Coughing. Coughing is done to mobilize and expel respiratory
system secretions which, because of the effects of anesthesia, tend to pool in the lungs
and may cause pneumonia. The patient should be in a sitting or lying position. Instruct
the patient to:
Lean forward slightly while sitting in bed.
Take a deep breath.
Inhale fully with the mouth slightly open.
Let out three to four sharp "hacks."
With mouth open, take in a deep breath and give one or two
Repeat steps (a) through (e) ten times, as tolerated.
NOTE: The above steps should be repeated every two hours during the postoperative
phase or as prescribed.
(g) The patient may lace his fingers and hold them tightly across
the incision before coughing. This is used as a splint to minimize pressure and helps to
control pain when the patient is coughing. A small pillow or folded towel may be used in
place of laced fingers. See Figure 1-4.
NOTE: Encourage the patient to perform deep breathing exercises before coughing.
This stimulates cough reflex.
Extremity exercises. These exercises help to prevent circulatory
problems, such as thrombophlebitis, by facilitating venous return to the heart. It also
decreases postoperative "gas pains." See Figure 1-5 for legs and feet exercises. The
(a) Flex and extend each joint, particularity the hip, knee, and
ankle joints, keeping the lower back flat as the leg is lowered and straightened.
Move each foot in a circular motion.