Rehabilitation

1. Pulmonary rehabilitation training, deep breathing (exhalation: inhalation time ratio = 2:1, deep breathing 10 times/min, 3 times/day), effective coughing and expectoration (5 min/time, 3 times/day), breath-holding (supine breath-holding for 30 s, relax for 5 s, continuous practice for 5min as one time, 3 times/day), simple breathing training device (10 min/time, 3 times/day); 2. Upper limb activities: finger flexion and extension, fist clenching, shoulder and chest stretching activities, continuous practice for 10min as one time, 3 times/day; 3. Ankle pump activities for lower limbs: flexion and extension, circling movements, continuous practice for 10 min as one time, 3 times/day; 4. Turning training: patients need to turn over every 2 - 3 hours before getting out of bed.

Pain management

1. Use of pain assessment tools; 2. Pain-related knowledge education.

Thromboprophylaxis

1. Thrombosis risk assessment (Caprini assessment scale); 2. Thrombosis prevention knowledge education; 3. Training on wearing and removing elastic stockings; 4. Drug prevention.

Intraoperatively

Antibiotic use and fluid management

1. Administer drugs during surgery, prophylactic use of antibiotics during surgery; 2. Record intraoperative fluid volume.

Temperature control and thromboprophylaxis

1. Avoid intraoperative hypothermia, continuously monitor intraoperative body temperature, provide warming measures: adjust environmental temperature, use warming blankets; 2. Record intraoperative and transfer body temperature, actively raise body temperature after surgery until the patient’s temperature is >36°C; 3. Wear elastic stockings according to the situation.

Postoperatively

Diet & Nutrition

1. Inquire about postoperative nausea, vomiting, choking, abdominal distension, etc.; 2. For patients under general anesthesia, start drinking small amounts of water 4 hours after awakening, and if there is no discomfort after 6 hours, they can have a liquid diet. If there is no bloating, nausea, vomiting, etc., they can resume a normal diet within 24 hours after surgery, focusing on high-nutrition and high-protein foods; 3. Nutritional risk screening, implement nutritional supplementation according to medical orders.

Positioning and early mobility

1. If blood pressure is stable after returning to the ward, elevate the head of the bed to a semi-recumbent position; 2. For patients who are awake after anesthesia, if vital signs are stable, they can perform lung function exercises such as coughing and expectoration in a semi-sitting position; 3. For patients who are not awake after anesthesia, passive activities should be performed, and after awakening from anesthesia, active activities for the upper and lower limbs, turning over, and lifting the buttocks should be performed; 4. Patients should start getting out of bed within 24 hours after surgery; 5. Observe for any discomfort caused by activity.

Pulmonary rehabilitation management

1. Evaluate before respiratory training 2 hours after surgery, encourage patients to perform low-intensity respiratory function exercises; 2. Forms and frequency of respiratory training: active breathing cycle technique, inspiratory muscle training, diaphragmatic breathing training, effective coughing, abdominal breathing, pursed lip breathing, etc., 3 - 5 times a day, 15 - 20 minutes each time; 3. Observe if the patient experiences chest tightness, shortness of breath, or fatigue during the process, stop the exercise and instruct the patient to rest.

Airway management

Use glucocorticoids, bronchodilators, and mucolytic nebulization therapy 2 - 3 times a day.