(d) Noise. Sounds such as rattling or bubbling sounds indicate
(e) Stridor. Stridor is a high-pitched whistling sound, usually with
inhalation. Stridor is a serious sign that indicates an upper airway obstruction.
e. Unusual Position. Sometimes a patient will position himself in order to make
breathing easier. For example, a patient may lean forward and brace his arms against
his knees or the bed in order to breathe more normally. This is known as the tripod
position and should be noted during your assessment.
f. Coughing. A cough is a sudden and noisy expulsion of air from the lungs. It
is usually produced to remove secretions and foreign matter (dust, smoke, sprays, and
so forth) from the lungs. A cough can be acute or chronic, productive or nonproductive.
Acute. An acute cough is a cough that came on suddenly.
Chronic. A chronic cough is a cough that has existed for a long time (not
(3) Productive. A productive cough is a cough accompanied by sputum
expelled from the lungs.
(4) Nonproductive. A nonproductive cough does not contain sputum. It is
also called a dry cough.
g. Sputum. Sputum is mucous material that is expelled (coughed up) from the
lungs. It is not saliva. Saliva is produced by the salivary glands in the mouth to keep
the mouth moist and to help in the chewing and swallowing of food. If the patient's
cough is productive, note the amount, color, character, and odor of the sputum.
Amount. The amount may be scant, moderate, or copious.
(a) Scant. Scant means a small amount.
Copious. Copious means a large amount.
Moderate. A moderate amount is more than scant but less than
(2) Color. Normal sputum is clear. Abnormal sputum, such as caused by a
lung disease, may be green, yellow, reddish or pinkish (mixed with blood), or gray.