Who should not receive incentive spirometry?

* Patients who are unable to follow instructions or cooperate with the procedure.

* Patients who have severe respiratory distress or are receiving mechanical ventilation.

* Patients who have a history of recent facial or oral surgery.

* Patients who have a bleeding disorder or are taking anticoagulant medications.

* Patients who have a pneumothorax or other conditions that make it difficult to expand the lungs.