Day-to-Day Care


Observation:  Sputum




Sputum, also known as phlegm, is mucus and cells from the airway lining, cellular debris, bacteria, or other material coughed up from the respiratory tract through the mouth in a productive cough.  Normal sputum is white.
If a person is producing sputum, make sure he has a container with a lid into which he can spit.  The mug should be kept near to the person and a box of tissue paper together with a bag to put the used tissues.  
It is important to note the time when most of the expectoration occurs; whether it is produced at all times, just on rising from bed, or after a meal or after exertion.
Types of Sputum and Indications

When you observe sputum, check the colour, consistency (frothy, watery, tenacious, thick), and odor:


Red may indicate the present of blood (hemoptysis).  This is associated with a variety of pathologies.

Purulent (pus, yellow or greenish sputum, often copious and thick) denotes an acute and chronic infection.

Frothy (white or pink-tinged, foamy, thin sputum) is associated with pulmonary edema. 

Foul-smelling is typical of anaerobic infection.  This is associated with bronchiectasis, lung abscess, or cystic fibrosis.


If  the sputum is discoloured, you should find out if it clears with coughing.  Occasionally yellow sputum produced in the morning may clear with the second or third cough.  You have to determine whether the amount has recently increased or decreased and be certain that it is associated with coughing.
Consult your doctor if you are concerned about the sputum, especially if you notice blood in it (hemoptysis).  Describe your observation to the doctor according to amount, colour, duration, and if the blood is mixed with sputum.  Bloody or blood-tinged sputum require diagnostic test, such as examination of the sputum specimens, chest x-ray examination, and scope of the lung (bronchoscopy).


Return to Top



► Back to Nursing Manual Table of Contents