Postoperative Exercise

Postoperative Exercise

Med Equipments:

• Educational materials
• Tissue
• Disposal volume oriented incentive spirometer
• Pillow
• Non-sterile gloves

Nursing Interventions:

• Wash hand and obtain equipments
• Check the patient’s identification
• Place patient in a sitting position
• Then follow these procedures:

Deep Breathing

1. Demonstrate deep breathing exercise
2. Ask the patient to return demonstrate deep breathing
3. Place on hand on abdomen (umbilical area) during inhalation
4. Expand the abdomen and rib cage on inspiration
5. Slowly inhale through your nose until you achieve maximum chest expansion
6. Hold breath for 2-3 seconds
7. Exhale slowly through your mouth until maximum chest contraction has been achieved
8. Repeat the exercise three or four times and allow the patient to rest

Splinting and Coughing

1. Demonstrate splinting and coughing
2. Don gloves
3. Place the patient in a sitting position with the head is slightly flexed, shoulders relaxed and slightly forward, and feed supported on the floor
4. Instruct the patient to re-demonstrate splinting and coughing:
5. Slowly raise head and sniff the air


6. Slowly bend forward and exhale slowly through pursed lips
7. Repeat breathing two or three times
8. When ready to cough, ask the patient to place a folded pillow against the abdomen and grasp the pillow against the abdomen with clasped hands
9. Instruct patient to take a deep breath and begin coughing immediately after inspiration is completed by bending forward slightly and producing a series of soft and staccato coughs.
10. Have a tissue ready

Using an Incentive Spirometer

1. Instruct the patient on the use of an incentive spirometer:
2. Have a volume-oriented incentive spirometer upright
3. Take a normal breath and exhale then seal lips tightly around the mouthpiece, take slow, deep breath to elevate the balls in the plastic tube and hold the inspiration for at least 3 seconds
4. The patient simultaneously measures the amount of inspired air volume on the calibrated plastic tube
5. Remove the mouthpiece, and exhale normally
6. Take several normal breaths
7. Repeat the procedure 4-5 times
8. Ask the patient to cough after the incentive effort
9. Ask the patient to clean mouthpiece under running water

Leg and Foot Exercises

1. Explains the leg and foot exercises
2. Ask the patient to demonstrate in bed:
3. With heels on bed, push the toes of both feet toward the foot of the bed until the calf muscles tighten then relax feet. Pull the toes toward the chin until calf muscles tighten then relax feet
4. With heels on the bed, lift and circle both ankles: first to the right and then to the left, repeat three times then relax
5. Flex and extend each knee alternately, sliding foot up along the bed then relax

Turn in Bed and Get Out of Bed

1. Instruct the patient who will have a left-sided abdominal or ches incision to turn to the right side of bed and sit up as follows:
2. Flex the knees
3. With the right hand splint the incision with hand or small pillow
4. Turn toward right side by pushing with the left foot and grasping the shoulder of the nurseor partial foot rail of the bed with the left hand
5. Raise up to a sitting position on the side of the bed by using the left arm and hand to push down against the mattrees
6. Reverse procedure as using left side instead of right for the patient with a right-sided incision
7. Instruct patient with orthopedic surgery ho to use a trapeze bar