Cough is a protective reflex that helps clear the airways of secretions, foreign particles, and irritants. This nursing diagnosis focuses on identifying types of cough and associated symptoms and implementing appropriate interventions to manage cough effectively while preventing complications.
Causes (Related to)
Cough can be triggered by various factors affecting respiratory function:
- Airway inflammation or irritation
- Respiratory tract infections (viral, bacterial)
- Chronic conditions:
- Asthma
- COPD
- Bronchiectasis
- Gastroesophageal reflux disease (GERD)
- Environmental factors:
- Allergens
- Pollutants
- Smoke exposure
- Medications (e.g., ACE inhibitors)
- Postnasal drip
- Psychological factors (habit cough)
Signs and Symptoms (As evidenced by)
Subjective: (Patient reports)
- Urge to cough
- Chest discomfort or tightness
- Throat irritation
- Difficulty sleeping
- Fatigue from persistent coughing
- Anxiety about coughing episodes
- Sputum production
Objective: (Nurse assesses)
- Cough characteristics (dry/productive)
- Sputum characteristics
- Respiratory rate and pattern
- Breath sounds
- Use of accessory muscles
- Oxygen saturation levels
- Signs of respiratory distress
- Evidence of dehydration
Expected Outcomes
- The patient will demonstrate effective cough suppression techniques
- The patient will maintain clear airways
- The patient will show improved sleep patterns
- The patient will maintain adequate hydration
- The patient will report decreased frequency and severity of cough
- The patient will demonstrate proper sputum clearance techniques
- The patient will avoid complications
Nursing Assessment
Evaluate Cough Characteristics
- Frequency and timing
- Type (productive/nonproductive)
- Triggers and alleviating factors
- Associated symptoms
- Impact on daily activities
Assess Respiratory Status
- Breathing patterns
- Lung sounds
- Oxygen saturation
- Use of accessory muscles
- Presence of dyspnea
Monitor Hydration Status
- Fluid intake
- Mucous membrane moisture
- Skin turgor
- Urine output
- Sputum consistency
Evaluate Risk Factors
- Medical history
- Environmental exposures
- Medications
- Recent infections
- Occupational hazards
Nursing Care Plans
Nursing Care Plan 1: Ineffective Breathing Pattern
Nursing Diagnosis Statement:
Ineffective Breathing Pattern related to airway inflammation as evidenced by a persistent cough and altered respiratory pattern.
Related Factors:
- Airway irritation
- Inflammation
- Increased secretions
- Anxiety
Nursing Interventions and Rationales:
- Position the patient upright or semi-Fowler’s
Rationale: Optimizes lung expansion and reduces work of breathing - Teach pursed-lip breathing
Rationale: Helps control breathing and reduces anxiety - Monitor respiratory rate and pattern
Rationale: Identifies changes in respiratory status
Desired Outcomes:
- The patient will demonstrate an improved breathing pattern.
- The patient will report decreased work of breathing
- The patient will maintain oxygen saturation >95%
Nursing Care Plan 2: Ineffective Airway Clearance
Nursing Diagnosis Statement:
Ineffective Airway Clearance related to excessive secretions as evidenced by persistent cough with difficulty expectorating.
Related Factors:
- Thick secretions
- Inflammation
- Fatigue
- Ineffective cough
Nursing Interventions and Rationales:
- Perform chest physiotherapy as ordered
Rationale: Mobilizes secretions - Encourage deep breathing and coughing exercises
Rationale: Promotes effective secretion clearance - Maintain adequate hydration
Rationale: Thins secretions for easier expectoration
Desired Outcomes:
- The patient will demonstrate an effective cough technique.
- The patient will show improved secretion clearance
- The patient will maintain a patent airway
Nursing Care Plan 3: Disturbed Sleep Pattern
Nursing Diagnosis Statement:
Disturbed Sleep Pattern related to persistent cough as evidenced by frequent nighttime awakening and daytime fatigue.
Related Factors:
- Nocturnal cough
- Anxiety
- Physical discomfort
- Environmental factors
Nursing Interventions and Rationales:
- Elevate the head of the bed
Rationale: Reduces postnasal drip and nocturnal cough - Administer medications as prescribed
Rationale: Controls cough during sleep hours - Promote relaxation techniques
Rationale: Reduces anxiety and promotes sleep
Desired Outcomes:
- The patient will report improved sleep quality
- The patient will demonstrate increased daytime energy
- The patient will report a decreased nocturnal cough
Nursing Care Plan 4: Anxiety
Nursing Diagnosis Statement:
Anxiety related to persistent cough and fear of underlying condition as evidenced by expressed concerns and increased tension.
Related Factors:
- Persistent symptoms
- Fear of serious illness
- Social embarrassment
- Sleep deprivation
Nursing Interventions and Rationales:
- Provide education about cough management
Rationale: Increases sense of control - Teach stress reduction techniques
Rationale: Helps manage anxiety - Listen to patient concerns
Rationale: Provides emotional support
Desired Outcomes:
- The patient will report decreased anxiety
- The patient will demonstrate effective coping strategies
- The patient will verbalize understanding of the condition
Nursing Care Plan 5: Risk for Impaired Oral Mucous Membrane
Nursing Diagnosis Statement:
Risk for Impaired Oral Mucous Membrane related to mouth breathing and decreased fluid intake secondary to persistent cough.
Related Factors:
- Mouth breathing
- Dehydration
- Medications
- Oxygen therapy
Nursing Interventions and Rationales:
- Assess oral mucosa regularly
Rationale: Identifies early signs of tissue damage - Promote oral hygiene
Rationale: Maintains mucosal integrity - Encourage adequate fluid intake
Rationale: Prevents mucosal dryness
Desired Outcomes:
- The patient will maintain intact oral mucosa
- The patient will demonstrate adequate hydration
- The patient will perform proper oral care
References
- Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2023). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.
- De Blasio F, Virchow JC, Polverino M, Zanasi A, Behrakis PK, Kilinç G, Balsamo R, De Danieli G, Lanata L. Cough management: a practical approach. Cough. 2011 Oct 10;7(1):7. doi: 10.1186/1745-9974-7-7. PMID: 21985340; PMCID: PMC3205006.
- Harding, M. M., Kwong, J., & Hagler, D. (2022). Lewis’s Medical-Surgical Nursing: Assessment and Management of Clinical Problems, Single Volume. Elsevier.
- Herdman, T. H., Kamitsuru, S., & Lopes, C. (2024). NANDA International Nursing Diagnoses – Definitions and Classification, 2024-2026.
- Ignatavicius, D. D., Rebar, C., & Heimgartner, N. M. (2023). Medical-Surgical Nursing: Concepts for Clinical Judgment and Collaborative Care. Elsevier.
- McCrory DC, Coeytaux RR, Yancy WS Jr, et al. Assessment and Management of Chronic Cough [Internet]. Rockville (MD): Agency for Healthcare Research and Quality (US); 2013 Jan. (Comparative Effectiveness Reviews, No. 100.) Executive Summary. Available from: https://www.ncbi.nlm.nih.gov/books/NBK116698/
- Shuttari MF, Braun SR. Contemporary management of chronic persistent cough. Mo Med. 1992 Nov;89(11):795-800. PMID: 1291868.
- Silvestri, L. A. (2023). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.
