After abdominal surgery, which position improves ventilation and helps prevent atelectasis?

• A. Supine
• B. Semi-Fowler's position with incentive spirometry
• C. Trendelenburg
• D. Prone

Answer: (B)

Preventing atelectasis after abdominal surgery hinges on maximizing lung expansion and promoting deep breathing. The best approach combines a position that eases diaphragmatic movement with an active breathing technique. Elevating the head of the bed to about 30–45 degrees (Semi-Fowler's) reduces abdominal pressure on the diaphragm, allowing greater chest expansion and easier, deeper breaths. Pairing this with incentive spirometry gives the patient a concrete, repetitive target to inhale slowly and deeply, which helps recruit and reopen collapsed alveoli and improves overall ventilation.

Lying flat can impede diaphragmatic movement because abdominal contents push against the diaphragm, increasing the risk of atelectasis. A Trendelenburg position (head down) further increases abdominal pressure and is not favorable for ventilation. The prone position places the chest and abdomen under pressure and is not practical or beneficial for immediate post-op breathing in this scenario.