Nursing Diagnosis Impaired Gas Exchange

Gas exchange is the term used to describe the body’s ability to get oxygen into the bloodstream and carbon dioxide out of the bloodstream. Oxygen is critical for tissue health and cell activity throughout the body, while carbon dioxide is a waste product that must be removed from cells so they can function properly. In fact, one of every six deaths in hospitals is associated with complications related to impaired gas exchange—and most are preventable.

Nursing Diagnosis Impaired Gas Exchange

1. Nursing Diagnosis Impaired Gas Exchange

Gas exchange is the exchange of oxygen and carbon dioxide between the lungs and the blood. When gas exchange is impaired, there is a problem with how your body’s respiratory system transports oxygen to your tissues.

Your respiratory system includes all of the parts that make it possible for you to breathe:

  • Your nose, pharynx (throat), trachea (windpipe), bronchi (bronchial tubes) and lungs make up your upper airway; they transport air into and out of your lungs.
  • Your diaphragm moves downward as you inhale; ribs on both sides expand outward as you inhale to create more space in your chest cavity so more air can flow in. This creates negative pressure inside your thoracic cavity which pulls air into your lungs through inspiration. When you exhale, muscles relax allowing elastic recoil of lung tissue to push negative pressure outside so that gas can be exchanged between hemoglobin molecules within blood cells for respiratory gases like oxygen and carbon dioxide by diffusion across capillary walls back into alveoli where diffusion exchange occurs again before returning them back down into systemic circulation through exhalation via action potentials from neuronal signaling from endings in parasympathetic nervous system branches at base of brain stem controlling smooth muscle fibers around bronchi/alveolar ducts leading directly into large veins carrying deoxygenated blood leaving capillaries entering right side lung going up towards left side alveoli getting ready for another cycle!

2. Criteria for Impaired Gas Exchange Nursing Diagnosis

Impaired gas exchange is a nursing diagnosis that may be used to describe any situation in which the exchange of gases in and out of the body is impaired.

It can be caused by a number of factors that include:

  • Decreased oxygen availability, such as when someone has low blood oxygen levels (hypoxemia) or when their lungs do not work well enough for oxygen to reach the bloodstream (carbon dioxide retention).
  • Increased carbon dioxide levels in the blood stream, such as those caused by lung disease or heart failure.
  • Decreased blood flow to certain parts of your body due to injury or illness.

Signs and symptoms associated with this impairment include: shortness of breath, dizziness upon standing up after lying down flat on one’s back for long periods of time; fatigue while performing even simple activities; increased heart rate; anxiety/fearfulness about being unable to breathe normally; dry mouth/throat due to dehydration resulting from having difficulty swallowing because they are so thirsty all the time but cannot get enough liquids into their system fast enough before becoming too exhausted again.”

3. Impaired Gas Exchange Interventions and Goals

When patients have impaired gas exchange, it is essential that the nurse assess them carefully and promptly. The nurse should assess the patient’s respiratory rate, depth of breathing, and skin color. At this time the nurse should also assess the patient’s oxygen saturation using pulse oximetry. During regular assessments and throughout treatment, it is important for you to note changes in your patient’s vital signs and inform medical staff if anything seems abnormal or worrisome.

The following interventions are recommended for patients with impaired gas exchange:

  • Supplemental oxygen administration as prescribed by physician (when available).
  • Oxygen administration via nasal cannula at 100% when arterial oxygen saturation is below 92%.

4. By including gas exchange in the nursing interventions, the nurse can be sure that the patient is receiving adequate oxygenation.

The nurse needs to know that gas exchange is the exchange of O2 and CO2 between the lungs and bloodstream. Gas exchange is impaired when the lungs are unable to transfer oxygen from the atmosphere into capillaries in the alveoli of the lung tissue, or it can be impaired when carbon dioxide cannot be removed from blood vessels in alveoli. The latter may occur due to anemia or infection.

As an example, if a patient has pneumonia and develops hypoxia (low oxygen levels), his/her ability to perform activities requiring sustained effort will be affected.


When the nurse recognizes that a patient is experiencing impaired gas exchange, she will know how to treat and monitor the condition. The nurse can also be aware of what other nursing diagnoses might be present and should order laboratory tests or other diagnostic procedures accordingly.

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