A patient has been taught how to cough and deep breath. which evaluation method is most appropriate?

It’s important to practice deep breathing and coughing so that you’ll be able to do the exercises below easily after surgery. These exercises will help your breathing, clear your lungs, and lower your risk of pneumonia.

Breathe deeply and cough every hour while you’re awake for the first 2 to 3 days after minor surgery, and until the pain in your incision is gone after you’ve had major surgery. These exercises work better if you do them sitting up.

It’s also important to move and change your position often. These position changes help to make your breathing and coughing exercises work better.

Deep Breathing Exercises

Do these exercises every hour when you’re awake.

1. 
   Breathe in deeply and slowly through your nose, expanding your lower rib cage, and letting your abdomen move forward.
2. Hold for a count of 3 to 5.
3. Breathe out slowly and completely through pursed lips. Don’t force your breath out.
4. Rest and repeat 10 times every hour. Rest longer if you become dizzy or lightheaded.

Coughing Exercises

It’s best to do coughing exercises when you’re feeling comfortable. Your healthcare provider will tell you if you shouldn’t do the coughing exercises in this handout.

1. 
   If you’re lying on your back, bend your knees (if your surgeon says you can), and rest your feet on the bed.
2. Depending on the surgery you had, support your incision firmly with your hands or a small pillow before you try to cough.
3. Breathe in deeply and cough firmly. If you cough up some mucous, clear it into a tissue. Repeat the coughing until there isn’t any more mucous. If you have a lot of mucous, you may need to take a break so you don’t get too tired.

Foot and Leg Exercises

Foot and leg exercises, also help you to get better sooner and prevent problems like blood clots. You may also have SCD stockings (Sequential Compression Devices) on your legs (the stockings inflate and deflate to keep good blood flow in your legs).

Do these exercises every hour while you’re awake.

A. Ankle Pump

1. Pump your ankles up and down for 1 minute.
2. Relax both feet.
3. Repeat 5 times then relax.

B. Ankle Circles

1. Circle both ankles; first to the right, and then to the left.
2. Repeat 5 times then relax.

If your surgeon says you can:

1. Bend each knee one at a time, sliding your foot up along the bed and then back down.
2. Repeat 5 times then relax.

Changing Positions

Change your position every hour while awake, or as directed by your nurse. It’s important to move often to prevent problems like a lung infection, blood clots, and weak muscles.

Walking

• For your safety, it’s important to have a nurse or physical therapist with you the first time you get up, and remember to wear proper footwear.
• At first you may need some help. As you become stronger, you’ll be able to move around more on your own. You may need to take short rests in between walks.
• It’s normal to feel dizzy and uncomfortable when you first get up. Remember to move slowly. If you have more pain or dizziness, please tell your nurse or physical therapist.
• The goal is to be able to walk in the hall several times a day.

If you have any questions about these exercises, please ask your physical therapist or nurse.

Current as of: May 8, 2019

Author: Provincial Physiotherapy Professional Practice Council, Alberta Health Services

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