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
• 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.