What is a Nanda nursing diagnosis for breathing difficulty?

October 1, 2025 •

3 min read

According to the National Institutes of Health, commonly used NANDA-I nursing diagnoses for patients with dyspnea include Impaired Gas Exchange and Ineffective Breathing Pattern. Understanding what is a Nanda nursing diagnosis for breathing difficulty? is crucial for healthcare professionals to provide targeted and effective care.

Quick Summary

NANDA nursing diagnoses for breathing difficulty identify problems such as inadequate ventilation, impaired oxygen and carbon dioxide exchange at the alveolar level, or ineffective clearance of the airway. These diagnoses guide nursing interventions based on specific patient symptoms.

Key Points

Differentiating Diagnoses: Breathing difficulty can be categorized into several NANDA diagnoses based on the root cause, such as ineffective breathing mechanics, impaired gas exchange, or airway obstruction.
Core Diagnoses: The main NANDA diagnoses for breathing issues are Ineffective Breathing Pattern, Impaired Gas Exchange, and Ineffective Airway Clearance.
Assessment is Key: Accurate assessment of symptoms, physical signs, and lab values is critical for selecting the correct NANDA diagnosis and creating an appropriate care plan.
Targeted Interventions: Nursing interventions should be tailored to the specific diagnosis. For example, positioning for Ineffective Breathing Pattern differs from suctioning for Ineffective Airway Clearance.
Nursing vs. Medical Diagnosis: NANDA diagnoses focus on the patient's human response to a health condition, guiding nursing-specific interventions, which differs from a medical diagnosis.
PES Format: A NANDA diagnosis is often written using the PES format: Problem, Etiology, and Symptoms to provide a complete picture for the care team.

Understanding the NANDA Framework

NANDA International (NANDA-I) provides a standardized language for nursing diagnoses. This framework standardizes the diagnosis step of the nursing process (ADPIE: Assessment, Diagnosis, Planning, Implementation, Evaluation), ensuring consistency and clarity in patient care planning. A nursing diagnosis differs from a medical diagnosis by focusing on the patient's individual response to a health condition rather than the condition itself.

The PES Format

Problem-focused NANDA nursing diagnoses often use the PES format: Problem, Etiology, and Symptoms. The problem comes from the NANDA list, the etiology describes the related factors, and the symptoms are the defining characteristics evidenced by the patient.

Primary NANDA Diagnoses for Respiratory Compromise

Several NANDA diagnoses may apply to breathing difficulty, depending on the specific cause. The three most common respiratory diagnoses are Impaired Gas Exchange, Ineffective Breathing Pattern, and Ineffective Airway Clearance. Accurate assessment is crucial to select the most appropriate diagnosis.

Impaired Gas Exchange

This diagnosis describes an issue with oxygenation and/or carbon dioxide elimination at the alveolar-capillary membrane. Defining characteristics may include abnormal arterial blood gas (ABG) results, abnormal skin color, confusion, restlessness, hypoxemia, hypercapnia, or tachycardia.

Ineffective Breathing Pattern

This diagnosis refers to inspiration and/or expiration that does not provide adequate ventilation. This can be due to factors like pain, anxiety, or respiratory muscle fatigue. Defining characteristics may include abnormal breathing rate or rhythm, dyspnea, use of accessory muscles, pursed-lip breathing, nasal flaring, or orthopnea.

Ineffective Airway Clearance

This diagnosis indicates the inability to clear secretions or obstructions from the respiratory tract. Defining characteristics may include adventitious breath sounds, ineffective cough, excessive sputum, or altered respiratory rate or rhythm.

A Comparison of Common NANDA Respiratory Diagnoses


Assessment Finding	Impaired Gas Exchange	Ineffective Breathing Pattern	Ineffective Airway Clearance
Underlying Problem	Altered O2/CO2 exchange at alveolar level	Problem with inspiration/expiration mechanics	Inability to clear secretions/obstructions
Key Symptom	Hypoxemia, hypercapnia	Dyspnea, abnormal respiratory rate	Cough, adventitious sounds
Vitals	Low SpO2, abnormal ABGs, tachycardia	Abnormal respiratory rate/rhythm	Abnormal respiratory rate, adventitious sounds
Physical Signs	Cyanosis, restlessness, confusion	Use of accessory muscles, nasal flaring, pursed-lip breathing	Excessive sputum, ineffective cough

Comprehensive Nursing Interventions

A comprehensive nursing plan is essential for patients with breathing difficulty, with interventions tailored to the specific diagnosis.

Interventions for Ineffective Breathing Pattern

These may include positioning the patient upright, teaching breathing techniques like pursed-lip or diaphragmatic breathing, and managing anxiety.

Interventions for Impaired Gas Exchange

These may involve administering oxygen therapy, monitoring vital signs, and obtaining and monitoring ABGs.

Interventions for Ineffective Airway Clearance

These may include suctioning, encouraging coughing and hydration, and providing chest physiotherapy.

Conclusion

Accurately identifying the correct NANDA nursing diagnosis for breathing difficulty is the first step toward creating an effective care plan. By differentiating between issues with gas exchange, breathing mechanics, and airway clearance, nurses can implement targeted interventions. Continuous assessment, collaborative care, and patient education are key to managing respiratory issues. Recognizing specific defining characteristics for each diagnosis helps nurses advocate for their patients' respiratory health. For more on nursing classifications, the NANDA-I website is a valuable resource [https://nanda.org/].

Frequently Asked Questions

Impaired Gas Exchange refers to a problem at the alveolar-capillary level, where oxygen and carbon dioxide are exchanged, while Ineffective Breathing Pattern relates to a mechanical issue with the act of inspiration and expiration itself, such as an abnormal rate or rhythm.

A nurse uses a thorough patient assessment, including observing defining characteristics like breathing rate, rhythm, oxygen saturation, and accessory muscle use. The nurse then matches these signs and symptoms to the most appropriate NANDA diagnosis.

Yes, it is possible for a patient to have multiple diagnoses. For instance, a patient with chest pain from a fractured rib may have both Ineffective Breathing Pattern (due to pain-induced shallow breathing) and Risk for Impaired Gas Exchange.

Interventions include positioning the patient upright (e.g., Fowler's position), teaching controlled breathing techniques like pursed-lip breathing, and managing anxiety to reduce the patient's work of breathing.

This diagnosis is appropriate when a patient is unable to clear their respiratory tract of secretions or obstructions. A nurse might observe ineffective coughing, excessive sputum, or adventitious breath sounds like crackles or wheezing.

Anxiety can be a related factor for Ineffective Breathing Pattern. A patient who is anxious or panicked may hyperventilate, leading to an irregular breathing rhythm and the sensation of dyspnea, which can be managed with calming techniques and reassurance.

Objective measures, such as pulse oximetry, provide critical evidence for a nursing diagnosis. A low oxygen saturation level would be a key defining characteristic for diagnoses like Impaired Gas Exchange.