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.
a. Percussion, a method of tapping massage, is done to mobilize secretions, to
aid in expansion of lung tissue, and to promote efficient use of respiratory muscles.
b. Prior to administering percussion, review the patient's chart to determine the
reason or purpose for the treatment. Familiarize yourself with the patient's diagnosis
and condition. Discuss the procedure with the patient and assemble the necessary
(1) Suction equipment, if necessary, to remove secretions that cannot be
Toothpaste, toothbrush, basin.
Pillows to help support the patient in the desired position.
When administering percussion, it is necessary to observe the following
a. Avoid fatiguing the patient by modifying positions according to the patient's
b. Avoid performing percussion immediately before or within one hour after
meals to avoid nausea, vomiting, and aspiration.
c. Avoid percussing over the spine, liver, kidneys, or spleen to avoid injury.