: false

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