monitoring B/P before and after administering negative isotropic agents (e.g. propranonl), vasodilators,and narcotic analgesics, consult physician before giving negative inotropic and vasodilating agents if B/P is below 11/70 mm Hg.(50), the present study revealed as regard table (2) mean score of vital signs immediately after operation, after 15 min and after one hour, and there were an improement, while table(3) revealed that there were an improvement of 24 hour urine collection after operation and at the fifth day ,represented by creatinine clearance, urea nitrogen, sodium, chlorid, calcium, and as regard (4) demonstrated paired sample correlations of arterial blood gases immediately after operation and at the fifth day, also as regard table (5) Hemodynamic monitoring immediately after operation ,after one ,and four hours were improved also as regard table (6)Demonstrated an improvement of CVP, plumonary artery pressure (Swan Ganz), cardiac output of the patients were improved, also as table (8) presented the percentages of immediate post-operative complications ,after one ,four and six hours, also table (9&10) and there were an improvements. Ineffective airway clearance related to: stasis of secretions associated with decreased activity and poor cough effort resulting from depressant effects of anesthesia and some medications (narcotic analgesics, muscle relaxants) pain, weakness, and fatigue, increased secretions associated with irritation of the respiratory tract. (40). Facilitate removal of pulmonary secretions by liquefy tenacious secretions: maintain a fluid