Impaired Gas Exchange Care Plan and Nursing Diagnosis

One of the important body systems is respiratory system, which ensures adequate oxygenation for the normal functioning of the body organs. It has a number of functions, one of which is gas exchange. When a person breathes, he or she takes in the oxygen for its further transportation to the alveoli of lungs and all vital body organs. The body organs use oxygen and release a by-product of carbon dioxide, while the lungs exhale out of the body. Impaired gas exchange care plan is a special set of procedures aimed at normalization of the gas exchange in the body.

Impaired gas exchange definition presents it as the case of respiratory diseases and abnormalities related to gas exchange. It is a state of the human body with either decreased or excessive individual oxygenation that causes changes of the adequate respiratory process. Thus, a person has excessive carbon dioxide or oxygen in the body and the body systems and organs suffer.

Gas exchange impairment can have a number of causes, including the alveoli collapse of those who have pulmonary edema, pneumonia, atelectasis, or syndrome of acute respiratory distress. Other causes can be a low level of hemoglobin or hypoventilation. The changes in the process of gas exchange can be caused by respiratory system diseases. Therefore, it is a matter of crucial concern to maintain normal respiration as it will ensure adequate supply of oxygen for all body systems and normal functioning of the whole body.

Impaired Gas Exchange Nursing Diagnosis: Factors

  • Insufficient supply of oxygen
  • Decrease in blood hemoglobin with lack of carried oxygen
  • Changes in the alveolar-capillary membranes
  • Imbalance between ventilation and perfusion
  • Cardiac diseases
  • Allergic reactions
  • Pulmonary diseases
  • Fatigue
  • Various infections
  • Anxiety
  • Smoking
  • Cognitive problems
  • Pain
  • Fear
  • Traumas
  • Surgeries

Characteristics of Impaired Gas Exchange

  1. Abnormality of the levels of gasses in arterial blood
  2. Abnormality of the level of arterial pH
  3. Abnormality of patterns in breathing (inadequate depth, rate, and rhythm of breathing)
  4. Low level of carbon dioxide
  5. Diaphoresis
  6. Problems with breathing or dyspnea
  7. Hypoxia
  8. Elevation of BP
  9. Hypercapnea
  10. Irritation
  11. Hypoxemia
  12. Pallor
  13. Nasal flaring
  14. Tachycardia
  15. Symptom of restlessness

Expected Outcomes for Impaired Gas Exchange Care Plan

  • Better process of gas exchange
  • Lack of signs that the patient has difficulties with breathing
  • Normal rate of respiration rate (12-20 cycles per minute)
  • Normal level of gas in the arterial blood
  • Clear lung fields
  • Lack of signs that indicate respiratory infections
  • No symptoms or characteristics of respiratory distress.

Nursing Interventions for Impaired Gas Exchange: Assessment and Rationale



Assessment of the respiratory rate to determine the abnormalities, if any

It provides baseline data for specifying the changes in gas exchange.

Assessment of both lungs done via the auscultation of the sounds of breathing.

It specifies if there are respiratory problems if the lung sounds can be heard.

Checking on the mental status and behavior of the patient

It indicates possible lack of brain oxygenation

Checking for the changes in heart rate and blood pressure.

It indicates lack of oxygenation or hypoxia.

Observation and analysis of mucus membranes, nail beds, tongue and skin

It indicates cyanosis and decreased oxygenation which require urgent interventions to be taken

Continuous monitoring of oxygen saturation with a pulse oximeter.

It indicates oxygenation changes.

Assessment of the individual nutritional status.

It specifies the status of nutrition. Obese patients may experience difficult breathing due to the higher oxygenation needs 

Impaired gas exchange care plan includes checking on the blood level of Hgb, blood component that carries oxygen

Low level of Hgb demonstrates low level of oxygenation.

Checking on the results of the diagnostic procedure of chest X-ray

It demonstrates lung abnormalities.

Assessment of how well the patient can cough out the secretions with further reporting on the consistency, color, and quantity of the sputum.

Breathing difficulties can be related to the secretions.

Nursing Interventions and Rationale

A nursing care plan for pneumonia impaired gas exchange as well as other types of problems covers a number of interventions which are presented below.



The patient should be seated in a semi-Fowler's position

This position lets the lungs expand and minimizes the breathing difficulties

Proceed with ambulation or any required activities

Lungs can be expanded with mobility which prevents secretion accumulation in the lungs

According to the prescription, do the administration of the humidified oxygen

It may be necessary to provide supplemental oxygen for the maintenance of PaO2 at the adequate level.

Assist the patient in doing breathing exercises. Ensure the controlled coughing procedure.

Thus, it will be easier for the patient to cough out the secretions. It can ensure stasis prevention

Suction, if needed.

Thus, the secretion stasis will be prevented via manual suction.

Help with ADLs.

The procedures are aimed at preventing the secretion stasis; however, the negative effect is consuming too much oxygen. The activities should be done one at a time at a slow rate.

Impaired gas exchange care plan provides for the required medications to be given.

The causative factors determine the needed medication: bronchodilators or antibiotics.

Give the instruction to the patient to have limited exposure to people with potential respiratory infections.

Thus, the infections will not be spread.

The patient's family required support as well.

It is helpful for the relatives to get reassurance from an experienced nurse.

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