What is the priority nursing diagnosis for a patient with atelectasis?

• A. Impaired gas exchange related to alveolar collapse
• B. Acute pain
• C. Activity intolerance
• D. Imbalanced nutrition

Answer: (A)

Atelectasis directly reduces the surface area available for oxygen and carbon dioxide exchange because some alveoli collapse and are not ventilated. This creates a mismatch between ventilation and perfusion and leads to hypoxemia, which is why the priority nursing diagnosis is impaired gas exchange related to alveolar collapse. The focus, then, is on interventions that re-expand the alveoli and improve oxygenation—promoting deep breathing and coughing, using incentive spirometry, encouraging ambulation and position changes to optimize lung expansion, and closely monitoring oxygen saturation and assessments for signs of respiratory distress. While pain, activity tolerance, and nutrition are important to overall recovery, they do not address the immediate risk of inadequate gas exchange as directly as the plan to restore alveolar ventilation and oxygenation.