Nursing Care Plan for Activity Intolerance

Sample of nursing care plan for activity intolerance

Nursing diagnosis: activity intolerance


Definition of activity intolerance

  • Insufficient physiological or psychological energy to endure or complete required or desired daily activities
Related Factors of activity intolerance| Nursing Care Plan for Activity Intolerance



Defining Characteristics of activity intolerance| Nursing Care Plan for Activity Intolerance

SUBJECTIVE

  • Report of fatigue or weakness

  • Exertional discomfort or dyspnea

  • [Verbalizes no desire and/or lack of interest in activity]

OBJECTIVE

  • Abnormal heart rate or blood pressure response to activity

  • Electrocardiographic changes reflecting dysrhythmias or ischemia

  • [Pallor, cyanosis]


Functional Level Classification (Gordon, 1987) | Nursing Care Plan for Activity Intolerance


  • Level I: Walk, regular pace, on level indefinitely; one flight or more but more short of breath than normally

  • Level II: Walk one city block [or] 500 ft on level; climb one flight slowly without stopping

  • Level III: Walk no more than 50 ft on level without stopping; unable to climb one flight of stairs without stopping

  • Level IV: Dyspnea and fatigue at rest



Desired Outcomes/Evaluation of activity intolerance| Nursing Care Plan for Activity Intolerance

Criteria—Client Will:

  • Identify negative factors affecting activity tolerance and eliminate or reduce their effects when possible.

  • Use identified techniques to enhance activity tolerance.

  • Participate willingly in necessary/desired activities.

  • Report measurable increase in activity tolerance.

  • Demonstrate a decrease in physiologic signs of intolerance (e.g., pulse, respirations, and blood pressure remain within client’s normal range).


Nursing interventions for activity intolerance| Nursing Care Plan for Activity Intolerance


NURSING PRIORITY NO. 1. To identify causative/precipitating factors:

  • Note presence of factors contributing to fatigue (e.g., acute or chronic illness, heart failure, hypothyroidism, cancer, and cancer therapies, etc.).

  • Evaluate current limitations/degree of deficit in light of usual status. (Provides comparative baseline.)

  • Note client reports of weakness, fatigue, pain, difficulty accomplishing tasks, and/or insomnia.

  • Assess cardiopulmonary response to physical activity, including vital signs before, during, and after activity. Note progression/accelerating degree of fatigue.

  • Ascertain ability to stand and move about and degree of assistance necessary/use of equipment.

  • Identify activity needs versus desires (e.g., is barely able to walk upstairs but would like to play racquetball).

  • Assess emotional/psychologic factors affecting the current situation (e.g., stress and/or depression may be increasing the effects of an illness, or depression might be the result of being forced into inactivity).

  • Note treatment-related factors, such as side effects/interactions of medications.

NURSING PRIORITY NO. 2. To assist client to deal with contributing factors and manage activities within individual limits:

  • Monitor vital/cognitive signs, watching for changes in blood pressure, heart and respiratory rate; note skin pallor and/or cyanosis, and presence of confusion.

  • Adjust activities to prevent overexertion. Reduce intensity

  • Provide/monitor response to supplemental oxygen and medications and changes in treatment regimen.

  • Increase exercise/activity levels gradually; teach methods to conserve energy, such as stopping to rest for 3 minutes during a 10-minute walk, sitting down instead of standing to brush hair.

  • Plan care with rest periods between activities to reduce fatigue.

  • Provide positive atmosphere, while acknowledging difficulty of the situation for the client. (Helps to minimize frustration, rechannel energy.)

  • Encourage expression of feelings contributing to/resulting from condition.

  • Involve client/SO(s) in planning of activities as much as possible.

  • Assist with activities and provide/monitor client’s use of assistive devices (crutches, walker, wheelchair, oxygen tank, etc.) to protect client from injury.

  • Promote comfort measures and provide for relief of pain to enhance ability to participate in activities. (Refer to ND Pain, acute or Pain, chronic.)

  • Provide referral to other disciplines as indicated (e.g., exercise physiologist, psychologic counseling/therapy, occupational/physical therapists, and recreation/leisure specialists) to develop individually appropriate therapeutic regimens.

NURSING PRIORITY NO. 3. To promote wellness (Teaching/Discharge Considerations):

  • Plan for maximal activity within the client’s ability.

  • Review expectations of client/SO(s)/providers to establish individual goals. Explore conflicts/differences to reach agreement for the most effective plan.

  • Instruct client/SO(s) in monitoring response to activity and in recognizing signs/symptoms that indicate need to alter activity level.

  • Plan for progressive increase of activity level as client tolerates.

  • Give client information that provides evidence of daily/ weekly progress to sustain motivation.

  • Assist client to learn and demonstrate appropriate safety measures to prevent injuries.

  • Provide information about the effect of lifestyle and overall health factors on activity tolerance (e.g., nutrition, adequate fluid intake, mental health status).

  • Encourage client to maintain positive attitude; suggest use of

  • Encourage participation in recreation/social activities and hobbies appropriate for situation. (Refer to ND Diversional Activity, deficient.)



Documentation Focus | Nursing Care Plan for Activity Intolerance

ASSESSMENT/REASSESSMENT

• Level of activity as noted in Functional Level Classification.

• Causative/precipitating factors.

• Client reports of difficulty/change.



PLANNING| Nursing Care Plan for Activity Intolerance

• Plan of care and who is involved in planning.



IMPLEMENTATION/EVALUATION| Nursing Care Plan for Activity Intolerance

  • Response to interventions/teaching and actions performed.

  • Implemented changes to plan of care based on Assessment/Reassessment findings.

  • Teaching plan and response/understanding of teaching plan.

  • Attainment/progress toward desired outcome(s).



DISCHARGE PLANNING| Nursing Care Plan for Activity Intolerance

  • Referrals to other resources.

  • Long-term needs and who is responsible for actions.

This is a sample of Nursing Care Plan for Activity Intolerance.
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