Expectoration

Definition

Expectoration is the process of coughing up and ejecting sputum, mucus, or phlegm from the respiratory tract. It is an important defense mechanism to clear airways of secretions and pathogens.

Sputum Characteristics

• Clear/white: Normal or viral infection
• Yellow/green: Bacterial infection
• Pink, frothy: Pulmonary edema (CHF)
• Rust-colored: Pneumococcal pneumonia
• Blood-streaked/hemoptysis: TB, bronchitis, cancer, PE
• Foul-smelling: Anaerobic infection, lung abscess

Nursing Interventions

Encourage hydration (thins secretions), humidified air, coughing and deep breathing, incentive spirometry, positioning (semi-Fowler's), postural drainage, and chest physiotherapy. Collect sputum specimens in the morning, before oral care (but mouth rinsed with water, not mouthwash). Teach patients proper cough techniques.

NCLEX Relevance

Color tells diagnosis. Classic: pink frothy = pulmonary edema; rust = pneumonia.