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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
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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.


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Keywords: Breathing exercise; CABG; Ida Jean Orlando; nursing care; postoperative hypoxia

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