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; Elly Nurachmah; Hermin Esti Dyaningtyas; Musaddad Kamal; Amelia Ganefianty

doi:10.14710/nmjn.v12i2.45394

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

- 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

- Clinical Nurse Specialist Program in Medical-Surgical Nursing, Faculty of Nursing, Universitas Indonesia, Indonesia

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

BibTex Citation Data :

@article{NMJN45394,
    author = {Ismail Fahmi and Elly Nurachmah and Hermin Esti Dyaningtyas and Musaddad Kamal and Amelia Ganefianty},
    title = {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},
    journal = {Nurse Media Journal of Nursing},
  volume = {12},
    number = {2},
    year = {2022},
    keywords = {Breathing exercise; CABG; Ida Jean Orlando; nursing care; postoperative hypoxia},
    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.   },
   issn = {2406-8799},   pages = {249--257}  doi = {10.14710/nmjn.v12i2.45394},
    url = {https://ejournal.undip.ac.id/index.php/medianers/article/view/45394}
}

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

In Vol 12, No 2 (2022): (August 2022)

Recent articles

Factors Affecting the Quality of Life of Older People during the COVID-19 Pandemic Quality of Clinical Nursing Education Programme in Ghana: Preceptors’ Perspectives The Challenges of Intensive Care Unit Nurses Caring for COVID-19 Patients in Indonesia: A Qualitative Study Editorial Back Matter Editorial Front Matter More recent articles

Most cited articles

EFFECTIVENESS OF MUSIC THERAPY TOWARD REDUCING PATIENT’S ANXIETY IN INTENSIVE CARE UNIT Nurses’ Patient Safety Competencies in Aceh Province, Indonesia Review: Anxiety and Quality of life in Patients with Myocardial Infarction Nausea, Vomiting and Retching of Patients with Cervical Cancer undergoing Chemotherapy in Bali, Indonesia Nursing Students’ Attitudes towards Caring for Dying Patients More cited articles

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
American Heart Association (AHA). (2018). The grants register 2019. Palgrave Macmillan. https://doi.org/10.1007/978-1-349-95810-8_75
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
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
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
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
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
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
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
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
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
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
May, B. A. (2013). Orlando’s nursing process theory in nursing practice. MR Alligood (Ed.), Nursing theory: Utilization and practice, 285-302. Elsevier
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
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
PERKI. (2015). Pedoman tatalaksana sindroma koroner akut [Guidelines for the management of acute coronary syndromes]. Centra Communications
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
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
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
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
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
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
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
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
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
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
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: 2024-12-26 06:08:05

No citation recorded.

This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.

Journal Author(s) Rights

In order for the Department of Nursing, Faculty of Medicine, Universitas Diponegoro to publish and disseminate research articles, we need non-exclusive publishing rights (transferred from the author(s) to the publisher). This is determined by a publishing agreement between the author(s) and the Department of Nursing, Faculty of Medicine, Universitas Diponegoro. This agreement involves the transfer or licensing of the copyright for publishing to the publisher, while authors still retain significant rights to use and share their own published articles. The Department of Nursing, Faculty of Medicine, Universitas Diponegoro supports the need for authors to share, disseminate, and maximize the impact of their research through these rights in any databases.

As the author(s), you have rights to a wide range of uses of your article, including use by your employing institution or company. These author rights can be exercised without the need to obtain specific permission. Authors publishing in the Nurse Media Journal of Nursing have extensive rights to use their works for teaching and scholarly purposes without needing to seek permission, including:

use for classroom teaching by the author or the author’s institution and presentation at a meeting or conference, including distributing copies to attendees;
use for internal training by the author’s company;
distribution to colleagues for their research use;
use in a subsequent compilation of the author’s works;
inclusion in a thesis or dissertation;
reuse of portions or extracts from the article in other works (with full acknowledgment of the final article);
preparation of derivative works (other than for commercial purposes) (with full acknowledgment of the final article);
voluntary posting on open websites operated by the author or the author’s institution for scholarly purposes;

following the open access license of the Creative Commons CC BY-SA License.

Authors, readers, and third parties can copy and redistribute the material in any medium or format, as well as remix, transform, and build upon the material for any purpose, even commercially, but they must give appropriate credit (including the name of the creator and attribution parties, detailed information about the authors, a copyright notice, an open access license notice, a disclaimer notice, and a link to the material), provide a link to the license, and indicate if changes were made. The publisher will indicate any modification of the material (if any) and retain an indication of previous modifications using a CrossMark Policy and information about Erratum-Corrigendum notifications.

Authors, readers, and third parties can read, print, and download, redistribute or republish the article (e.g., display it in a repository), translate the article, download it for text and data mining purposes, reuse portions or extracts from the article in other works, sell or reuse it for commercial purposes, remix, transform, or build upon the material. They must distribute their contributions under the same license as the original Creative Commons Attribution-ShareAlike (CC BY-SA).

Copyright Transfer Agreement for Publishing (Publishing Right)

The Authors submitting a manuscript do so on the understanding that if accepted for publication, non-exclusive right for publishing (publishing right) of the article shall be assigned/transferred to Publisher of the Nurse Media Journal of Nursing (Department of Nursing, Faculty of Medicine, Universitas Diponegoro).

Upon acceptance of an article, authors will be asked to complete a 'Copyright Transfer Agreement for Publishing (CTAP)'. An e-mail will be sent to the Corresponding Author confirming receipt of the manuscript together with a 'Copyright Transfer Agreement for Publishing' form by online version of this agreement.

Nurse Media Journal of Nursing and Department of Nursing, Faculty of Medicine, Universitas Diponegoro, the Editors and the Editorial Board make every effort to ensure that no wrong or misleading data, opinions or statements be published in the journal. In any way, the contents of the articles and advertisements published in the Nurse Media Journal of Nursing are sole and exclusive responsibility of their respective authors and advertisers.

Please note that even though we ask for a transfer of copyright for publishing (CTAP), our journal Author(s) retain (or are granted back) significant scholarly rights as mentioned before.

The Copyright Transfer Agreement for Publishing (CTAP) Form can be downloaded here: [Copyright Transfer Agreement for Publishing (CTAP) Form NMJN 2024]

The copyright form should be signed electronically and send to the Editorial Office in the form of original e-mail below:

Dr. Meira Erawati (Editor-in-Chief)
Editorial Office of Nurse Media Journal of Nursing
Department of Nursing, Faculty of Medicine, Universitas Diponegoro
Jl. Prof. Soedarto, Tembalang, Semarang, Central Java, Indonesia 50275
Telp.: +62-24-76480919; Fax.: +62-24-76486849
E-mail: media_ners@live.undip.ac.id

(This policy statements has been updated at 24th January 2024)

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

Journal Author(s) Rights

Copyright Transfer Agreement for Publishing (Publishing Right)

OFFICE INFORMATION