A nurse is developing a plan of care for a client who is postoperative. Which of the following interventions should the nurse include in the plan to prevent pulmonary complications?

Choice A rationale Suction equipment is primarily utilized for maintaining a patent airway when a client is unable to clear secretions independently due to a diminished cough reflex or neurological impairment. While essential for airway management in specific populations, it does not actively prevent pulmonary complications like atelectasis or pneumonia in the typical postoperative client. Instead, it serves as a reactive measure to clear existing obstructions rather than a proactive strategy for lung expansion. Choice B rationale Range-of-motion exercises are vital interventions for preventing musculoskeletal stiffness and reducing the risk of deep vein thrombosis by promoting venous return in the extremities. While these exercises improve overall circulation, they do not directly target the alveolar expansion required to prevent postoperative pulmonary issues. Pulmonary care specifically requires maneuvers that increase intrathoracic pressure or facilitate deep breathing to ensure that the lower lobes of the lungs remain well-ventilated during the recovery period. Choice C rationale An incentive spirometer encourages voluntary deep breathing by providing visual feedback, which helps the client achieve maximum inspiratory concentration. This process promotes alveolar expansion and prevents atelectasis, which is the collapse of lung tissue commonly seen after general anesthesia. By increasing transpulmonary pressure and inspiratory volumes, it facilitates the clearance of secretions and improves gas exchange. Regular use is a cornerstone of postoperative care to decrease the incidence of hospital-acquired pneumonia. Choice D rationale Expectorants are pharmacological agents designed to reduce the viscosity of secretions, making them easier to cough up and expel from the respiratory tract. While they can be helpful if a client has thick, tenacious mucus, they are not a standard preventive intervention for all postoperative clients. Over-reliance on medication without mechanical lung expansion exercises fails to address the underlying risk of shallow breathing and lung collapse caused by anesthesia and postoperative pain.