Which of the following factors is NOT associated with a higher risk of post-surgical complications in obese patients?

A. Pursed-lip breathing does not require a specific body position, but it is often more comfortable and effective when the patient is in a semi-Fowler’s position (elevated head of the bed) or sitting upright. Being flat on the back might actually make breathing more difficult for some patients with COPD.
B. The technique involves inhaling slowly through the nose and exhaling through pursed lips, which creates a slight resistance during expiration. This helps to keep the airways open longer, reduce airway collapse, and improve oxygen exchange. Proper inhalation and exhalation technique are key components of effective pursed-lip breathing.
C. In pursed-lip breathing, expiration should be longer than inspiration. The recommended pattern is to inhale slowly through the nose for about 2 counts and then exhale slowly through pursed lips for about 4 counts. The extended expiration phase helps to remove trapped air from the lungs and improves overall ventilation.
D. Coughing forcefully is not a part of pursed-lip breathing. Pursed-lip breathing focuses on controlled breathing to improve airflow and ease breathing. Coughing can be done separately if needed, but it is not a component of the pursed-lip breathing technique.

A. Lubricating the suction catheter tip with sterile saline is generally not recommended. The catheter tip is usually not lubricated before suctioning. Instead, suctioning should be performed using a dry, sterile catheter to prevent introducing any substances into the airway that could cause irritation or infection.
B. Hyperoxygenating the patient with 100% oxygen before suctioning is a crucial step. This helps to prevent hypoxia during the suctioning procedure, as suctioning can temporarily reduce the oxygen levels in the blood. By providing 100% oxygen for 30 to 60 seconds, the nurse ensures that the patient has an adequate oxygen reserve and reduces the risk of oxygen desaturation during suctioning.
C. Performing chest physiotherapy is not a routine pre-suctioning action and is generally done as part of a separate management strategy for clearing secretions. Chest physiotherapy involves techniques such as percussion, vibration, and postural drainage to help mobilize secretions from the lungs.
D. Instilling normal saline into the airway before suctioning (known as “normal saline lavage”) is not recommended. This practice can actually cause harm, such as increasing the risk of infection, causing bronchospasm, and diluting secretions which may then become more difficult to suction.