Management of Ineffective Breathing Patterns via Ventilatory Support with Diaphragmatic Breathing Therapy in Asthma Patients at dr. Gondo Suwarno Regional General Hospital, Ungaran

Abstract

Asthma is a chronic inflammatory airway disease that may cause ineffective breathing patterns because airway narrowing increases the work of breathing and limits adequate ventilation. Diaphragmatic breathing is a non-pharmacological nursing intervention that can be used as supportive ventilation to improve breathing control and reduce respiratory discomfort. This case study aimed to describe the management of ineffective breathing pattern through ventilatory support with diaphragmatic breathing therapy in an asthma patient at RSUD dr. Gondo Suwarno Ungaran. A descriptive case study design was used with a nursing process approach consisting of assessment, nursing diagnosis, planning, implementation, and evaluation. The subject was one 74-year-old man with asthma attack and dyspnea accompanied by comorbid congestive heart failure, peripartum cardiomyopathy, hypertensive heart disease, and right heart failure. The intervention was implemented for three days, 29–31 July 2026, and included respiratory monitoring, semi-Fowler positioning, oxygen therapy according to the medical program, collaborative nebulization, and diaphragmatic breathing exercise for 10–15 minutes. Evaluation was performed descriptively using subjective and objective findings and SOAP documentation. The initial assessment showed dyspnea, increased respiratory effort, respiratory rate of 28 breaths/minute, and oxygen saturation of 93% while receiving oxygen through a nasal cannula at 3 L/minute. During the three-day management, the patient reported progressively reduced dyspnea, showed improved breathing pattern, reduced use of accessory muscles, and became able to perform diaphragmatic breathing independently. On the third day, blood pressure was 139/87 mmHg, pulse 83 beats/minute, temperature 37°C, SpO₂ 100%, and respiratory rate 22 breaths/minute. The nursing problem was assessed as partially resolved. The findings indicate that diaphragmatic breathing may support improvement of respiratory status when combined with comprehensive medical and nursing management. Because the patient also received oxygen, positioning, nebulization, and other medical interventions, the improvement cannot be attributed to diaphragmatic breathing alone. Continued respiratory monitoring and patient-family education are recommended.