Activity Intolerance Nursing Diagnosis and Nursing Care Plan

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Activity Intolerance Nursing Care Plans Diagnosis and Interventions

Activity Intolerance NCLEX Review and Nursing Care Plans

An Activity Intolerance nursing diagnosis that can be used when a person has difficulty completing activities due to fatigue, pain, or breathlessness. Activity intolerance may also occur when an individual has difficulty mobilizing due to weakness or stiffness.

Nursing interventions for activity intolerance include providing rest periods, teaching about pacing oneself, and providing support and assistance with activities as needed.

Nanda nursing diagnosis defines activity intolerance as a state in which a person is unable to produce enough physical or mental energy to complete one or more activities of daily living (ADLs).

Related Factors to Activity Intolerance

There are several factors that may affect an individual’s tolerance to activity. These include:

  • Advanced age
  • Mental status such as: depression, lack of motivation, cognitive deficiency, severe stress
  • Generalized weakness
  • Sedentary lifestyle
  • Deconditioned state
  • Inadequate sleep / rest
  • Immobility
  • Extended bed rest or imposed activity restriction
  • Muscular problems
  • More oxygen demand than supply
  • Pain

Signs and Symptoms of Activity Intolerance

Activity Intolerance can be characterized by the following signs and symptoms:

  • Generalized body weakness
  • Dizziness
  • Shortness of breath upon exertion or during activity
  • Verbalization of unusual discomfort when doing ADLs
  • Inability to perform basic activities such as brushing teeth and going to the toilet
  • Blood pressure and/or heart rate changes during activity

Activity Intolerance Nursing Diagnosis

Activity Intolerance Nursing Care Plan 1

Infective Endocarditis

Nursing Diagnosis: Activity intolerance related to pulmonary insufficiency secondary to infective endocarditis as evidenced by fatigue during activity, shortness of breath upon exertion, generalized body weakness, and oxygen desaturation to less than 94% after activity

Desired Outcome: The patient will demonstrate active participation in necessary and desired activities and demonstrate increase in activity levels.

Activity Intolerance Nursing InterventionsRationales
Assess and monitor the cardiopulmonary status of the patient by checking the vital signs before and after and activity. Include monitoring of orthostatic blood pressure.Normally, the adult heart rate does not increase more than 20 – 30 beats per minute on top of the resting heart rate. Elderly patients may have orthostatic hypotension when changing positions or doing activities, which can be evidenced by dizziness or increased weakness.
Assess the patient’s oxygen saturation during activity using a portable pulse oximeter.A portable pulse oximeter is helpful in determining the body’s need for supplemental oxygen to help the patient cope with increased oxygen demand when performing activities of daily living or exercise.
Observe the patient’s response to activity and document in an Activity Chart.An Activity chart can help show trends on a patient’s tolerance to performing ADLs or exercise, such as duration, need for supplemental oxygenation, support from staff, or pain medication.
Teach the patient to gradually do more active range of motion (ROM) exercises while in bed. Start with sitting from the bed into the chair for 30 mins, standing and walking for a minute or two, and sitting again.It is important to promote ROM exercises to prevent muscular decline and improve energy levels. However, this must be done gradually to prevent overexertion.
Encourage the patient to perform deep breathing exercise at least 3 times a day.Deep breathing exercises, also known as thoracic expansion exercises, help in increasing lung volumes and moving any phlegm from the lower lobes of the lungs upwards to be effectively coughed out.

Activity Intolerance Nursing Care Plan 2

Fracture

Nursing Diagnosis: Activity intolerance related to neuromuscular skeletal impairment and limb immobilization secondary to hip fracture as evidenced by limited range of motion (ROM), decreased muscular strength, pain upon movement, and imposed restrictions due to the required restrictive therapy.

Desired Outcome: The patient will demonstrate active participation in necessary and desired activities and demonstrate increase in activity levels.

Activity Intolerance Nursing Interventions Rationales
Assess the patient’s degree of immobility due to the restrictive therapy for the fracture. Monitor for other factors that affect activity intolerance such as pain and muscular weakness, during activity.Immobility due to the therapy is the main reason for the patient’s activity intolerance, but he/she might also require pain medications or support from nursing staff to perform ADLs.
Encourage the patient to perform active and passive ROM exercises for all muscle groups. Assist the patient as needed.ROM exercises help increase blood flow to bones and muscles. In turn, this improves muscular tone and preserves joint mobility while preventing muscular atrophy and contracture formation.
Teach the patient about isometric exercises to be done with the unaffected limbs.Isometric exercises work by contracting muscles without having to move the whole limb or bend the joints. Isometrics help in maintaining muscular mass and strength. It is important to note not to perform them on the affected limb or any area with acute bleeding or edema.
Encourage the patient to use the trapeze and post position as needed.The trapeze can help the patient move on the bed during skin care, hygiene, or linen changes.
Refer the patient to physical therapy/ occupational therapy/ rehabilitation team.A physical therapist can work with the patient and the rest of the team in creating a customized exercise regimen to help the patient gradually progress in tolerating daily activities. An occupational therapist and rehabilitation specialist can help the patient get back to his/her normal activities of daily living, or at least achieve the optimal performance of such activities, depending on the degree of injury and result of treatments.

Activity Intolerance Nursing Care Plan 3

Chronic Obstructive Pulmonary Disease (COPD)

Nursing Diagnosis: Activity intolerance related to imbalance between oxygen supply and demand secondary to COPD as evidenced by fatigue, overwhelming lack of energy, verbalization of tiredness, generalized weakness, and shortness of breath upon exertion

Desired Outcome: The patient will demonstrate active participation in necessary and desired activities and demonstrate increase in activity levels.

Activity Intolerance Nursing Interventions Rationales
Assess the patient’s activities of daily living, as well as actual and perceived limitations to physical activity. Ask for any form of exercise that he/she used to do or wants to try.To create a baseline of activity levels and mental status related to fatigue and activity intolerance.
Encourage progressive activity through self-care and exercise as tolerated. Explain the need to reduce sedentary activities such as watching television and using social media in long periods. Alternate periods of physical activity with 60-90 minutes of undisturbed rest.To gradually increase the patient’s tolerance to physical activity. To prevent exacerbation of COPD by allowing the patient to pace activity versus rest.
Teach deep breathing exercises and relaxation techniques.   Provide adequate ventilation in the room.To allow the patient to relax while at rest and to facilitate effective stress management. To allow enough oxygenation in the room.
Refer the patient to physiotherapy / occupational therapy team as required.To provide a more specialized care for the patient in terms of helping him/her build confidence in increasing daily physical activity.
Educate the patient on energy conservation techniques, which include:Working or moving at an even pacePushing rather than pullingSliding rather than pullingSitting to perform some tasksUsing aids such as wheeled carts for shopping, laundry, and carrying thingsPositioning frequently used items within reachResting for about an hour or two post-meals before doing an activityEnergy conservation techniques help reduce the body’s demand for oxygen, which allows the patient to accomplish more ADLs.

Activity Intolerance Nursing Care Plan 4

Alzheimer’s Disease

Nursing Diagnosis: Activity intolerance related to cognitive and perceptual impairment as evidenced by inability to move at will, inability to bear weight, muscular weakness, gait disturbances, moments of immobility, decreased fine and gross motor movement, and balance and coordination deficits.

Desired Outcome: The patient will demonstrate active participation in necessary and desired activities and demonstrate increase in activity levels.

Activity Intolerance Nursing Interventions Rationales
Assess the patient’s functional ability in terms of mobility and tolerance to activity. Assess for cognitive impairment that affects activity intolerance. Monitor for other factors that affect activity intolerance such as pain and muscular weakness, during activity.Immobility due to the progression of Alzheimer’s disease is the main reason for the patient’s activity intolerance, but he/she might also require pain medications or support from nursing staff to perform ADLs.
Encourage the patient to perform active and passive ROM exercises for all muscle groups. Assist the patient as needed.ROM exercises help increase blood flow to bones and muscles. In turn, this improves muscular tone and preserves joint mobility while preventing muscular atrophy and contracture formation.
Assist the patient in performing ADLs by providing simple and easy-to-understand instructions.Simple instructions can help the patient with AD to perform a task successfully with little to no help from a caregiver. There might be a need to repeat instructions.
Provide enough time for the patient to perform each activity.It is important not to rush the patient to avoid triggering disturbed thought or confusion.
Refer the patient to physical therapy/ occupational therapy/ rehabilitation team.A physical therapist can work with the patient and the rest of the team in creating a customized exercise regimen to help the patient gradually progress in tolerating daily activities. An occupational therapist can help the patient to achieve the optimal performance of such activities.

Activity Intolerance Nursing Care Plan 5

Cerebrovascular Accident (CVA) or Stroke

Nursing Diagnosis: Activity intolerance related to neuromuscular skeletal impairment secondary to stroke as evidenced by limited range of motion (ROM), and decreased muscular strength.

Desired Outcome: The patient will demonstrate active participation in necessary and desired activities and demonstrate increase in activity levels.

Activity Intolerance Nursing Interventions Rationales
Assess the patient’s activities of daily living, as well as actual and perceived limitations to physical activity. Ask for any form of exercise that he/she used to do or wants to try.To create a baseline of activity levels and mental status related to fatigue and activity intolerance.
Encourage the patient to perform active and passive ROM exercises for all muscle groups. Assist the patient as needed.ROM exercises help increase blood flow to bones and muscles. In turn, this improves muscular tone and preserves joint mobility while preventing muscular atrophy and contracture formation.
Teach deep breathing exercises and relaxation techniques. Provide adequate ventilation in the room.To allow the patient to relax while at rest and to facilitate effective stress management. To allow enough oxygenation in the room.
Provide adaptive equipment for the patient to use in performing ADLs.Stroke patients can benefit from using adaptive aids to help them gain independence in performing self-care tasks and reducing energy consumed while doing ADLs.
Encourage progressive activity through self-care and exercise as tolerated. Alternate periods of physical activity with 60-90 minutes of undisturbed rest.To gradually increase the patient’s tolerance to physical activity.  
Refer the patient to physical therapy/ occupational therapy/ rehabilitation team.A physical therapist can work with the patient and the rest of the team in creating a customized exercise regimen to help the patient gradually progress in tolerating daily activities. An occupational therapist and rehabilitation specialist can help the patient to achieve the optimal performance of such activities.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2022). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

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Please follow your facilities guidelines and policies and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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