TEACHING THE CLIENT COUGHING EXERCISES

I. DEFINITION
Coughing – is the type of exercise which involves contraction of expiratory intercostals
muscles, an upward push of the diaphragm to force air to be expelled and expel liquid or
solid out of the respiratory tract.

II. PURPOSES
1. To protect clients against accumulation of secretions in the bronchi and bronchioles.
2. To mobilize and remove bronchial secretion and exudates.
3. To improve pulmonary ventilation.

III. EQUIPMENT
Hospital bed in upright position or a straight chair
Pillows for positioning and abdominal support
Waste receptacle

IV. PLANNING AND IMPLEMENTATION

ACTION RATIONALE
1. Wash your hands To avoid or reduce the number of bacterial floor

2. Provide privacy. For clients comfort

3. Place client in sitting position Comfortable position and aspiration of secretions

can be prevented.

For Post – operative client the nurse should

instruct the following:
a. Pre-operatively he should be assured that This can support the incisional area which can be
coughing post-operatively will not “break prevent pain and encourage client to cough more
his incision open” an informed that he will effectively.
be assisted to cough every hour.
b. The nurse’s hands should support the
post-op incision or small, firm pillow or The abdominal accessory respiratory muscle
rolled towel may be placed over the should be used to make the cough more effective.
incision area.
c. The client is instructed to take several
deep breath, inhale and cough forcibly.
4. Have then client then take another deep Accumulated secretions in the lungs can
breath and give more strong coughs. compromise the bronchioles.

5. Offer adequate mouth hygiene The client’s appetite may be lessened due to the
odor and the taste in his mouth.

6. Offer citrus juice. Makes the mouth feel fresher make the client is
then receptive to the meal

V. EVALUATION AND DOCUMENTATION

1. Record the amount, and odor of the sputum.

 TRACHEOSTOMY SUCTIONING CHECKLIST

PROCEDURE 3 2 1 0
1. Wash your hands
2. Provide privacy.
3. Place client in sitting position
For Post-operative client the nurse should instruct the following:
a. Pre-operatively he should be assured that coughing post-operatively
will not “break his incision open” an informed that he will be assisted
to cough every hour.
b. The nurse’s hands should support the post-op incision or small, firm
pillow or rolled towel may be placed over the incision area.
c. The client is instructed to take several deep breath, inhale and cough
forcibly.
4. Have the client then take another deep breath and give more strong
coughs.
5. Offer adequate mouth hygiene.
6. Offer citrus juice.

Legend:
3 - Performed in the exact manner as stated in the procedure with in-depth explanation of rationale
2- Performed in the exact manner in the procedure but the rationale is unclear and less in-depth
1 - Performed the procedure without explanation of the rationale
0 - Not performed

Rating: __________

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Signature of Clinical Instructor over Printed Name Signature of Student