Introduction: chronic respiratory failure involves changes in the respiratory system, preventing its normal functioning. Inadequate gas exchange leading to the onset of compensatory mechanisms characterized by a sustained decrease in arterial oxygen pressure.Objective: manage the nursing care process for a pediatric patient with spinal muscular atrophy and chronic respiratory failure. Method: a qualitative, descriptive single case study was carried out. Data were collected through the use of observation, physical examination, documented review and interview techniques and the information was organized using the Assessment Guide according to Marjory Gordon's 11 functional health patterns.Results: the 4 altered patterns were identified and 8 nursing diagnoses were formulated (taxonomy II of NANDA I) prioritizing three: deterioration of spontaneous ventilation, ineffective cleaning of the airways and risk of deterioration of skin integrity. Subsequently, the objectives were set and care plans were created (NOC and NIC taxonomy) to then execute a large percentage of said nursing care and finally the NOC indicators were evaluated, differentiating both final and baseline scores. At the end, change scores of +1, +3, +2 were obtained.Conclusions: the nursing care process applied in the preschool was the basis for identifying the present problems and risks, as well as planning the necessary interventions and activities, executing them and evaluating them, in this way it was possible to adequately manage the care. pediatric