You’re helping Mrs. Lopez with her morning routine when she has a coughing fit. She hands you a tissue, and you notice the substance inside is thick and discolored. This isn’t just spit; this is sputum, and knowing the difference is a key part of protecting her lung health.
What is Sputum?
Sputum (SPYOO-tum) is mucus that is coughed up from the lower respiratory tract—specifically the lungs and bronchi. It is distinct from saliva or spit, which comes from the mouth. Sputum is produced when the lungs are trying to clear out irritants, dust, bacteria, or mucus. While “phlegm” is a term often used interchangeably by patients, sputum is the medical term for the expectorated secretion used for diagnosis and monitoring.
Why Sputum Matters in Your Daily Care
Changes in sputum are often the earliest warning sign of a respiratory infection like pneumonia, bronchitis, or COPD exacerbation. By observing the color, amount, and consistency, you provide the nurse with critical data that can stop an illness from progressing to a hospital stay. Your eyes and ears are the first line of defense in spotting respiratory distress before it becomes an emergency.
What You’ll See During Your Shift
You will encounter sputum when a resident has a “productive” cough, meaning they are coughing up secretions. Instead of just tossing the tissue, you need to glance at it. Is it clear/white, yellow, green, or blood-tinged? Is it thin and watery or thick and sticky?
“Hey Sarah, I just helped Mr. Henderson with breakfast and he had a hard time coughing. He produced about a tablespoon of thick, green sputum. He’s running a low temp too, so I wanted you to know.”
Common Pitfall & Pro Tip
⚠️ Pitfall: Confusing saliva with sputum. If a resident spits into a tissue but it’s just clear, watery fluid from the mouth, it isn’t sputum. Reporting this as a productive cough can mislead the nurse.
Pro Tip: Look at the tissue before throwing it away. If a resident is coughing, note the color immediately. A change from clear to yellow or green usually signals an infection that needs assessment.
Memory Aid for Sputum
Think “Sputum is Deep Lung Slime.”
This reminds you that true sputum originates deep in the respiratory system (lungs), not just the mouth (slime/spit). If it didn’t come from a deep cough, it’s likely just saliva.
State Test Connection
Expect questions on the CNA exam regarding the observation and reporting of abnormal sputum. You may be asked to identify which color or consistency (like green, bloody, or foul-smelling) requires immediate reporting to the nurse.
Related Care Concepts
Observing sputum connects directly to deep breathing and coughing exercises, which help residents clear this secretions effectively. It is also relevant to specimen collection, as you may be asked to obtain a sputum sample for lab testing to identify bacteria. Furthermore, it links to infection control practices, specifically hand hygiene after handling soiled tissues or assisting a resident with a cough.
Quick Reference
✓ Key signs/steps: Observe color (clear, yellow, green, blood), consistency (thin, thick), and amount ✓ When to report: Any blood (hemoptysis), foul odor, or sudden increase in amount ✓ Care reminders: • Encourage fluids to thin secretions (if allowed) • Encourage deep breathing and coughing to clear lungs • Practice good hand hygiene after handling tissues • Place residents in High Fowler’s position to ease breathing
Bottom line: Never ignore a change in a resident’s cough. When you pay attention to sputum, you’re catching lung infections early—that’s proactive care that saves lives.