<![CDATA[Ineffective airway clearance remains a leading nursing problem in patients with pulmonary tuberculosis (TB), particularly among older adults whose atypical clinical presentation often delays diagnosis and complicates respiratory management. This case is clinically noteworthy because the patient's advanced age (75 years), frail physical status, and dual burden of pulmonary TB and hypertension placed her at elevated risk of impaired secretion clearance, and her presentation illustrates how a low-cost, non-pharmacological nursing intervention can be applied safely in this vulnerable, resource-limited inpatient setting. This case report aims to describe the nursing care of an elderly patient with pulmonary TB experiencing ineffective airway clearance, managed through the application of an effective cough technique. A descriptive case study design, informed by the CARE guidelines for case reporting, was used to document the assessment, nursing diagnosis, intervention, implementation, and evaluation of care provided to a 75-year-old woman admitted with dyspnea, productive cough, and rhonchi. Data were collected through interview, physical examination, and medical record review over three consecutive days. The effective cough technique, comprising deep-breathing exercises and controlled forceful coughing, was implemented once daily across three sessions. Following the intervention, the patient's respiratory rate declined progressively from 26 breaths per minute at initial assessment to 24, 23, and 22 breaths per minute after the first, second, and third sessions respectively; sputum was expectorated more effectively, adventitious breath sounds diminished, and the patient reported reduced dyspnea and increased calmness. These outcomes are consistent with international evidence supporting breathing-cycle and coughing techniques for secretion mobilization in chronic respiratory disease. The findings reinforce the effective cough technique as an accessible, low-cost, evidence-based nursing intervention for managing ineffective airway clearance in pulmonary TB, and highlight its particular relevance for elderly patients in resource-limited settings.]]>
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