Deep Breathing, Coughing, and Moving After Surgery

Deep Breathing, Coughing, and Moving After
Surgery
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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.
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.
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.
Breathing & Coughing Exercises

The following is a guideline for breathing and coughing exercises. During clinical
assessment, students will be automatically failed if those steps highlighted with an
underline and bolded are not performed according to the guidelines.
1. Introduces self
2. Provides explanation
3. Seeks permission to perform procedure
4. Enlists patient participation
5. Obtains history
6. Provides privacy
7. Ascertains need for analgesia
8. Assesses breath sounds as per physical examination: auscultation of the chest
guidelines (if applicable)
9. Ensures tissues and sputum receptacles are within reach
10.Demonstrates the following deep (diaphragmatic) breathing exercises:
a) places hands palm down on the border of the rib cage and inhales
slowly and evenly through the nose until the greatest chest expansion
is achieved
(b) holds the breath for 2-3 seconds, exhales slowly through the mouth
with pursed lips and continues exhalation until maximum chest
contraction is achieved
11. Assists patient to sitting position
12. If patient is unable to sit instructs patient to bend knees to reduce tension on the
back and abdominal muscles
13. Instructs patient to do three deep breathing exercises
 (a) asks the patient to inhale deeply, hold the breath for a few seconds,
and then cough one or two times
 (b) ensures that the patient coughed deeply and did not just clear the
throat
14. FOR SURGICAL PATIENT: Demonstrates how the nurse or patient could
support (splint) the incision post-operatively as the patient coughs that is;
(a) places the palms of the hands on either side of the incision, or directly over
the incision, holding the palm of one hand over the other
(b) instructs the patient how to splint the incision independently with a firmly
rolled
(c) instructs the patient to start the exercises as soon as he or she is able after
surgery.
15. Encourages patients with abdominal or chest surgery to carry out deep breathing
and coughing at least three or four times daily and at each session to take a minimum
of five breaths and not greater than twelve in any one session
16. Explains to the patient that deep breathing and coughing exercises will increase
lung expansion and prevent the accumulation of secretions, which might occur after
anaesthesia or during prolonged bedrest
17. Notes characteristics of any sputum expectorated and documents observations in

the medical records plus, identifies the role of a RN if abnormal sputum
characteristics noted
18. Terminates encounter suitably

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Deep Breathing, Coughing, and Moving After

Deep Breathing Exercises

Do these exercises every hour while you’re awake.

If your surgeon says you can:

Breathing & Coughing Exercises

11. Assists patient to sitting position

13. Instructs patient to do three deep breathing exercises

17. Notes characteristics of any sputum expectorated and documents observations in

18. Terminates encounter suitably

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