In this guide are eight (8) NANDA nursing diagnosis for asthma nursing care plans including their nursing assessment and interventions. Learn more about the goals, related factors and rationale for each nursing interventions for asthma.
What is asthma?
Asthma is a chronic inflammatory lung disease that causes airway hyperresponsiveness, mucus production, and mucosal edema resulting in reversible airflow obstruction. Allergens, air pollutants, cold weather, physical exertion, strong odors, and medications are common predisposing factors for asthma. When an individual is exposed to a trigger, an immediate inflammatory response with bronchospasm happens. This inflammatory process leads to recurrent episodes of asthmatic symptoms such as cough, dyspnea, wheezing, and increased mucus production.
Status asthmaticus is severe and persistent asthma that does not respond to usual therapy; attacks can occur with little or no warning and can progress rapidly to asphyxiation.
Nursing Care Plans
The nursing care plan goals for asthma focuses on preventing the hypersensitivity reaction, controlling the allergens, maintaining airway patency and preventing the occurrence of reversible complications.
Here are eight (8) nursing care plans and nursing diagnosis for asthma:
- Ineffective Breathing Pattern
- Ineffective Airway Clearance
- Deficient Knowledge
- Activity Intolerance
- Health-Seeking Behaviors: Prevention of Asthma Attack
- Interrupted Family Processes
Ineffective Airway Clearance
Common related factors for this nursing diagnosis:
- Increased pulmonary secretions
- Ineffective cough
- Mucosal edema
The common assessment cues that could serve as defining characteristics or part of your “as evidenced by” in your diagnostic statement.
- Abnormal arterial blood gasses
- Adventitious lung sounds (Wheezes, Rhonchi)
- Changes in respiratory rate and rhythm
- Chest tightness
- Dyspnea; orthopnea
- Retained secretions
Common goals and expected outcomes:
- Patient will verbalize understanding of cause and therapeutic management regimen.
- Patient will maintain airway patency as evidenced by clear breath sounds, improved oxygen exchange, normal rate and depth of respiration, and ability to effectively cough out secretions.
Nursing Interventions and Rationales
Here are the nursing assessment and interventions for this asthma nursing care plan.
|Assess respiratory rate, depth, and rhythm.||Changes in the respiratory rate and rhythm may indicate an early sign of impending respiratory distress.|
|Assess for color changes in the buccal mucosa, lips, and nail beds.||Cyanosis indicates low oxygenation and that breathing is ineffective to maintain adequate tissue oxygenation.|
|Auscultate lungs for adventitious breath sounds (wheezes and rhonchi).||Wheezes suggest partial obstruction or resistance. While rhonchi may indicate retained secretions in the lungs.|
|Assess the effectiveness of cough.||Coughing is a natural way to clear the throat and breathing passage of foreign particles, irritants, and mucus. Severe bronchospasm, thick secretions, and respiratory muscle fatigue are some of the causes of an ineffective cough.|
|Assess the amount, color, odor and viscosity of the secretions.||Normal secretion is clear or gray and minimal; abnormal sputum is green, yellow, or bloody; malodorous; often copious. Thick tenacious secretions increase airway resistance.|
|Monitor and record intake and output (I&O) adequately.||Provides information on the fluid balance of the patient. Dehydration can contribute in viscous secretions and may result to decrease airway clearance.|
|Monitor oxygen saturation using pulse oximetry.||Oxygen saturation of less than 90% indicates problems with oxygenation.|
|Monitor chest x-ray results.||A chest x-ray provides information regarding the presence of infiltrates, lung inflation, or the presence of barotrauma.|
|Monitor laboratory results as indicated:|
||Increased WBC count indicates an infection.|
||The use of beta-adrenergic agonists shift potassium into the cell and cause hypokalemia.|
||Therapeutic range of theophylline is between 10 to 20 mcg/mL. Signs of toxicity include hypotension, tachycardia, GI symptoms, and restlessness.|
|Monitor arterial blood gasses (ABGs).||Retention of carbon dioxide happens due to fatigue from labored breathing caused by bronchospasm. Once the client is mechanically ventilated, permissive hypercapnia may be utilized to prevent lung damage and maintain plateau pressure less than 30 to 35 cm H20.|
|Obtain peak expiratory flow rate (PEFR) or forced expiratory volume in 1 second (FEV1) before and after respiratory treatment.||Peak expiratory flow rate (PEFR) is the maximum flow rate generated during forceful exhalation. It should be improved with effective therapy. FEV1 is the volume exhaled during the first second of a forced expiratory maneuver started from the level of total lung capacity.|
|Pace the client’s activities.||Break up activities into smaller parts and take rest breaks in between to avoid fatigue. increased effort in breathing properly.|
|Encourage deep breathing and coughing exercises.||Helps loosen and expectorate excess secretions and contribute in effective clearing mucus out of the lungs.|
|Encourage increased fluid intake of up to 3000 ml/day within cardiac or renal reserve.||Fluids help minimize mucosal drying and increases ciliary action to remove secretions.|
|Limit alcohol and caffeinated drinks.||When consumed in excess, it may contribute to dehydration making difficulty for secretions to be expectorated. In addition, it may also increased the risk of CNS and cardiovascular system side effects of medications.|
|Administer IV fluids and medication as ordered.||IV fluid therapy can be beneficial for clients with dehydration. Medications such as bronchodilators and inhaled corticosteroids may be prescribed.|
|Administer oxygen as ordered.||Oxygen therapy corrects hypoxemia, which can be caused by retained respiratory secretions.|
|Anticipate the need for intubation and mechanical ventilation.||Acute exacerbations of asthma can lead to respiratory failure requiring mechanical ventilation.|
Recommended nursing diagnosis and nursing care plan books and resources.
- Nursing Care Plans: Nursing Diagnosis and Intervention (10th Edition)
An awesome book to help you create and customize effective nursing care plans. We highly recommend this book for its completeness and ease of use.
- Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions and Rationales
A quick-reference tool to easily select the appropriate nursing diagnosis to plan your patient’s care effectively.
- NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023 (12th Edition)
The official and definitive guide to nursing diagnoses as reviewed and approved by the NANDA-I. This book focuses on the nursing diagnostic labels, their defining characteristics, and risk factors – this does not include nursing interventions and rationales.
- Nursing Diagnosis Handbook, 12th Edition Revised Reprint with 2021-2023 NANDA-I® Updates
Another great nursing care plan resource that is updated to include the recent NANDA-I updates.
- Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5(TM))
Useful for creating nursing care plans related to mental health and psychiatric nursing.
- Ulrich & Canale’s Nursing Care Planning Guides, 8th Edition
Claims to have the most in-depth care plans of any nursing care planning book. Includes 31 detailed nursing diagnosis care plans and 63 disease/disorder care plans.
- Maternal Newborn Nursing Care Plans (3rd Edition)
If you’re looking for specific care plans related to maternal and newborn nursing care, this book is for you.
- Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care (7th Edition)
An easy-to-use nursing care plan book that is updated with the latest diagnosis from NANDA-I 2021-2023.
- All-in-One Nursing Care Planning Resource: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health (5th Edition)
Definitely an all-in-one resources for nursing care planning. It has over 100 care plans for different nursing topics.
Other recommended site resources for this nursing care plan:
- Nursing Care Plans (NCP): Ultimate Guide and Database
Over 150+ nursing care plans for different diseases and conditions. Includes our easy-to-follow guide on how to create nursing care plans from scratch.
- Nursing Diagnosis Guide and List: All You Need to Know to Master Diagnosing
Our comprehensive guide on how to create and write diagnostic labels. Includes detailed nursing care plan guides for common nursing diagnostic labels.
Other nursing care plans related to respiratory system disorders:
- Asthma | 8 Care Plans
- Bronchiolitis | 5 Care Plans
- Bronchopulmonary Dysplasia (BPD) | 5 Care Plans
- Chronic Obstructive Pulmonary Disease (COPD) | 7 Care Plans
- Cystic Fibrosis | 5 Care Plans
- Hemothorax and Pneumothorax | 3 Care Plans
- Influenza (Flu) | 5 Care Plans
- Lung Cancer | 5 Care Plans
- Mechanical Ventilation | 6 Care Plans
- Near-Drowning | 5 Care Plans
- Pleural Effusion | 6 Care Plans
- Pneumonia | 11 Care Plans
- Pulmonary Embolism | 4 Care Plans
- Pulmonary Tuberculosis | 5 Care Plans
- Tracheostomy | 5 Care Plans
References and Sources
The following are the references and sources for the nursing diagnosis and nursing care plan for asthma:
- Ackley, B. J., Ladwig, G. B., Msn, R. N., Makic, M. B. F., Martinez-Kratz, M., & Zanotti, M. (2019). Nursing Diagnosis Handbook E-Book: An Evidence-Based Guide to Planning Care. Mosby. [Link]
- Carpenito-Moyet, L. J. (2006). Handbook of nursing diagnosis. Lippincott Williams & Wilkins. [Link]
- Joyce, B. M., & Jane, H. H. (2008). Medical surgical nursing. Clinical management for positive outcome. Volume 1. Eight Edition. Saunders Elsevier. St. Louis. Missouri. [Link]
- Pellico, L. H., Bautista, C., & Esposito, C. (2012). Focus on adult health medical-surgical nursing. [Link]
- Yang, B. H., Chen, Y. C., Chiang, B. L., & Chang, Y. C. (2005). Effects of nursing instruction on asthma knowledge and quality of life in schoolchildren with asthma. The journal of nursing research: JNR, 13(3), 174-183. [Read Abstract]