Hemoptysis

Coughing up blood from the respiratory tract

Definition

Hemoptysis is the expectoration of blood or blood-streaked sputum from the respiratory tract. It is distinguished from hematemesis (blood from GI tract) by its frothy, alkaline, and bright red appearance.

Causes

  • Pulmonary embolism
  • Tuberculosis
  • Lung cancer
  • Bronchitis/bronchiectasis
  • Pneumonia
  • Pulmonary edema (pink, frothy)
  • Trauma
  • Anticoagulant therapy

Nursing Priorities

  • Assess airway, breathing, circulation
  • Position upright or lean forward; affected lung DOWN if known to prevent blood spreading to healthy lung
  • Suction as needed; protect airway
  • Monitor oxygen saturation, vital signs
  • Obtain chest x-ray, CT, bronchoscopy as ordered
  • Prepare for possible embolization, surgery

NCLEX Relevance

Massive hemoptysis = airway emergency. TB classic cue.