2-13
Section IV. SPECIAL NURSING MANAGEMENT
2-13. COUGHS AND DEEP BREATHE
a. Unless contraindicated, coughing is encouraged in order to clear mucous secretions from the trachea and bronchi. If secretions are allowed to accumulate, they block the air passages and prevent air from reaching lung tissue. Effective coughing, deep breathing, and change of position are all measures that help to promote complete aeration of lung tissue in bedridden, debilitated, and postoperative patients. When coughing is
prescribed, teach and assist the patient to cough effectively. It can often be a painful experience, and the
patient may try to suppress the cough, give a small "hacking" cough, or merely clear his throat. The
patient can cough most effectively in the sitting position.
b. Using good body mechanics assist the patient to sit upright in bed or in a stable straight-backed chair. If the patient is unable to sit up, assist him to a supine position and raise the head of the bed if permissible. Provide tissue and an emesis basin for the expectorated secretions. Instruct the patient to inhale deeply, cough on exhalation, and expectorate the coughed-up secretions into the tissue or basin. Repeat the procedure several times in order to clear the air passages. Assist the patient into a comfortable position and document the results of the procedure.
