Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 6-2

Deep Breathing Exercises, Coughing,

and Splinting

Goal:The patient and/or significant other verbalizes an

understanding of the instructions and is able to demonstrate

the activities. Comments

1. Check the patient’s chart for the type of surgery and
   review the medical orders.


2. Gather the necessary supplies and bring to the bedside
   stand or overbed table.


3. Perform hand hygiene and put on PPE, if indicated.


4. Identify the patient.


5. Close curtains around bed and close the door to the room,
   if possible. Explain what you are going to do and why you
   are going to do it to the patient.


6. Identify the patient’s learning needs. Identify the patient’s
   level of knowledge regarding deep breathing exercises,
   coughing, and splinting of the incision. If the patient has
   had surgery before, ask about this experience.


7. Explain the rationale for performing deep breathing exer-
   cises, coughing, and splinting of the incision.


8. Provide teaching about deep breathing exercises.
   a. Assist or ask the patient to sit up (semi- or high-Fowler’s
   position) and instruct the patient to place the palms of
   both hands along the lower anterior rib cage.
   b. Instruct the patient to exhale gently and completely.
   c. Instruct the patient to breathe in through the nose as
   deeply as possible and hold breath for 3 seconds.
   d. Instruct the patient to exhale through the mouth, purs-
   ing the lips like when whistling.
   e. Have the patient practice the breathing exercise three
   times. Instruct the patient that this exercise should be
   performed every 1 to 2 hours for the first 24 hours after
   surgery.


9. Provide teaching regarding coughing and splinting (provid-
   ing support to the incision).
   a. Ask the patient to sit up (semi-Fowler’s position) and
   apply a folded bath blanket or pillow against the part
   of the body where the incision will be (e.g., abdomen or
   chest).

ExcellentSatisfactoryNeeds Practice