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4 Apnea Nursing Care Plans

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By Paul Martin, BSN, R.N.
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Developing a nursing care plan for apnea patients requires a thorough understanding of the nursing diagnosis for this condition. Learn about common nursing diagnoses for apnea and how they can improve patient outcomes. Discover assessment, planning, and intervention strategies for apnea nursing care plans.

What is Apnea?

Apnea is defined as periodic cessation of breathing for more than 15 seconds in the full term or more than 20 seconds in the preterm infant. It may be related to sepsis, gastroesophageal reflux, metabolic abnormality, seizure disorder, trauma, or the impairment of breathing during sleep, although it is not uncommon to find no apparent causative factor.

Apneas in a preterm infant may be central, obstructive, or mixed. In central apnea, there is a loss of chest wall movement due to the depressed respiratory center in the brain, while obstructive apnea is caused by pharyngeal collapse, neck flexion, or nasal obstruction. Mixed apneas involve a central apnea that is directly followed by obstructive apnea.

Apnea occurs during infancy and is usually resolved by one year of age without resulting in the death of the infant. The apparent life-threatening event (ALTE) that is indicative of apnea is not considered a cause of SIDS (sudden infant death syndrome), although the infant with apnea is at slightly higher risk. Both apnea and high-risk SIDS infants may be monitored by an apnea-monitoring device as a preventive measure.

Nursing Care Plans

Nursing care plan for sleep apnea is directed at supporting the infant’s cardiopulmonary status, improvement in gas exchange and breathing pattern, attainment of an optimal level of parental coping, knowledge of the treatment program and home care, and absence of complications.

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Here are four (4) nursing care plans and nursing diagnosis for sleep apnea:

  1. Ineffective Breathing Pattern
  2. Impaired Gas Exchange
  3. Compromised Family Coping
  4. Risk for Altered Parenting

1. Ineffective Breathing Pattern

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Ineffective Breathing Pattern

Patients with apnea may exhibit ineffective breathing patterns related to impaired regulation. A dysfunction in the brain’s breathing regulation can cause irregular breathing patterns or pauses during sleep, leading to reduced oxygen levels and other health complications associated with sleep apnea.

Nursing Diagnosis

May be related to

  • Impaired regulation

Possibly evidenced by

  • Apnea during sleep
  • Shallow breathing
  • Changes in respiratory depth
  • Pallor, cyanosis

Desired Outcomes

  • The infant/child will maintain respiratory status to baseline parameters for pattern rate, depth, and ease.

Nursing Assessment and Rationales

1. Assess the frequency and pattern of breathing; Observe the presence of apnea and changes in the heart rate.
Infants with apnea have periods of cessation of breathing over 15-20 seconds accompanied by bradycardia.

2. Assess skin, nail beds, skin, and mucous membranes for pallor or cyanosis.
Reveals the presence of hypoxemia causing cyanosis from uneven distribution of gases and blood in the lungs, and alveolar hypoventilation caused by airway obstruction and absence of chest wall movement.

3. Place the infant on an apnea monitor and pulse oximeter.
Identify changes in the chest movement,  heart rate, and oxygen saturation caused by apnea.

Nursing Interventions and Rationales

1. Position the infant’s head and neck in a neutral position.
If the neck bends too far forward or backward, blockage of breathing can happen.

2. Avoid prolonged suctioning; Discourage taking rectal temperatures and tube feedings.
Vagal stimulation may cause bradycardia, triggering apneic episodes.

3. Provide tactile stimulation by applying a gentle rub on the soles of the feet or chest wall.
Indicated for mild and intermittent episodes of apnea to stimulate spontaneous breathing.

4. Administer methylxanthines (e.g., (theophylline, caffeine) as prescribed.
Used as a smooth muscle relaxant and a cardiac muscle and central nervous system stimulant.

5. Anticipate the use of nasal Continuous positive airway pressure (CPAP).
Indicated when the infant remains to have episodes of apnea despite producing a therapeutic level of methylxanthine.

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1. Ineffective Breathing Pattern

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance.

NANDA International Nursing Diagnoses: Definitions & Classification, 2021-2023
The definitive guide to nursing diagnoses is reviewed and approved by NANDA International. In this new version of a pioneering text, all introductory chapters have been rewritten to provide nurses with the essential information they need to comprehend assessment, its relationship to diagnosis and clinical reasoning, and the purpose and application of taxonomic organization at the bedside. A total of 46 new nursing diagnoses and 67 amended nursing diagnostics are presented.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions from NANDA-I 2021-2023 and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Other nursing care plans for pediatric conditions and diseases:

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Paul Martin, BSN, R.N.
Paul Martin R.N. brings his wealth of experience from five years as a medical-surgical nurse to his role as a nursing instructor and writer for Nurseslabs, where he shares his expertise in nursing management, emergency care, critical care, infection control, and public health to help students and nurses become the best version of themselves and elevate the nursing profession.

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