Fundamentals of Nursing Q 452
The nurse explains to a patient that a cough:
A. Is a protective response to clear the respiratory tract of irritants.
B. Is primarily a voluntary action.
C. Is induced by the administration of an antitussive drug.
D. Can be inhibited by “splinting” the abdomen.
Correct Answer: A. Is a protective response to clear the respiratory tract of irritants
Coughing, a protective response that clears the respiratory tract of irritants, usually is involuntary. A cough is an innate primitive reflex and acts as part of the body’s immune system to protect against foreign materials. This reflex is characterized with the closing of the glottis apparatus with subsequent increases in the intrathoracic pressure which often exceeds 300 mm Hg. This is followed by the forceful expulsion of the airway contents through the glottis into the pharyngeal space and out of the body.
Option B: However, it can be voluntary as when a patient is taught to perform coughing exercises. Coughing is associated with a wide assortment of clinical associations and etiologies. Furthermore, there are no objective tools to measure or clinically quantify a cough. As such, evaluation of a cough is initially a subjective and highly variable assessment.
Option C: An antitussive drug inhibits coughing. Cough suppressants may be used to lessen the cough by blunting the cough reflex, and expectorants may be used when excessive mucous secretions are determined to be the primary issue to increase mucus clearance. The most commonly used suppressant is dextromethorphan, and the most common suppressant is guaifenesin.
Option D: Splinting the abdomen supports the abdominal muscles when a patient coughs. The reflex of coughing is initiated with a chemical irritation at peripheral nerve receptors within the trachea, main carina, branching points of large airways, and more distal smaller airways. They are also present in the pharynx. Laryngeal and tracheobronchial receptors respond to mechanical and chemical stimuli.