NANDA-I 2024-2026 edition · Reviewed November 2, 2026 by the editorial team
What happens in pneumonia and where nursing comes in
The infection fills the alveoli with exudate: the patient has secretions they cannot clear, oxygen moves into the blood less efficiently, temperature rises and the work of breathing goes up. Nursing care targets the airway, oxygenation, fever, hydration and mobility.
What to assess
- Respiratory rate, work of breathing and oxygen saturation.
- Cough, amount and appearance of secretions, and lung sounds.
- Temperature and heart rate.
- Mental status, especially in older adults.
- Fluid intake, urine output and signs of dehydration.
- Activity tolerance when sitting up or walking.
NANDA-I 2024-2026 nursing diagnoses for pneumonia
| Code | Diagnosis | When it applies |
|---|---|---|
| 00031 | Ineffective airway clearanceProblem-focused | Copious or thick secretions and a cough that cannot clear them. |
| 00030 | Impaired gas exchangeProblem-focused | Low SpO2 or abnormal ABGs from exudate in the alveoli. |
| 00007 | HyperthermiaProblem-focused | Fever from the infection. |
| 00032 | Ineffective breathing patternProblem-focused | Tachypnea and shallow breathing, often due to pleuritic pain. |
| 00298 | Decreased activity toleranceProblem-focused | Dyspnea and fatigue with movement during the acute phase and recovery. |
| 00420 | Risk for inadequate fluid volumeRisk · former code 00028 | Fever, tachypnea and poor oral intake increase fluid losses. |
How to prioritize them
Airway and oxygenation first (00031 and 00030), then fever and hydration, and activity tolerance last. Your assessment makes the final call: anything that threatens life (airway, breathing, circulation) comes first.
Sample nursing diagnosis statements
Ineffective airway clearance related to thick secretions and incisional pain with coughing as evidenced by a weak cough that does not clear secretions, bilateral basilar rhonchi and SpO2 of 91%.
Impaired gas exchange related to shallow breathing from pleuritic pain and prolonged supine positioning as evidenced by SpO2 of 86% on room air, drowsiness and PaCO₂ of 55 mmHg on ABG.
Hyperthermia related to dehydration and exposure to a hot environment as evidenced by axillary temperature of 39.2 °C (102.6 °F), hot flushed skin and heart rate of 118 bpm.
Ineffective breathing pattern related to pain on inspiration after thoracotomy and respiratory muscle fatigue as evidenced by respiratory rate of 28 breaths/min, shallow breathing and accessory muscle use.
Decreased activity tolerance related to prolonged bed rest and inadequate oxygenation during exertion as evidenced by HR increase of 32 bpm when walking 10 meters, SpO2 of 87% while ambulating, and Borg dyspnea score of 6/10.
Risk for Inadequate Fluid Volume related to losses from an NG tube to suction, fever, and NPO status, in a patient with acute pancreatitis (associated condition).
Fictional cases written by our team. Adapt them to your patient with the PES statement generator.
Nursing care plan summary
Main goals and interventions for the priority diagnoses. Each diagnosis page has the full plan, with rationales and a case study.
Ineffective airway clearance (00031)
Goals
- Patient clears secretions with an effective cough within 24 hours.
- Rhonchi decrease on auscultation by day 2.
Interventions
- Auscultate lung fields every shift and before and after airway clearance techniques.
- Teach effective coughing: deep breath, hold, then two or three coughs.
- Encourage fluid intake unless restricted.
- Position the patient sitting or semi-sitting and reposition frequently.
Impaired gas exchange (00030)
Goals
- Patient maintains an oxygen saturation of 92% or higher (or 88-92% with COPD and CO₂ retention).
- Patient is awake and oriented within 12 hours.
Interventions
- Give oxygen as prescribed with the ordered device and flow rate, and document saturation.
- Use semi-Fowler's or Fowler's position and reposition regularly.
- Monitor mental status every shift.
- Encourage coughing and deep breathing or incentive spirometry.
Hyperthermia (00007)
Goals
- Temperature drops below 38 °C (100.4 °F) within 2 hours of starting the ordered measures.
- Urine output stays above 0.5 mL/kg/h in adults or 1 mL/kg/h in children.
Interventions
- Check temperature every 1 to 4 hours depending on the trend.
- Give prescribed antipyretics and reassess in 30-60 minutes.
- Remove excess clothing and keep the room cool and well ventilated.
- Apply cooling measures such as lukewarm compresses if indicated. Do not use alcohol or ice water.
Build the full care plan as a table with the generator.
Frequently asked questions
What is the priority nursing diagnosis for pneumonia?
It depends on your assessment, but the most common one is Ineffective airway clearance (00031) when the patient has secretions they cannot clear. If oxygen saturation is low, Impaired gas exchange (00030) moves to the top.
Can I write "pneumonia" as the related factor?
No. Pneumonia is the associated condition. The related factor should be something nursing can change, such as thick secretions or pain when coughing.
How many nursing diagnoses should a pneumonia care plan have?
As many as your assessment supports. For school assignments, three to five prioritized diagnoses is typical.
Other conditions
Study material: the diagnosis selection, sample statements and care plans were written by our editorial team using the NANDA-I 2024-2026 classification. They do not replace clinical judgment or your facility's protocols.
Classification sources: NANDA-I 2024-2026, Thieme supplement · Elsevier summary of changes. Reviewed November 2, 2026.