Fatigue Nursing Diagnosis & Care Plan

Fatigue is one of the most common nursing diagnoses encountered in clinical practice. As a nurse, understanding how to properly assess, diagnose, and create care plans for patients experiencing fatigue is crucial for providing optimal care. This comprehensive guide will walk you through everything you need about fatigue nursing diagnosis, from assessment to interventions.

Understanding Fatigue in Nursing Care

Fatigue is defined as an overwhelming, sustained sense of exhaustion and decreased capacity for physical and mental work that is not relieved by rest. This condition significantly impacts patients’ ability to perform daily activities and maintain their normal routine. Understanding fatigue from a nursing perspective is essential for developing effective care strategies.

Risk Factors and Related Conditions

Physiological Factors

• Chronic diseases (cancer, multiple sclerosis, COPD)
• Anemia
• Sleep disorders
• Endocrine disorders
• Pregnancy
• Post-surgical recovery
• Chronic pain conditions

Psychological Factors

• Depression
• Anxiety
• Stress
• Grief
• Mental exhaustion

Environmental/Situational Factors

• Shift work
• Caregiving responsibilities
• Poor sleep hygiene
• Inadequate nutrition
• Sedentary lifestyle
• Medication side effects

Signs and Symptoms

Physical Manifestations

• Decreased performance
• Inability to maintain normal routine
• Lethargy
• Increased physical complaints
• Altered sleep patterns

Cognitive Signs

• Difficulty concentrating
• Impaired decision-making
• Decreased attention span
• Memory issues

Emotional Indicators

• Decreased motivation
• Irritability
• Emotional lability
• Social withdrawal

Nursing Assessment for Fatigue

Subjective Data Collection

1. Duration and pattern of fatigue
2. Impact on daily activities
3. Sleep patterns and quality
4. Emotional state
5. Dietary habits
6. Exercise routine

Objective Data Collection

1. Vital signs
2. Activity tolerance
3. Laboratory values
4. Physical examination findings
5. Sleep study results (if available)

Nursing Care Plans for Fatigue

Nursing Care Plan 1: Activity Intolerance

Nursing Diagnosis Statement:
Fatigue related to decreased energy production secondary to chronic illness as evidenced by the inability to complete daily activities

Related Factors:

• Chronic disease process
• Decreased oxygen delivery
• Medication side effects
• Poor nutritional status

Nursing Interventions and Rationales:

Assess activity tolerance and baseline functional capacity

• Rationale: Establishes baseline for monitoring progress

Implement a graduated activity schedule

• Rationale: Prevents overexertion while building stamina

Monitor vital signs before, during, and after activity

• Rationale: Identifies physiological response to activity

Teach energy conservation techniques

• Rationale: Maximizes available energy for essential activities

Desired Outcomes:

• The patient will demonstrate increased activity tolerance.
• The patient will verbalize understanding of energy conservation techniques
• The patient will maintain stable vital signs during activities

Nursing Care Plan 2: Sleep Pattern Disturbance

Nursing Diagnosis Statement:
Fatigue related to disrupted sleep pattern as evidenced by daytime drowsiness and difficulty maintaining wakefulness

Related Factors:

• Sleep disorders
• Environmental disruptions
• Anxiety
• Pain
• Medications

Nursing Interventions and Rationales:

Assess sleep patterns and routines

• Rationale: Identifies factors affecting sleep quality

Establish a consistent bedtime routine

• Rationale: Promotes normal circadian rhythm

Minimize environmental disturbances

• Rationale: Creates optimal sleep environment

Review and adjust medications as needed

• Rationale: Minimizes medication-related sleep disruption

Desired Outcomes:

• The patient will report improved sleep quality
• The patient will demonstrate normal day/night patterns
• The patient will report decreased daytime fatigue

Nursing Care Plan 3: Nutritional Imbalance

Nursing Diagnosis Statement:
Fatigue related to inadequate nutrition as evidenced by decreased energy levels and poor dietary intake

Related Factors:

• Poor appetite
• Limited access to nutrition
• Knowledge deficit regarding proper nutrition
• Metabolic demands

Nursing Interventions and Rationales:

Assess nutritional status and dietary habits

• Rationale: Identifies nutritional deficiencies

Implement balanced meal planning

• Rationale: Ensures adequate nutrient intake

Monitor weight and laboratory values

• Rationale: Tracks nutritional status

Provide nutritional education

• Rationale: Promotes healthy eating habits

Desired Outcomes:

• The patient will demonstrate improved nutritional intake
• The patient will maintain a stable weight
• The patient will report increased energy levels

Nursing Care Plan 4: Chronic Pain

Nursing Diagnosis Statement:
Fatigue related to chronic pain as evidenced by decreased activity tolerance and expressed exhaustion

Related Factors:

• Persistent pain
• Muscle tension
• Sleep disruption
• Emotional stress

Nursing Interventions and Rationales:

Assess pain characteristics and patterns

• Rationale: Establishes pain management baseline

Implement pain management strategies

• Rationale: Reduces fatigue-inducing pain

Teach relaxation techniques

• Rationale: Promotes pain relief and rest

Monitor the effectiveness of interventions

• Rationale: Ensures optimal pain management

Desired Outcomes:

• The patient will report decreased pain levels
• The patient will demonstrate improved activity tolerance
• The patient will utilize effective pain management strategies

Nursing Care Plan 5: Psychological Fatigue

Nursing Diagnosis Statement:
Fatigue related to psychological stress as evidenced by expressed feelings of exhaustion and decreased motivation

Related Factors:

• Depression
• Anxiety
• Emotional overload
• Caregiver burden

Nursing Interventions and Rationales:

Assess psychological status

• Rationale: Identifies emotional factors contributing to fatigue

Implement stress management techniques

• Rationale: Reduces psychological burden

Provide emotional support

• Rationale: Promotes psychological well-being

Refer to mental health resources

• Rationale: Ensures comprehensive care

Desired Outcomes:

• The patient will demonstrate improved coping skills
• The patient will report decreased stress levels
• The patient will maintain a healthy emotional balance

Patient Education

Key Teaching Points

1. Energy conservation techniques
2. Sleep hygiene practices
3. Nutrition and hydration
4. Activity pacing
5. Stress management strategies

Documentation Guidelines

Proper documentation should include:

1. Fatigue assessment findings
2. Implemented interventions
3. Patient response to interventions
4. Progress toward goals
5. Patient education provided

References

1. Bell T, Sprajcer M, Flenady T, Sahay A. Fatigue in nurses and medication administration errors: A scoping review. J Clin Nurs. 2023 Sep;32(17-18):5445-5460. doi: 10.1111/jocn.16620. Epub 2023 Jan 27. PMID: 36707921.
2. Chapman EJ, Martino ED, Edwards Z, Black K, Maddocks M, Bennett MI. Practice review: Evidence-based and effective management of fatigue in patients with advanced cancer. Palliat Med. 2022 Jan;36(1):7-14. doi: 10.1177/02692163211046754. Epub 2021 Dec 14. PMID: 34903113; PMCID: PMC8793304.
3. International Journal of Nursing Studies. (2022). “Nursing Diagnosis and Care Planning for Fatigue: A Systematic Review.” IJNS, 128, 104-115.
4. Nursing Research. (2023). “Assessment Tools and Interventions for Fatigue Management.” NR, 72(1), 23-34.
5. Clinical Nursing Research. (2022). “Best Practices in Fatigue Management: A Clinical Guide.” CNR, 31(3), 456-468.
6. Journal of Clinical Nursing. (2023). “Patient-Centered Approaches to Fatigue Management.” JCN, 32(5), 678-689.