Which option correctly lists three nursing interventions to prevent respiratory complications in an immobile patient?

• A. Deep breathing and coughing every 2 hours while awake; turning every 1 to 2 hours while awake; incentive spirometer 5 times every 30 minutes during the first 24 to 48 hours postoperatively
• B. Only ambulation with assistance
• C. Limiting fluids to reduce coughing
• D. Use of a continuous positive airway pressure device without turning

Answer: (A)

Immobility reduces chest expansion, makes it easier for secretions to pool, and increases the risk of atelectasis and pneumonia. The best trio of nursing interventions targets lung expansion, secretion clearance, and maintaining alveolar inflation, especially early after surgery. Turning the patient every 1 to 2 hours while awake keeps different lung regions ventilated and helps prevent one area from collapsing. Deep breathing and coughing every 2 hours while awake encourage maximal inspiratory effort and clearance of secretions, reducing mucus buildup and improving airway patency. Incentive spirometry, performed about five attempts every 30 minutes during the first 24 to 48 hours postoperatively, actively promotes sustained maximal inspiration and helps re-expand collapsed alveoli. Together, these practices address the mechanical and clearance aspects of preventing respiratory complications in an immobile patient. Ambulation alone may not be feasible or sufficient; limiting fluids can thicken secretions and hinder clearance; and relying on a continuous positive airway pressure device without turning fails to provide the necessary chest wall movement and airway clearance needed in immobility.