DOI: https://doi.org/10.14710/nmjn.v12i2.45394

Application of Breathing Exercises Using Ida Jean Orlando’s Dynamic Nurse-Patient Relationship Model in Overcoming Postoperative Hypoxia (POH) after Coronary Artery Bypass Grafting: A Case-Series

*Ismail Fahmi orcid scopus publons  -  Department of Nursing, Jambi Polytechnic of Health, Indonesia
Elly Nurachmah  -  Departement of Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia
Hermin Esti Dyaningtyas  -  Clinical Nurse Specialist Program in Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia
Musaddad Kamal  -  Clinical Nurse Specialist Program in Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia
Amelia Ganefianty scopus  -  Clinical Nurse Specialist Program in Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia
Open Access Copyright (c) 2022 Nurse Media Journal of Nursing
Creative Commons License This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Citation Format:
Abstract

Background: Postoperative hypoxia (POH) is a complication that often occurs in patients after Coronary Artery Bypass Grafting (CABG). Breathing exercises are considered effective in overcoming POH after CABG. However, this intervention has not been implemented using the dynamic nurse-patient relationship model from Ida Jean Orlando. The dynamic nurse-patient relationship model is expected to improve the quality of nursing care after cardiac surgery.

Purpose: This study aimed to describe the application of breathing exercises in postoperative hypoxia after CABG using the dynamic nurse-patient relationship model.

Methods: This study was the summary of the case presentation along with the interventions on three patients after CABG through the dynamic nurse-patient relationship model approach with the main intervention focusing on breathing exercises.

Results: After three days of implementing the intervention, most patients showed improvement in POH. This condition was evidenced by an increase in the PaO2/FiO2 ratio from less than 200 to above 200, with an average increase of 89.3. The blood gas analysis results supported the results from a respiratory alkalosis condition to a normal PH and a PaCO2 value from <35 mmHg to the normal range (35-45 mmHg). Also, X-rays of the patients showed pulmonary atelectasis improvement.

Conclusion:Applying breathing exercises in postoperative hypoxia after CABG using the dynamic nurse-patient relationship model can improve POH in post-cardiac surgery patients. We recommend using the model theory approach because this theory can see patients’ psychological and physical changes dynamically in post-CABG patients.

 

Fulltext View|Download
Keywords: Breathing exercise; CABG; Ida Jean Orlando; nursing care; postoperative hypoxia

Article Metrics:

Article Info
Section: Articles
Language : EN
Recent articles
Patient Safety Competency and its Related Aspects in Professional Education among Nursing Students of Two Nursing Schools in Iran: A Comparative Study Illuminating the Experience of Stigma among Persons Living with HIV using Participative Drawing Method Factors Affecting the Quality of Life of Older People during the COVID-19 Pandemic Editorial Back Matter Editorial Front Matter More recent articles
Most cited articles
Case Study: Evidence-Based Interventions Enhancing Diabetic Foot Care Behaviors among Hospitalized DM Patients The Lived Experience of PLWHA and Partner’s Responses toward the Fulfillment of Sexual Needs Decision Making towards Maternal Health Services in Central Java, Indonesia A Review of the Quality Improvement in Discharge Planning through Coaching in Nursing Nurses’ Patient Safety Competencies in Aceh Province, Indonesia More cited articles
  1. Abdoli, S., & Safavi, S. S. (2010). Nursing students’ immediate responses to distressed clients based on Orlando’s theory. Iranian Journal of Nursing and Midwifery Research, 15(4), 178
  2. American Heart Association (AHA). (2018). The grants register 2019. Palgrave Macmillan. https://doi.org/10.1007/978-1-349-95810-8_75
  3. Badenes, R., Lozano, A., & Belda, F. J. (2015). Postoperative pulmonary dysfunction and mechanical ventilation in cardiac surgery. Critical Care Research and Practice, 2015, 1-8. https://doi.org/10.1155/2015/420513
  4. Corley, A., Caruana, L. R., Barnett, A. G., Tronstad, O., & Fraser, J. F. (2011). Oxygen delivery through high-flow nasal cannulae increase end-expiratory lung volume and reduce respiratory rate in post-cardiac surgical patients. British Journal of Anaesthesia, 107(6), 998–1004. https://doi.org/10.1093/bja/aer265
  5. El-Kader, S. M. A. (2018). Blood gases response to different breathing modalities in phase I of cardiac rehabilitation program after coronary artery bypass graft. Electronic Journal of General Medicine, 8(2), 85-91. https://doi.org/10.29333/ejgm/82706
  6. Eltorai, A. E. M., Baird, G. L., Pangborn, J., Eltorai, A. S., Antoci, V., Paquette, K., Connors, K., Barbaria, J., Smeals, K. J., Riley, B., Patel, S. A., Agarwal, S., Healey, T. T., Ventetuolo, C. E., Sellke, F. W., & Daniels, A. H. (2018). Financial impact of incentive spirometry. Inquiry: The Journal of Health Care Organization, Provision, and Financing, 55, 1-8. https://doi.org/10.1177/0046958018794993
  7. Gaudet, C., & Howett, M. (2018). Communication and technology: Ida Orlando’s theory applied. Nursing Science Quarterly, 31(4), 369-373. https://doi.org/10.1177%2F0894318418792891
  8. Guan, Z., Lv, Y., Liu, J., Liu, L., Yuan, H., & Shen, X. (2016). Smoking cessation can reduce the incidence of postoperative hypoxemia after on-pump coronary artery bypass grafting surgery. Journal of Cardiothoracic and Vascular Anesthesia, 30(6), 1545–1549. https://doi.org/10.1053/j.jvca.2016.05.011
  9. Hussain, S. M. A., & Harky, A. (2019). Complications of coronary artery bypass grafting. International Journal of Medical Reviews, 6(1), 1-5. https://dx.doi.org/10.29252/IJMR-060101
  10. Kołodziej, T., Maciejewski, T., Mendrala, K., Darocha, T., Węglarzy, A., Budziarz, B., Kiermasz, K., & Kucewicz-czech, E. M. (2019). Enhanced recovery after cardiac surgery. Nursing, 48(11), 31-32. https://doi.org/10.1097/01.nurse.0000547797.15775.7a
  11. Li, M., Zhang, J., Gan, T. J., Qin, G., Wang, L., Zhu, M., Zhang, Z., Pan, Y., & Ye, Z. (2018). European Journal of Cardio-thoracic Surgery, 54(March), 491–497. https://doi.org/10.1093/ejcts/ezy100
  12. Lopatina, E., Donald, F., DiCenso, A., Martin-Misener, R., Kilpatrick, K., Bryant-Lukosius, D., Carter, N., Reid, K., & Marshall, D. A. (2017). Economic evaluation of nurse practitioner and clinical nurse specialist roles: A methodological review. International Journal of Nursing Studies, 72(2), 71–82. https://doi.org/10.1016/j.ijnurstu.2017.04.012
  13. May, B. A. (2013). Orlando’s nursing process theory in nursing practice. MR Alligood (Ed.), Nursing theory: Utilization and practice, 285-302. Elsevier
  14. Nicholson, A., Lowe, M. C., Parker, J., Lewis, S. R., Alderson, P., & Smith, A. F. (2014). Systematic review and meta-analysis of enhanced recovery programmes in surgical patients. Journal of British Surgery, 101(3), 172–188. https://doi.org/10.1002/bjs.9394
  15. Noss, C., Prusinkiewicz, C., Nelson, G., Patel, P. A., Augoustides, J. G., & Gregory, A. J. (2018). Enhanced recovery for cardiac surgery. Journal of Cardiothoracic and Vascular Anesthesia, 32(6), 2760–2770. https://doi.org/10.1053/j.jvca.2018.01.045
  16. PERKI. (2015). Pedoman tatalaksana sindroma koroner akut [Guidelines for the management of acute coronary syndromes]. Centra Communications
  17. Ranucci, M., Ballotta, A., La Rovere, M. T., & Castelvecchio, S. (2014). Postoperative hypoxia and length of intensive care unit stay after cardiac surgery: The underweight paradox?. PLoS ONE, 9(4), 1–8. https://doi.org/10.1371/journal.pone.0093992
  18. Salifu, D. A., Heymans, Y., & Christmals, C. D. (2022). Facilitating the development of clinical competence in a low-resource setting: Perceptions and challenges of nurse educators. Nurse Media Journal of Nursing, 12(1), 42-60. https://doi.org/10.14710/nmjn.v12i1.43995
  19. Shakuri, S. K., Salekzamani, Y., Taghizadieh, A., Sabbagh-Jadid, H., Soleymani, J., Sahebi, L., & Sahebi, R. (2015). Effect of respiratory rehabilitation before open cardiac surgery on respiratory function: A randomized clinical trial. Journal of Cardiovascular and Thoracic Research, 7(1), 13–17. https://doi.org/10.15171/jcvtr.2014.03
  20. Sheldon, L. K., & Ellington, L. (2008). Application of a model of social information processing to nursing theory: How nurses respond to patients. Journal of Advanced Nursing, 64(4), 388-398. https://doi.org/10.1111/j.1365-2648.2008.04795.x
  21. Stephens, R. S., Shah, A. S., & Whitman, G. J. R. (2013). Lung injury and acute respiratory distress syndrome after cardiac surgery. Annals of Thoracic Surgery, 95(3), 1122–1129. https://doi.org/10.1016/j.athoracsur.2012.10.024
  22. Sutton, A. D. J., Bailey, M., Bellomo, R., Eastwood, G. M., & Pilcher, D. V. (2014). The association between early arterial oxygenation in the ICU and mortality following cardiac surgery. Anaesthesia and Intensive Care, 42(6), 730–735. https://doi.org/10.1177/0310057x1404200608
  23. Thielmann, M., Sharma, V., Al-Attar, N., Bulluck, H., Bisleri, G., Bunge, J. J. H., Czerny, M., Ferdinandy, P., Frey, U. H., Heusch, G., Holfeld, J., Kleinbongard, P., Kunst, G., Lang, I., Lentini, S., Madonna, R., Meybohm, P., Muneretto, C., Obadia, J. F., … Hausenloy, D. J. (2017). ESC Joint Working Groups on Cardiovascular Surgery and the Cellular Biology of the Heart Position Paper: Peri-operativemyocardial injury and infarction in patients undergoing coronary artery bypass graft surgery. European Heart Journal, 38(31), 2392–2411. https://doi.org/10.1093/eurheartj/ehx383
  24. Wynne, R., & Botti, M. (2004). Postoperative pulmonary dysfunction in adults after cardiac surgery with cardiopulmonary bypass: Clinical significance and implications for practice. American Journal of Critical Care, 13(5), 384–393. https://doi.org/10.4037/ajcc2004.13.5.384
  25. Yazdannik, A., Bollbanabad, H. M., Mirmohammadsadeghi, M., & Khalifehzadeh, A. (2016). The effect of incentive spirometry on arterial blood gases after coronary artery bypass surgery (CABG). Iranian Journal of Nursing and Midwifery Research, 21(1), 89–92. https://doi.org/10.4103/1735-9066.174761
  26. Yekefallah, L., Ashktorab, T., Ghorbani, A., Pazokian, M., Azimian, J., & Samimi, R. (2017). Orlando’s nursing process application on anxiety levels of patients undergoing endoscopy examination. International Journal of Epidemiologic Research, 4(1), 53-60
  27. Yousefshahi, F., Samadi, E., Paknejad, O., Hagh, E. B., & Aminzadeh, S. (2019). Effect of hypoxemia in the determination of short-term prognosis of coronary artery bypass graft patients: A prospective study. Anesthesiology and Pain Medicine, 9(1), 1–7. https://doi.org/10.5812/aapm.81785

Last update:

No citation recorded.

Last update: 2023-09-22 22:06:06

No citation recorded.