Which interventions likely to reduce the risk of postoperative atelectasis following abdominal surgery? (Select all that apply)

Choice C reason: Encouraging coughing and deep breathing exercises increases alveolar expansion and facilitates the clearance of secretions. Following abdominal surgery, patients tend to have shallow respirations due to pain (splinting). Deep breathing maneuvers help to re-expand collapsed alveoli, which is the primary mechanism in preventing and treating postoperative atelectasis. Choice D reason: Early ambulation is one of the most effective interventions for preventing postoperative pulmonary complications. Physical activity increases the depth of ventilation and stimulates the production of surfactant. By moving the patient out of a recumbent position, gravity helps the diaphragm descend more easily, allowing for better expansion of the lower lung lobes. Choice E reason: Assisting the patient to move and reposition in bed prevents the pooling of secretions in dependent areas of the lungs. Frequent changes in position ensure that different segments of the lung are ventilated and perfused, reducing the risk of localized alveolar collapse that occurs when a patient remains in a static supine position. Choice F reason: Sustained Maximal Inspiration (SMI), typically performed with an incentive spirometer, provides visual feedback to the patient to encourage long, deep breaths. Utilizing this device every 1 to 2 hours while awake ensures that the patient regularly reaches their inspiratory capacity, which is essential for opening collapsed small airways and alveoli. Choice G reason: Dangling or sitting the client up helps to optimize lung expansion by reducing the pressure of the abdominal contents on the diaphragm. This upright posture increases functional residual capacity and makes it easier for the patient to take the deep breaths necessary to keep the peripheral lung tissues inflated after general anesthesia.