Cough Flashcards
Describe a cough
A sudden, forceful release of air from the lungs
- Reflex triggered by irritation or obstruction
- Clears the lung passages via a rush of air
What is the cough reflex?
Step 1: Airway sensory nerves respond to pro-tussive stimulus
Step 2: Impulse travels along the VAGUS NERVE to the medulla
- The cough control center
Step 3: Medullary center sends message to respiratory pattern generator, eliciting cough response
Describe an Acute Cough:
Lasts less than 3 weeks
Usually associated with viral upper respiratory infections
List possible causes of acute cough.
- Possibly pneumonia
- Acute L ventricular failure due to stretching caused by fluid backing into lungs
- Asthma
- Foreign body aspiration
Describe a Subacute Cough:
Describe a Subacute Cough:
Lasts 3 to 8 weeks
- 3 to 4 weeks in kiddos
List possible causes of a subacute cough
- Post-infectious cough
- Bacterial sinusitis
- Asthma
Describe a Chronic Cough:
Lasting over 8 weeks in adults
- >4 weeks in kiddos
List causes of a chronic cough in non-smokers:
- Upper Airway Cough Syndrome (UACS)
- AKA Post Nasal Drip - Asthma
- GERD due to acid irritation
- CHF
- Aspiration (commonly pneumonia)
- Lung Disorders
- ACE Inhibitors (>20% of pts)
- B-blockers in patients with COPD and asthma
- Even eye drops can cause effects
What are the major causes of cough in children?
- Viral/bacterial respiratory infection
- Heart disease
- Foreign body aspiration
- Poor coordination of sucking and swallowing reflexes
- Esophageal motility disorders
What are symptoms and signs of a productive cough?
Wet or “chesty” cough
- Expels secretions from the lower respiratory tract
- Retention of secretions can cause impaired ventilation and decreases the lungs ability to resist infection
Patient presents with a productive cough and has been diagnosed with an anaerobic infection? Describe the secretions the patient may cough up.
Malodorous = foul-smelling
Patient coughs up yellow secretions. What is the possible cause?
yellow = inflammation (WBCs present)
Patient coughs up red/pink secretions. What is the possible cause?
hemoptysis - blood that initially came from lower respiratory tract
Patient coughs up clear secretions. What is the possible cause?
bronchitis
Describe the signs/symptoms of a patient who has a dry cough and what can cause this?
"Hacking" cough that serves no physiological purpose Causes: Viral respiratory tract infections Atypical bacterial infections GERD Cardiac disease Medications: ACE inhibitors
What are the concerning complications of a patient who has a persistent cough?
Exhaustion, insomnia, muscle pain, hoarseness, sweating, urinary incontinence
- Some may induce vomiting, cardiac dysrhythmias, syncope, stroke, rib fractures due to intensity
When should you refer a patient to a physician for a cough?
Child under 4 years old
Cough lasting > 7 days
Violent cough, night sweats - May be Pneumonia or TB
Coughing up blood or non-clear sputum
SOB - may sound like barking or whooping
Fever ≥ 103° in adults or ≥ 102° in children
Abdominal swelling
Unintentional weight loss
Hx of chronic lung disease
Foreign object aspiration
Suspected drug-induced cough
Cough is unresponsive/worsening with self-treatment
What are the top 3 causes of chronic cough in adults?
#1 UACS - Post nasal drip #2 Asthma #3 GERD
When should you recommend a patient use Hydrocodone for a cough? What should you counsel the patient on?
Antitussive = non-producitve cough
Adults who no history of substance abuse disorders (CII)
Children 6+ years old
What is the role of antitussives in cough treatment?
Control or eliminate cough by increasing the cough threshold for non-productive coughs
