This paper summarizes the systematic rehabilitation nursing experience for a patient with acute respiratory failure combined with heart failure and obesity. Key nursing interventions included implementing a sequential respiratory support strategy (high-flow oxygen therapy → non-invasive ventilation → transition to home ventilator), conducting phased exercise rehabilitation training, delivering precise nutritional management (total daily calorie intake controlled at 1500-1800 kcal), enhancing interdisciplinary risk prevention and control, and employing SMART goal setting for behavioral intervention. Following systematic intervention, after 4 days of hospitalization, the patient's SpO₂ increased from 80% to 92% while off mechanical ventilator support, and the self-care ability score rose to 85 points. One week after discharge, the patient's body weight had decreased by 2 kg, pulmonary function indices showed improvement, and the patient successfully returned to work.