Insufficient physiologic pr psychological energy to complete or endure required or desired daily activities
- usual activity level, including self-care (dressing, feeding, toileting), transfer, walking, stair climbing, and aids for ambulation
- Cardiovascular status, including blood pressure, heart rate and rhythm (at rest and with activity), skin temperature and color, edema, and chest pain
- respiratory status, including arterial blood gas levels, auscultation for breath sounds, rate, rhythm, depth, and pattern of respirations at rest and with activity
- musculoskeletal status, including range of motion, muscle size, strength, tone, and functional mobility as follows:
0 = completely independent
1 = requires use of equipment or device
2 = requires help, supervision, or teaching from another person
3 = requires help from another person and equipment or device
4 = dependent, does not participate in activity
- laboratory studies, including complete blood count
- environmental factors, including safety hazards
- history of chronic illnesses
- sensory deficits, including hearing, vision, and touch
- psychosocial status, including cognitive and mental status, mood, affect, behavior, family support, coping style
- economic status
- medication history, including prescribed and over-the-counter medications
- cognitive impairment
- decreased mobility caused by chronic illness, contracture or stiffness or muscles or joints, pain on movement, or an unsafe environment
- feelings of isolation
- inability to manage one or more activities of daily living, such as shopping, housekeeping, laundry, and cooking
- inability to perform one or more self-care activities
ASSOCIATED MEDICAL DIAGNOSES
- Advanced cardiopulmonary illness
- advanced dementia
- chronic obstructive pulmonary disease
- macular degeneration
- rheumatoid arthritis
EXPECTED OUTCOMES (numbers following to each outcome correspond to numbered interventions)
- Patient uses assistive devices to carry out activities (1,2,7)
- Members of the interdisciplinary health care team coordinate to develop an activity regimen for the patient (3,5,7,9,10)
- patient identifies meaningful activities and develops a plan to incorporate them into is daily routine (4,6,7,8)
- Patient participates in exercise and social activities to the extent possible (8)
- Patient’s pulse, respirations, and blood pressure remain within established parameters during periods of activity. (9,10)
- patient discusses importance of good nutrition and adequate rest (11)
- patient describes plans to use support services (12)
INTERVENTIONS AND RATIONALES
- establish realistic goals for improving patient’s activity level, considering his physical limitations and energy level, to help improve his quality of life
- Demonstrate use of assistive devices, such as a cane, walker, or trapeze, to teach methods of conserving energy and independence.
- Coordinate patient’s activity regimen. For example, balance medical treatment, exercise program, nutrition plan, and referrals (such as home health services) to address the patient’s physical and psychosocial needs.
- encourage patient to express feelings about decreased energy levels to enhance acceptance
- Monitor patient’s medication to identify drugs that may impair activity tolerance.
- Help patient identify meaningful activities and incorporate them into his daily routine to heighten satisfaction with energy expenditure.
- Modify the environment to aid independent activity. for example, place bed on the first floor of the home, near a bathroom, and tell patient about energy –saving devices, such as an elevated toilet seat, a trapeze bar on the bed, and a chair that rise him to a standing position to promote independence.
- Encourage patient to become involved in exercise and social activities to increase stamina and decrease social isolation.
- Perform periodic health assessments and monitor complaints of weakness or fatigue to assess whether acute idleness or exacerbation of a chronic condition is causing activity intolerance.
- Establish progressive goals to increase ambulation. Since older patient may tire easily, his activity should increase gradually. Monitor vital signs before and after ambulation to detect cardiovascular insufficiency.
- Teach patient bout good nutrition and adequate rest to improve health practices.
- Refer patient to a home care agency for follow-up. discuss the impact on self-esteem of getting help from people or devices, and encourage patient to interview and select home health personnel to maintain independence
- observations of patient’s response to activity
- patient’s statements regarding need for activity
- observations of the patient’s skill in modifying activity level and use of support services to adjust to activity intolerance
- patient’s statements indicating willingness to adapt to activity limitations
- evaluations for each expected outcome
NURSING DIAGNOSIS CARDS 8th Edition