Postoperative prevention of atelectasis: which nursing intervention is most helpful?

• A. Keep patient flat
• B. Encouraging deep breathing and coughing
• C. Limit fluids
• D. Sleep with oxygen mask

Answer: (B)

Postoperative atelectasis occurs when shallow breathing and poor lung inflation lead to collapsed alveoli. The most effective prevention is promoting adequate ventilation and airway clearance. Encouraging deep breathing and coughing directly expands the lungs, increases tidal volume, and helps mobilize secretions, which reopens collapsed airways and improves oxygenation. Teach the patient to take slow, deep breaths through the nose, hold briefly, and then cough to clear secretions; using an incentive spirometer can reinforce this activity. Pain control is important so the patient isn’t hesitant to take deep breaths.

Keep the patient flat reduces diaphragmatic excursion and lung expansion, which can worsen atelectasis. Limiting fluids can thicken mucus and hinder clearance. Sleeping with an oxygen mask is an intervention for hypoxemia, not a routine prevention for atelectasis.