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TEACHING POST-OPERATIVE LEG EXERCISES

Purpose:

a. To prevent postoperative complications, (i.e.,

thrombophlebitis).

b. To promote optimal circulation in lower

extremities.

Preparation:

Review history related to recent surgical

procedure(s), peripheral vascular disease, and/or

thrombophlebitis.

Assess for pain/discomfort before and duringexercises.

Determine patients ability to understand,

cooperate, and participate in the procedure.

Determine patients ability to perform exercises

independently after initial instructions.

Special Considerations:

Pediatric, Elderly, and Physically and Mentally

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Challenged Patients

May need additional assistance, support, and

follow-up teaching to learn to perform the exercisesindependently and following a prescribed schedule.

Relevant Nursing Diagnoses

Risk for altered tissue perfusion related to

immobilityRisk for impaired gas exchange related to

pulmonary embolus

Expected Outcome

Patient will have optimal circulation in lowerextremities postoperatively and without developing

thrombophlebitis

Implementation

1. Identify patient; explain purpose, procedure, andhow patient can assist in learning these exercises.

Assess patients or family members ability to

participate.

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Rationale: Meets patients right to be informed that

these exercises will prevent pooling of blood in the

lower extremities after surgery and will prevent clotformation; encourages cooperation and

participation.

2. Wash hands and don clean gloves.

Rationale: Reduces transmission of infectiousmicroorganisms.

3. Place patient in supine or semi-Fowlers position.

Rationale: Patient comfort.

4. Instruct patient to bend knee, raise foot in air,

and hold in this position for 23 seconds.

Rationale: Circulates blood from lower extremities

back to body.

5. Have patient extend leg and lower it to bed.

Rationale: Extends muscles and circulates blood

from lower extremities to upper body.

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6. Repeat procedure with other leg.

Rationale: Ensures consistency of exercising bothlower extremities.

7. Complete sequence 510 times each hour while

awake.

Rationale: Ensures consistent and constant optimalcirculation to lower extremities.

8. Instruct patient to extend toes (plantar flexion)

toward bottom of bed, then flex (dorsiflexion)

toward head of bed.Rationale: Optimizes blood circulation from feet to

legs.

9. Repeat foot extension and flexion with the other

side.Rationale: To be consistent for both lower

extremities.

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10. Repeat sequence 5 times each hour while

awake.

Rationale: Ensures consistent and optimal bloodcirculation to lower extremities.

11. Instruct patient to make circles with the ankle

moving first to the left and then to the right.

Rationale: Promotes optimal blood circulation tothe foot.

12. Repeat sequence 5 times each hour while

awake.

Rationale: Ensures consistent optimal bloodcirculation to lower extremities.

13. If you used gloves to assist patient with leg

exercises, remove them and wash hands.

Rationale: Prevents transmission of infectiousmicroorganisms.

Evaluation and follow up activities

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Evaluate patient compliance and ability to

participate/perform exercises

Patient performed exercises correctly andconsistently as instructed

Patients circulation is improved and without

postoperative thrombophlebitis

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