Which nursing diagnosis is associated with impaired gas exchange?

• A. Acute pain related to injury
• B. Impaired gas exchange related to respiratory conditions
• C. Risk for infection related to poor hygiene
• D. Activity intolerance related to fatigue

Answer: (B)

Impaired gas exchange reflects a mismatch between ventilation and perfusion at the level of the lungs, leading to inadequate oxygen uptake and/or insufficient removal of carbon dioxide. In nursing diagnoses, this label is used when a patient has a respiratory condition that disrupts the alveolar-capillary interface or airflow, such as pneumonia, COPD, pulmonary edema, or atelectasis. That connection is why this option best fits: the problem is specifically tied to a respiratory condition causing impaired exchange of gases.

Think about what you’d expect to see with impaired gas exchange: increased work of breathing, rapid or shallow breathing, use of accessory muscles, restlessness or confusion from hypoxemia, tachycardia, and low oxygen saturation or abnormal arterial blood gases showing low PaO2 and/or elevated PaCO2. Interventions focus on supporting ventilation and oxygenation, such as positioning to improve chest expansion, encouraging effective breathing patterns, airway clearance techniques, incentive spirometry, suctioning if needed, ensuring prescribed oxygen delivery, and treating the underlying condition to restore gas exchange.

The other options describe different nursing problems—for example, pain related to injury, infection risk related to hygiene practices, or activity intolerance due to fatigue—that do not center on the lungs’ ability to exchange gases. While those issues can accompany respiratory problems, they are not the nursing diagnosis that directly captures impaired gas exchange.