A Guide to Ineffective Breathing Patterns – Nursing Diagnosis Care Plans

A young female nurse checks an older man's chest with her stethoscope checking for Ineffective Breathing Pattern patient

For nurses, knowing how to recognize and treat an ineffective breathing pattern is an essential part of providing treatment. Ineffective breathing patterns can happen in various situations, but they are always dangerous for patients’ health.

As a medical professional, you will provide nursing interventions to help alleviate the ineffective airway clearance and improve the overall function of the respiratory system.

If you are a nursing student, you will want to fully understand the signs, symptoms, and treatments of ineffective breathing patterns. This can help you prepare for your future career. We will walk you through an overview of what you need to know.

What is an ineffective breathing pattern?

An ineffective breathing pattern occurs when the patient cannot breathe productively. This can happen either as the person inhales (inspiration), exhales (expiration), or both.

The defining characteristics of this condition can be observed when the breathing is abnormal in one or more of the following ways:

  • Rate
  • Timing
  • Rhythm
  • Pattern
  • Depth

When an ineffective breathing pattern occurs, the body generally cannot get enough oxygen to the cells, which in turn can create a dangerous physical situation for the patient. If the patient does not receive proper treatment, it can result in respiratory failure.

This condition can occur due to various conditions, including COPD, heart failure, impairment of the spinal cord, respiratory infection, or airway obstruction.

Because of the seriousness of an ineffective breathing pattern, it is considered a critical NANDA (North American Nursing Diagnosis Association) nursing diagnosis.

We will now explore the clinical indicators of impaired gas exchange and the types of care plans you might use based on the particular diagnoses and risk factors

Ineffective breathing pattern signs

There are various signs and symptoms you might see that indicate your patient is experiencing an ineffective breathing pattern.

Here are some of the key symptoms you will want to keep an eye out for:

  • Bradypnea: when the patient breaths more slowly than typical.
  • Dyspnea: when a patient experiences a shortness of breath.
  • Orthopnea: when a patient has a more challenging time breathing while lying down.
  • Tachypnea: characterized by shallow breathing, this is when the patient takes short and fast breaths. Similarly, hyperventilation, when the patient takes deep, fast breaths, is a sign.
  • Coughing: if the cough is productive, you will watch for the color and consistency of the sputum, which can point to potential causes of respiratory problems.
  • Cyanosis: when the body appears to have a slightly bluish tint because of poor oxygen levels in the blood.
  • Fremitus: a vibration in the chest wall.
  • Nasal flaring: occurs when the nostrils widen while breathing, indicating increased effort to inhale enough air.
  • Abnormal respiratory rate: an off-rhythm in the breathing.
  • Pursed-lip breathing: a technique of slowing down the breathing rate and taking deep breaths in through the nose and out through the mouth with pursed lips, as though preparing to whistle. This strategy is used to try and make each breath more effective and control the feeling of being out of breath.
  • Use of accessory muscles: this means the patient is using muscles other than the typical respiratory muscles of the diaphragm and muscles in between the ribs to breathe, such as the pectoralis muscles, scalene muscles, or sternocleidomastoid muscles. This can occur because of muscle fatigue in the muscles usually used for breathing.
  • Hypoxia and hypoxemia: indicates that the patient’s oxygen levels have gotten too low in the blood (hypoxemia) or tissues (hypoxia).

If you see these symptoms or any other signals that indicate your patient is struggling to breathe, you will want to take steps to establish a plan of care and help them improve their respiration. Your care plan will help the patient achieve adequate ventilation, improve their gas exchange, and address related factors that could further hinder their breathing.

Ineffective breathing pattern care plans

As you begin to learn what indicates an ineffective breathing pattern, you also want to make sure you understand how to set up a care plan to help the patient.

Your care plan will include how you monitor the patient and the steps you’ll take as a nurse to help improve the outcome. Note that while the care plans have similar goals, they have some subtle differences based on the specific conditions faced by each patient. Here are some common types of breathing care plans you will need to familiarize yourself with.

Chronic bronchitis care plan

When patients face chronic bronchitis, they often experience shortness of breath and a productive cough. Their SpO2 levels might drop to 85%. As a nurse, you want to help them achieve an effective breathing pattern, so their oxygen saturation reaches 88% to 92%. You also want to help them improve their respiratory rates to 12 to 20 beats per minute.

For their nursing care plan, you will likely do the following:

  • Regularly assess the patient’s vital signs and breathing about every four hours.
  • Provide supplemental oxygen to help raise the patient’s oxygen saturation levels into the target range.
  • Provide any prescribed bronchitis medications, such as steroids, bronchodilators, nebulizers, or antibiotics.
  • Work to clear airway secretions with chest physiotherapy, steam inhalation, or nebulization with sodium chloride.
  • Elevate the head of the bed so that the patient can get into the semi-Fowler’s position and improve lung expansion.

Liver cirrhosis care plan

Cirrhosis of the liver can also result in patients struggling with breathing. Generally, patients will exhibit shallow respiration and decreased lung expansion because of the disease, impacting how you’ll provide care. You want to help them experience an improved respiratory pattern so that their respiratory function will be within the acceptable limits.

As a nurse, your care plan will likely include the following types of tasks:

  • Regularly monitoring the patient to see if they experience any changes in their respiration, which could indicate problems such as fluid accumulation.
  • Watching for a crackling sound when the patient breathes, other adventitious breath sounds, or auscultate breath sounds. This can indicate atelectasis or a collapsed lung.
  • Looking for changes in the sensorium. This will include checking for changes in the patient’s Glasgow Coma Score (GCS). The GCS looks for signs of impaired consciousness in the patient.
  • Monitoring for other signs of respiratory status, including pulse oximetry and lung vitality. You will also monitor the ABGs (arterial blood gas) analysis.
  • Providing the patient with oxygen support whenever it is needed.
  • Keeping the head of the bed elevated to reduce the pressure on the abdomen and help with lung expansion.

Seizure care plan

When patients experience seizures, it can cause neuromuscular impairment. This, in turn, can cause problematic respiration or apnea. Therefore, the care plan you use as a nurse will need to consider the source of the irregular breathing pattern to help patients better cope with the condition.

Your care plan will likely include elements such as the following:

  • Continue to monitor respiratory function to provide a baseline and look for changes in the patient’s condition.
  • Make sure the patient’s mouth remains free of anything that could hinder breathing, such as chewing gum or dentures.
  • When the patient experiences a seizure, make sure the person remains flat on their back to encourage the drainage of any secretions during seizures.
  • You will provide oxygen as needed to maintain oxygen levels in the blood.
  • You will protect the patient’s tongue and help suction secretions by inserting a plastic airway if needed.
  • You will be ready to help with intubation if the patient shows signs of apnea and does not get enough oxygen.

Studying to become a nurse? See how SimpleNursing can help

As you continue your education toward a healthcare career, you must thoroughly understand the conditions that might impact your patients. This will also help you perform well on your nursing examinations, such as the NCLEX-RN.

When you work as a nurse, you will face various situations that will call for you to provide patients with care, such as assistance with ineffective breathing. Given the danger of this condition, the care you provide is critical to the well-being and health of your patients. Therefore, you want to be prepared for all that is needed to thrive in your new role.

As you begin to study this important material and prepare for your exams, use study resources that will help you target your learning and better grasp the material in question. This will help you perform well on your exams and prepare you for your career as a nurse. SimpleNursing is here to provide you with exceptional study resources so that you can walk into your NCLEX exam confidently. Get started studying now and prepare for your future career with SimpleNursing.