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 during
exercises.
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

Challenged Patients
May need additional assistance, support, and
follow-up teaching to learn to perform the exercises
independently and following a prescribed schedule.
Relevant Nursing Diagnoses
Risk for altered tissue perfusion related to
immobility
Risk for impaired gas exchange related to
pulmonary embolus
Expected Outcome
Patient will have optimal circulation in lower
extremities postoperatively and without developing
thrombophlebitis
Implementation
1. Identify patient; explain purpose, procedure, and
how patient can assist in learning these exercises.
Assess patients or family members ability to
participate.

Rationale: Meets patients right to be informed that

these exercises will prevent pooling of blood in the
lower extremities after surgery and will prevent clot
formation; encourages cooperation and
participation.
2. Wash hands and don clean gloves.
Rationale: Reduces transmission of infectious
microorganisms.
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.

6. Repeat procedure with other leg.

Rationale: Ensures consistency of exercising both
lower extremities.
7. Complete sequence 510 times each hour while
awake.
Rationale: Ensures consistent and constant optimal
circulation 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.

10. Repeat sequence 5 times each hour while

awake.
Rationale: Ensures consistent and optimal blood
circulation 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 to
the foot.
12. Repeat sequence 5 times each hour while
awake.
Rationale: Ensures consistent optimal blood
circulation to lower extremities.
13. If you used gloves to assist patient with leg
exercises, remove them and wash hands.
Rationale: Prevents transmission of infectious
microorganisms.
Evaluation and follow up activities

 Evaluate patient compliance and ability to

participate/perform exercises
Patient performed exercises correctly and
consistently as instructed
Patients circulation is improved and without
postoperative thrombophlebitis