Cough: Clinical Assessment, Laboratory Evaluation, and Pharmacological and Nursing Management in Healthcare Practice

Abstract

Background: Cough is a frequent clinical symptom across care settings. It reflects airway reflex activity. It is linked to infection, inflammation, cardiac disease, gastrointestinal reflux, and drug effects. It creates diagnostic difficulty due to many causes and limited objective measurement. Aim: This work reviews clinical assessment, laboratory evaluation, and management of cough in healthcare practice. It focuses on classification, risk factors, nursing role, and coordinated care. Methods: A narrative clinical review approach was used. Evidence from respiratory medicine, nursing practice, and diagnostic guidelines was synthesized. Data were organized across acute, subacute, and chronic cough categories. Clinical evaluation pathways and treatment strategies were analyzed. Results: Cough accounts for about 30 million outpatient visits yearly. Around 40 percent of cases require specialist referral. Asthma affects about 26 million individuals in the United States. Gastroesophageal reflux contributes to up to 40 percent of chronic cough cases. Prevalence ranges from 5 to 40 percent across populations. Assessment depends on history, duration, medication review, and red flag symptoms. Chest radiography, spirometry, computed tomography, bronchoscopy, and reflux testing support diagnosis. Management depends on cause. Acute cases often require symptomatic treatment. Chronic cases require targeted therapy such as inhaled steroids for asthma, proton pump inhibitors for reflux, antibiotics for infection, and neuromodulators for neurogenic cough. Nursing care focuses on airway clearance, hydration, positioning, education, and secretion management. Conclusion: Cough is a symptom with multiple causes across organ systems. It requires structured assessment to identify etiology. Early classification reduces missed serious disease. Treatment must target the cause rather than suppress symptoms alone. Nursing interventions improve airway clearance and patient comfort. Multidisciplinary coordination improves diagnosis and reduces delayed treatment.