What would my responsibility be...


as a nurse, what would be my rsponsibility to my patient who's exhibiting those signs and symptoms (implementation)?

for example, dry noproductive cough?

will increase of fluid intake affect the accumulation of fluids in the lung/s?



63 Posts

Many respiratory infections start with unproductive cough and then turn into productive with expectoration of sputum.Increasing fluid intake will actually help to loosen the thick secretion and help to expectorate them so as nurse you should make sure that the patient is drinking enough fluids of at least 3000 ml and they should be warm rather than cold.Also for the patient with diagnosed respiratory infection you should also:

*Assess rate/depth of respiration and monitor for signs of respiratory failure (cyanosis etc)

*Asculate the breath sounds for abnormal sounds (crakles)

*Elevate the head of the bed (unless contraindicated) so the patient can breath more comfortably.

*Change patien't position frequently (helps mobilize secretions)

*Assist client with frequent deep-breathing exercises.

Those just are the basic ones.Of course there are more advanced ones such as suctioning (PRN),administering medications,oxygen (per doctor order)

Daytonite, BSN, RN

4 Articles; 14,603 Posts

Specializes in med/surg, telemetry, IV therapy, mgmt. Has 40 years experience.

there are four types of nursing interventions (you are calling them responsibilities). you also need to include strategies that aim at the underlying cause of the cough. you didn't tell us anything about that, however. interventions for someone with a dry, productive cough include:

  • assess/monitor/evaluate/observe (to evaluate the patient's condition)
    • volume, color and odor of any sputum produced
    • assess lung sounds and note any areas of decreased or absent sounds, crackles, rales or wheezes

    [*]care/perform/provide/assist (performing actual patient care)

    • encourage oral fluid intake aiming for a total intake of 3,000 cc per 24 hours
    • warm fluids are felt to be better than cold fluids
    • a cool mist humidifier at the bedside can help to liquefy secretions
    • a warm shower if the patient is able to take one will also help to liquefy secretions an get them mobile
    • encourage patient to sit upright as high as possible when coughing in order to get maximum lung expansion
    • encourage mobility and ambulation to the extent that the patient is able to perform
    • make sure there are tissues for the patient at the bedside
    • have oxygen and suction equipment at the ready
    • give oral care q4h
    • throat lozenges will help soothe the throat
    • administer expectorants as ordered
    • if ordered, see that postural drainage, percussion and vibration is done as ordered to help mobilize secretions

    [*]teach/educate/instruct/supervise (educating patient or caregiver)

    • how to do controlled deep breathing and coughing and how to incorporate the use of an incentive spirometer
    • explain all equipment being used and why
    • teach patient how to use any inhalers and nebulizers
    • teach the importance of maintaining adequate fluid intake

    [*]manage/refer/contact/notify (managing the care on behalf of the patient or caregiver)

    • notify the physician of any change or worsening in the patient's symptoms
    • refer to respiratory therapy for treatment

you asked if increase of fluid intake affect the accumulation of fluids in the lung/s? it is thought that increasing fluid intake helps to keep fluids in the lung moving and more fluid making their expectoration easier. if the patient has an underlying medical disease where fluid buildup will occur in the lungs with increased fluid intake then increasing fluids may be contraindicated.

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