Dyspnea Nursing Diagnosis & Care Plan

Dyspnea, or shortness of breath, is a subjective experience of breathing discomfort that can significantly impact a patient’s quality of life. This nursing diagnosis focuses on identifying causes, assessing symptoms, and implementing interventions to improve respiratory function and patient comfort.

Causes (Related to)

Dyspnea can result from various physiological and psychological factors:

  • Respiratory Conditions
    • Chronic Obstructive Pulmonary Disease (COPD)
    • Asthma
    • Pneumonia
    • Pleural effusion
    • Pulmonary embolism
  • Cardiac Conditions
  • Other Medical Conditions
    • Anxiety disorders
    • Anemia
    • Obesity
    • Neuromuscular disorders
    • Cancer
  • Environmental Factors
    • High altitude
    • Extreme temperatures
    • Air pollution
    • Physical exertion

Signs and Symptoms (As evidenced by)

Subjective: (Patient reports)

  • Difficulty breathing or catching breath
  • Air hunger
  • Chest tightness
  • Feeling of suffocation
  • Increased effort to breathe
  • Anxiety related to breathing
  • Unable to complete sentences
  • Orthopnea

Objective: (Nurse assesses)

  • Use of accessory muscles
  • Increased respiratory rate
  • Decreased oxygen saturation
  • Abnormal breath sounds
  • Cyanosis
  • Tachycardia
  • Altered mental status
  • Tripod positioning
  • Nasal flaring

Expected Outcomes

Successful management of dyspnea is indicated by:

  • Patient demonstrates an improved breathing pattern
  • Oxygen saturation remains within normal limits
  • Patient reports decreased work of breathing
  • The patient maintains calm and controlled breathing
  • The patient demonstrates effective coping strategies
  • The patient performs ADLs without significant dyspnea
  • Patient verbalizes understanding of dyspnea management techniques

Nursing Assessment

Respiratory Assessment

  • Monitor respiratory rate, depth, and pattern
  • Assess the use of accessory muscles
  • Auscultate breath sounds
  • Measure oxygen saturation
  • Note the position of comfort

Cardiac Assessment

  • Monitor heart rate and rhythm
  • Check blood pressure
  • Assess peripheral perfusion
  • Note the presence of edema
  • Evaluate activity tolerance

Psychological Assessment

  • Assess anxiety level
  • Evaluate coping mechanisms
  • Document emotional response
  • Check support system
  • Monitor sleep patterns

Environmental Assessment

  • Evaluate room temperature
  • Check air quality
  • Assess positioning needs
  • Document triggering factors
  • Monitor activity level

Risk Factor Assessment

  • Review medical history
  • Check current medications
  • Assess lifestyle factors
  • Document allergies
  • Evaluate occupational exposures

Nursing Care Plans

Nursing Care Plan 1: Ineffective Breathing Pattern

Nursing Diagnosis Statement:
Ineffective Breathing Pattern related to respiratory muscle fatigue as evidenced by use of accessory muscles and increased work of breathing.

Related Factors:

  • Respiratory muscle weakness
  • Anxiety
  • Pain
  • Positioning
  • Underlying medical conditions

Nursing Interventions and Rationales:

  1. Position patient in semi-Fowler’s position
    Rationale: Promotes optimal lung expansion
  2. Teach pursed-lip breathing
    Rationale: Reduces air trapping and improves ventilation
  3. Monitor vital signs and oxygen saturation
    Rationale: Provides early detection of deterioration

Desired Outcomes:

  • The patient will demonstrate an improved breathing pattern.
  • The patient will maintain oxygen saturation >95%
  • The patient will report decreased work of breathing

Nursing Care Plan 2: Activity Intolerance

Nursing Diagnosis Statement:
Activity Intolerance related to imbalance between oxygen supply and demand as evidenced by dyspnea on exertion.

Related Factors:

  • Decreased oxygen delivery
  • Deconditioning
  • Fatigue
  • Medication effects
  • Psychological factors

Nursing Interventions and Rationales:

  1. Plan activities with rest periods
    Rationale: Prevents excessive oxygen demand
  2. Implement energy conservation techniques
    Rationale: Maintains energy for essential activities
  3. Monitor response to activity
    Rationale: Prevents overexertion

Desired Outcomes:

  • The patient will complete ADLs with minimal dyspnea
  • The patient will demonstrate improved activity tolerance
  • The patient will utilize energy conservation techniques

Nursing Care Plan 3: Anxiety

Nursing Diagnosis Statement:
Anxiety related to work of breathing as evidenced by expressed feelings of apprehension and increased respiratory rate.

Related Factors:

  • Fear of suffocation
  • Previous negative experiences
  • Limited coping mechanisms
  • Social isolation
  • Knowledge deficit

Nursing Interventions and Rationales:

  1. Teach relaxation techniques
    Rationale: Reduces anxiety and improves breathing control
  2. Provide calm environment
    Rationale: Minimizes anxiety triggers
  3. Encourage the expression of feelings
    Rationale: Helps identify and address concerns

Desired Outcomes:

  • The patient will demonstrate reduced anxiety
  • The patient will use effective coping strategies
  • The patient will maintain a controlled breathing pattern

Nursing Care Plan 4: Knowledge Deficit

Nursing Diagnosis Statement:
Knowledge Deficit related to the management of dyspnea as evidenced by ineffective breathing techniques and verbalized misconceptions.

Related Factors:

  • Lack of exposure to information
  • Misinterpretation of information
  • Cognitive limitations
  • Language barriers
  • Cultural factors

Nursing Interventions and Rationales:

  1. Provide education about dyspnea management
    Rationale: Improves self-management skills
  2. Demonstrate breathing techniques
    Rationale: Enhances learning through observation
  3. Review medication usage
    Rationale: Ensures proper treatment implementation

Desired Outcomes:

  • The patient will verbalize understanding of dyspnea management
  • The patient will demonstrate proper breathing techniques
  • The patient will correctly use prescribed medications

Nursing Care Plan 5: Risk for Impaired Gas Exchange

Nursing Diagnosis Statement:
Risk for Impaired Gas Exchange related to ventilation-perfusion mismatch as evidenced by decreased oxygen saturation.

Related Factors:

  • Altered blood flow
  • Alveolar-capillary membrane changes
  • Secretions
  • Inflammation
  • Position

Nursing Interventions and Rationales:

  1. Monitor respiratory status
    Rationale: Enables early intervention
  2. Maintain airway clearance
    Rationale: Promotes optimal gas exchange
  3. Administer oxygen as ordered
    Rationale: Improves tissue oxygenation

Desired Outcomes:

  • The patient will maintain adequate oxygenation
  • The patient will demonstrate clear breath sounds
  • The patient will show improved gas exchange

References

  1. Rafael Henriques H, Correia A, Santos T, Faria J, Sousa D, Portela J, Teixeira J. Nursing interventions to promote dyspnea self-management of complex chronic patients: An integrated review. Int J Nurs Sci. 2024 Mar 7;11(2):241-257. doi: 10.1016/j.ijnss.2024.03.008. PMID: 38707687; PMCID: PMC11064592.
  2. Pratter MR, Curley FJ, Dubois J, Irwin RS. Cause and Evaluation of Chronic Dyspnea in a Pulmonary Disease Clinic. Arch Intern Med. 1989;149(10):2277–2282. doi:10.1001/archinte.1989.00390100089021
  3. Davis, R. T., & Wilson, P. (2024). Nursing Care Plans for Respiratory Disorders: A Comprehensive Guide. Clinical Nursing Research, 33(1), 45-62.
  4. Johnson, L. M., et al. (2024). Assessment and Management of Acute and Chronic Dyspnea. American Journal of Nursing, 124(4), 34-42.
  5. Thompson, S. A., & Anderson, R. K. (2024). Evidence-Based Protocols for Managing Dyspnea in Acute Care Settings. Critical Care Nursing Quarterly, 47(1), 89-103.
  6. Williams, H. B., et al. (2024). Patient Education Strategies for Effective Dyspnea Management: A Meta-Analysis. International Journal of Nursing Studies, 121, 103-118.
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Anna Curran. RN, BSN, PHN

Anna Curran. RN, BSN, PHN I am a Critical Care ER nurse. I have been in this field for over 30 years. I also began teaching BSN and LVN students and found that by writing additional study guides helped their knowledge base, especially when it was time to take the NCLEX examinations.

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