A respiratory nursing diagnosis has to be precise about which part of breathing has actually failed - airway clearance, gas exchange, and breathing pattern are three genuinely different problems that can each look like "trouble breathing" from the doorway. This page holds NANDA-I care plans for pneumonia, lung cancer, tuberculosis, pulmonary embolism, pneumothorax, COPD, bronchiectasis, acute respiratory failure, and cor pulmonale, each one built to show exactly which mechanism is failing and why.
Each plan starts from assessment data specific enough to support that distinction: consolidation and productive cough in pneumonia, the sudden pleuritic chest pain and asymmetric breath sounds of a pneumothorax, the acute dyspnea and hypoxia of a pulmonary embolism, and the chronic productive cough and barrel chest changes of long-standing bronchiectasis or COPD. From there, the NANDA-I diagnosis is written in PES format - Ineffective Airway Clearance for a patient who can't mobilize secretions, Impaired Gas Exchange for one whose oxygenation is failing at the alveolar level, Ineffective Breathing Pattern for one whose mechanics of breathing are compromised - with the specific related factors and defining characteristics that justify which diagnosis actually fits.
SMART goals split into short-term goals focused on stabilizing oxygenation and long-term goals tied to disease management or recovery, since cor pulmonale and COPD are managed over years while a pneumothorax or acute respiratory failure episode is often resolved within a single admission. Evidence-based interventions carry rationales specific to each mechanism - chest tube management and reasoning for a pneumothorax, anticoagulation and clot-prevention teaching for pulmonary embolism, right-heart monitoring for cor pulmonale, and the airway clearance techniques central to bronchiectasis and chronic bronchitis.
Cor pulmonale deserves particular mention, since it's a condition that's easy to overlook in a general respiratory collection despite how directly it connects respiratory and cardiac nursing - right-sided heart failure caused specifically by chronic lung disease. Its inclusion here, alongside the more familiar respiratory diagnoses, reflects how often respiratory and cardiac pathology actually overlap in real patients rather than staying in separate specialties.
This page is built for nursing students and NCLEX candidates who need to reason through respiratory nursing diagnoses by mechanism rather than symptom, and for practicing respiratory and pulmonary nurses who want a dependable reference to confirm a diagnosis before finalizing a plan of care.
The distinction between airway clearance, gas exchange, and breathing pattern problems matters more than it might first appear, because the interventions genuinely diverge depending on which one applies. A patient with Ineffective Airway Clearance needs help mobilizing secretions - suctioning, chest physiotherapy, hydration. A patient with Impaired Gas Exchange needs interventions aimed at the alveolar-capillary level - positioning, supplemental oxygen, treating the underlying cause of poor diffusion. Applying an airway-clearance intervention to a gas-exchange problem, or the reverse, wastes time a patient in respiratory distress doesn't have, which is exactly why getting the diagnosis right before building the plan matters as much as it does in this specialty.
