Deep breathing and coughing nursing,secret pick 3 lottery system,how to change safari background - Reviews


Dangers of prolonged bed rest following surgery include respiratory and circulatory complications, including hypostatic pneumonia, blood clots (thrombophlebitis or DVT—deep vein thrombosis), pulmonary embolism, development of pressure ulcers, generalized edema, contractures, difficulty in weight-bearing and balance, formation of renal calculi, scrotal edema, constipation, urinary retention, loss of appetite, and general depression and disorientation.
Key Concept Postoperative skin assessment is particularly important, as the client may have remained in the same position for an extended period of time in the OR and PACU. Atelectasis is the collapse of air sacs in the lungs, usually caused by mucous plugs that close the bronchi and may involve all or part of a lung.
Splinting the incision helps relieve some pain and discomfort the client may experience during coughing (see Fig. The incentive spirometer, which forces the client to concentrate on inspirations while providing immediate feedback, aids deep breathing (see Fig. Key Concept Breathing exercises will be more effective if the client learns and practices them preopera-tively The client takes the incentive spirometer home at discharge, so these exercises can be continued.
Holding a pillow or a folded bath blanket and pulling it tightly against the incision splints the incisional area. Instruct the client to take a deep breath, hold it for 2 to 5 seconds, and then do a strong double-cough (or “hack out” three short coughs) with the mouth open.
Symptoms of DVT and thrombophlebitis include swelling, warmth, redness, and tenderness in the area.
If the embolism is in an arm or leg, circulation distal to the embolus is often cut off, causing related symptoms, such as numbness, pain, and absence of pulse.
One means of avoiding circulatory disorders is to apply elastic stockings, elastic roller bandages, or antiembolism (TED) stockings as ordered by the primary healthcare provider. Consequently, the sooner the client can move about after surgery, the better it is for the client.
Respiratory insufficiency (hypoventilation) leads to hypoxemia, and may cause respiratory arrest. The postoperative client often is reluctant to cough or breathe deeply because of incisional pain: this can lead to atelectasis. Listen to lung sounds at least once per shift for evidence of fluid accumulation, dyspnea, atelectasis, or other respiratory symptoms.Other important signs are fever and cyanosis.
A dangerous circulatory complication is thrombophlebitis, the inflammation of a vein associated with formation of a blood clot, a thrombus. Assist the client to hold the splint for the first few days after surgery, The client will be able to hold it in place after that.


This technique helps to make coughing or deep breathing more comfortable and promotes better oxygenation. Count aloud and feel the movement of the client’s breathing as he or she prepares to cough. The client should then take a second, deeper breath and force it out in short, panting movements. Rationale: An upright position allows the client to maximize the use of his or her diaphragm. Ensure that the client does not repeat the process too rapidly Rationale: You do not want the client to inadvertently hyperventilate.
Rationale: These actions promote circulatory function and prevent contractures, foot drop, and other complications. To test for thrombophlebitis, flex the client’s foot up toward the knee (dorsi-flexion) with the leg straight.
An embolus (plural, emboli) is a piece of a clot or thrombus that breaks off and enters the person’s circulatory system, usually obstructing the blood flow in a smaller vessel (embolism). An embolism often can be treated with the immediate administration of special medications that dissolve or split up existing blood clots (thrombolytic agents).
Other nursing measures used to prevent circulatory disorders include performing leg exercises every 2 hours, complete range-of-motion exercises every shift, and ambulation as soon as possible after surgery.
At first, the client may dangle his or her legs over the edge of the bed, then sit in a chair, and finally walk.The nurse helps clients to ambulate as soon as possible after surgical procedures, according to the surgeon’s orders.
Other respiratory complications include hypostatic or aspiration pneumonia (inflammation of the lung or accumulation of fluid in the lung) and atelectasis. This client may become somewhat cyanotic as respirations and pulse become very rapid and breathing becomes difficult.
Be sure to provide ample analgesia about one half hour prior to coughing and deep-breathing exercises.
The client should then take an even deeper third breath and exhale it quickly in a strong huff. Agree on the number of times and how often the procedure is to be done, within physician’s orders. Rationale: This motion promotes circulation and contributes to optimal respiratory exchange.


Rationale: This motion promotes contraction of the muscle, which is strengthened with repetition.
If pain occurs behind the knee on dorsiflexion, it is known as a positive Homans’ sign, indicating probable thrombophlebitis.
Symptoms of embolism depend on its location, but include severe pain and shock, and may include nausea and vomiting, as well as other symptoms.
Examples include alteplase, recombinant (Activase), a thrombolytic enzyme, and the thrombolytic agent, streptokinase (Streptase).
Early ambulation, preferably on the day of surgery, assists circulation, improves respiration, prevents lung congestion, and aids in voiding and bowel activity. The flow-activated incentive spirometer usually consists of one or more balls in a vertical tube. It is caused by venous stasis (the slowing or stopping of venous blood return) as a result of increased clotting, lack of activity, increased pressure within vessels, and other factors. Probably the most life-threatening embolism is a blood clot that lodges in the small vessels of the lung, a pulmonary embolism.
These agents must be used with caution after surgery because they may interfere with clot formation in the surgical incision, while dissolving the thrombi that caused the embolism. Because deep breaths (volume) are the objective, the length of time the client suspends the ball at the top of the tube determines the depth of the breath. Signs of a pulmonary embolism include difficult breathing, sharp chest pain, cough, cyanosis, rapid respirations and heart rate, and severe anxiety (Taylor, Lillis, LeMone, & Lynn, 2011). Volume-activated devices come in many shapes, but because they measure volume directly, they make it easier for the client to understand when he or she has accomplished a deep breath.
Clients at highest risk for DVT are those over age 40 with prior thromboembolism and who are undergoing major surgery on the lower extremities.
In addition, the use of graduated compression stockings and intermittent pneumatic compression devices can help prevent DVT.



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