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The appropriate action for a patient who has just undergone a total abdominal hysterectomy is to have the patient use a pillow while doing coughing and deep breathing exercises. This approach is essential for several reasons.

Post-surgery, particularly after abdominal procedures, patients may experience discomfort or pain during deep breathing and coughing due to surgical trauma. By using a pillow, the patient can apply gentle pressure on their abdomen, which can help to reduce discomfort and provide support to the surgical site. This technique can facilitate more effective coughing and breathing exercises, which are crucial for preventing respiratory complications such as atelectasis and pneumonia.

Additionally, encouraging coughing and deep breathing helps to promote lung expansion, ensuring that the airways remain clear and that the patient maintains adequate oxygenation. It is an integral part of post-operative care to enhance recovery and reduce the risk of complications.

Other options may not prioritize the patient's comfort or safety effectively. For example, immediate ambulation is typically encouraged after some time has passed to ensure that the patient is stable and can tolerate movement. Offering pain medication independently of nursing staff could overlook important assessments that should be made by the nurse regarding the patient's condition. Lastly, instructing the patient to avoid breathing exercises would be contrary to established post-operative care practices