A nurse is providing education to a client who has a prescription for incentive spirometry. Which of the following instructions should the nurse include in the teaching?

Incentive spirometry is a respiratory therapy technique used to promote lung expansion, prevent atelectasis, and improve oxygenation, especially after surgery or periods of immobility. It encourages sustained, deep inhalation to fully inflate the alveoli and enhance ventilation. Proper technique is essential for maximizing effectiveness and preventing postoperative pulmonary complications. Client education focuses on slow, controlled inhalation and regular use. A. Placing the mouthpiece in the mouth and inhaling slowly is the correct technique for incentive spirometry. A slow, deep inhalation allows full expansion of the lungs and helps open collapsed alveoli, improving gas exchange. The client should aim to raise the indicator to the prescribed target level while maintaining a steady breath. B. Removing the mouthpiece and exhaling quickly is incorrect because the primary goal of incentive spirometry is deep inspiration, not forceful exhalation. Rapid exhalation does not promote alveolar expansion and may reduce the effectiveness of the therapy. Controlled breathing in through the device is the key therapeutic action. C. Using the incentive spirometer every 4 hours is less frequent than recommended for most clients. Typically, clients are encouraged to use it 5 to 10 times every hour while awake, especially in the postoperative period. Frequent use is necessary to maintain lung expansion and prevent complications. D. Avoiding coughing during and after the session is incorrect because coughing is encouraged after using the incentive spirometer. Coughing helps mobilize and clear secretions that are loosened during deep breathing. This combination improves airway clearance and enhances lung function.