Weakness Nursing Diagnosis and Care Plan

Last updated on February 20th, 2023 at 09:18 am

Weakness, also referred to as asthenia, is the sensation of exhaustion or extreme fatigue in the body. A person suffering from weakness may be unable to move a specific body part properly. Weakness can also lead to a lack of energy to move specific, or even all, parts of the body, as well as mental fatigue.

Some individuals have weakness in one part of their body, such as their arms or legs. Others may experience total body weakness due to a viral or bacterial infection, such as seasonal flu or liver disease.

Weakness may be temporary, but in some instances, it is chronic or persistent. Weakness is not considered a disease but a symptom of many acute and chronic health conditions. Weakness can also occur as an adverse effect of certain medications.

Signs and Symptoms of Weakness

Regional Weakness

Regional weakness manifests in specific body parts, such as the legs or arms. It differs from paralysis, which is the incapacity to move. A person suffering from weakness may feel like they must exert significant effort to move. The body parts suffering from regional weakness may experience the following symptoms:

  • Cramps or spasms of the muscles
  • Tremors or shaking
  • slowed or delayed movement

Full-Body Weakness

The full-body weakness affects the whole body. Extreme tiredness or fatigue may also occur. Other signs and symptoms of total body weakness include

  • Fever
  • influenza-like symptoms
  • Tiredness
  • Malaise
  • difficulty carrying out daily routine

Severe Signs and Symptoms

Weakness may be a symptom of a stroke or heart attack in rare circumstances. Both of these conditions can weaken one or both sides of the body. Other sudden and severe symptoms associated with stroke include:

  • speaking or understanding difficulties
  • vision problems in one or both eyes
  • walking difficulties
  • loss of balance
  • ataxia (poor muscle control),
  • Lightheadedness
  • cognitive dissonance
  • a severe and sudden headache
  • paralysis of a body part

Other severe and sudden symptoms of a heart attack may also occur. Among the examples are the following:

  • chest pain, pressure, or squeezing sensations
  • back, chest, neck, or jaw pain or discomfort
  • pain in one or perhaps both arms
  • breathing difficulties
  • cold sweating
  • nausea
  • dizziness

Causes of Weakness

Underlying Conditions or Comorbidities. The following underlying medical conditions could lead to generalized fatigue and weakness:

  • flu
  • pituitary disorders
  • anemia
  • Gluten intolerance
  • chronic fatigue syndrome
  • fibromyalgia
  • depression
  • anxiety
  • insufficient sleep
  • obstructive sleep apnea
  • Diabetes that is poorly managed or undiagnosed
  • congestive heart failure
  • Vitamin B12 deficiency
  • Carcinoma
  • Stroke
  • coronary artery disease

Medications Side Effects. The following medications may cause weakness as a side effect:

  • opioids
  • mild tranquilizers used for the management of anxiety
  • antihistamines
  • antidepressants
  • Chemotherapy

Chemotherapy

Medications and vitamin overdoses can also cause weakness.

Natural Aging Process. Certain conditions that emerge more prevalently due to advancing age may also result in weakness. Among the possibilities are the following:

  • specific muscle diseases
  • arthritis
  • chronic obstructive pulmonary disease (COPD)
  • renal disorder
  • hepatic disease
  • Insomnia or other types of sleep disorders.

Other possible causes include the following:

  • muscle and nerve injuries or disorders
  • poison
  • eating an unbalanced diet
  • a sedentary lifestyle

Risk Factors of Weakness

  • Depression or anxiety. Mental disorders are some of the common causes of fatigue and account for nearly half of all cases of weakness.
  • Sedentary lifestyle. According to WHO, 60-85% of the world’s population does not get enough physical activity. Their muscles become weaker as a result of their inertia.
  • Aging. The ability of cells and tissues in the body to maintain homeostasis decreases with age, and symptoms of weakness appear more frequently when the person is under stress.
  • Infections. Persistent infectious diseases in the body, such as tuberculosis, hepatitis, or infective endocarditis, can result in muscle weakness and debilitation.
  • Chronic illnesses. Illnesses such as myasthenia gravis cause sudden, widespread weakness, and other chronic health conditions such as insomnia, diabetes, renal failure, and cancer can also impact the quality of life.
  • Pregnancy. The altered progesterone levels cause weakness and decrease energy levels during pregnancy.
  • Deficiencies. Nutrient deficiency is a typical risk factor for extreme weakness. Deficiencies, such as vitamin B12 insufficiency, can reduce the body’s energy levels. This insufficiency may cause the patient to feel dizzy and lethargic all of the time. An anemic person also has lower energy levels than someone who is not anemic.
  • Nervous System Disorders. Physical weakness can be caused by Parkinson’s disease, multiple sclerosis, and other neurological disorders.

Complications of Weakness

The following are complications of progressive weakness:

  • Difficulty walking. Some individuals who experience weakness will need to use a wheelchair at a certain point.
  • Difficulty in using the arms. When the muscles in the arms and shoulders are compromised, daily activities become more complex.
  • Muscle or tendon shortening around joints (contractures). Contractures can impede mobility even further.
  • Breathing difficulties. The muscles involved in breathing can suffer from progressive weakening. People with muscular dystrophy may need a breathing assistance device (ventilator) at some point, initially at night but even during the day.
  • Spine curve (scoliosis). Weakness may make it challenging to keep the spine straight.
  • Cardiac disorders. Weakness can impair cardiac muscle efficiency.
  • Difficulty swallowing. Nutritional difficulties and aspiration pneumonia might develop if the swallowing muscles are harmed. Using feeding tubes could be beneficial.

Diagnosis of Weakness

Weakness is not classified as a disease. Instead, it could be a manifestation of an underlying disease or an adverse reaction to a medication. As a result, the doctor first inquires about the nature of the fatigue, such as whether it is regional or generalized all through the body.

Then they look for the root causes.

  • Blood Tests
    • Complete blood count, including vitamin B12, folate, and ferritin levels.
    • In ruling out underlying chronic inflammatory disease, inflammatory markers such as ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein) should also be assessed.
    • Evaluating blood sugar levels, serum electrolytes, hepatic function tests, kidney function tests, thyroid function tests, and vitamin D levels is beneficial in diagnosing the root cause of weakness.
    • Autoantibody testing is used to rule out autoimmune disorders.
  • Urinalysis. A urinalysis is conducted to rule out hyperglycemia, liver or kidney disease, and pregnancy, particularly in women of reproductive age who have recently developed symptoms of fatigue or weakness.
  • Other laboratory examinations. If there is a presumption of underlying disorders, the subsequent tests may be performed:
    • HIV testingElectrocardiogram (ECG), and echocardiogram to rule out cardiovascular diseaseTuberculin testing, and a chest x-ray to rule out tuberculosis.
    • In some cases, a urine toxicology screen may be recommended, particularly if substance addiction is suspected.

Treatment of Weakness

The underlying d cause determines the treatment for weakness. In many cases, supportive care and counseling can be beneficial. Among the various treatments are the following:

  • NSAIDs and SSRIs. Used as symptomatic pain relief for weakness.
  • Individuals with generalized anxiety disorders, panic attacks, or adjustment disorders may be treated by therapists, general practitioners, or psychiatrists.
    • Antidepressants. Antidepressants are used to treat chronic weakness or fatigue caused by depression.
    • Cognitive behavioral therapy has also been demonstrated to be beneficial.
  • Antibiotics. Antibiotics are used to treat weakness that is caused by infection.
  • Oral or Intravenous electrolytes. If dehydration is the leading cause of weakness, the doctor will prescribe either oral or IV electrolytes, depending on the severity.
  • Iron supplements or Blood Transfusion. Iron and blood transfusion are necessary if the weakness is due to anemia.

Prevention of Weakness

Since weakness is related to various conditions, the most effective way to prevent it is to treat the underlying causes. Other possible preventive measures include: 

  • Increase physical activity. A sedentary lifestyle usually triggers weakness or asthenia.  
  • Eating nutritious foods and maintaining a balanced diet
  • Treat underlying sleep disorders since lack of sleep may also cause weakness.
  • Take medications if needed. 
  • Take supplements to prevent the effects of nutrient deficiency. Reduce caffeine and alcohol intake.
  • Consult a doctor once weakness starts to occur to prevent severe complications from arising.

Nursing Diagnosis for Weakness

Weakness Nursing Care Plan 1

Activity Intolerance

Nursing Diagnosis: Activity Intolerance related to weakness secondary to heart failure as evidenced by dyspnea, pallor, diaphoresis, imbalanced supply and demand of oxygen, fatigue, shortness of breath, and decreased cardiovascular function.

Desired Outcomes:

  • The patient will engage in chosen activities and meet self-care requirements.
  • The patient will see a significant increase in activity tolerance, as shown by decreased weakness and fatigue and vital signs within acceptable parameters during activity.
Weakness Nursing InterventionsRationale
Assess and monitor the patient’s response to activities.                  To assess whether vital signs and oxygen saturation levels are within the required range, they should be checked before, during, and shortly after activity. Within 3 minutes of finishing the activity, the heart rate should be restored to normal. The Heart Failure Association Guidelines advocate a moderate training program since it is effective, safe, and well-tolerated by heart failure patients. If the patient can endure the activity, use the information to establish goals for gradually increasing the frequency and duration of the activity.
Slow down the pace of treatment and provide the patient with enough rest before and after periods of activity. such as bathing, eating, and exercising.    Allow extra time for the patient to complete physical activities, especially for seniors. Because of decreasing muscle and strength, impaired balance, and other factors, older individuals are more prone to falls and accidents.
Examine the patient’s tolerance to increased activity.  Age, the existence of heart disease, and the level of activity are three factors that influence the danger of strenuous activities. Sudden cardiac arrest during exercise is unusual in healthy people. Individuals with cardiac disorders appear more vulnerable to abrupt cardiac arrest after intensive exercise (such as jogging) than healthy individuals.  
Consider using the 6-minute walk test (6MWT) to assess the patient’s physical capability.The 6MWT is an exercise test measuring the distance walked in 6 minutes. 6MWT aids in determining the patient’s cardiopulmonary response.
As needed, assist the patient with self-care activities and promote independence within prescribed boundaries.    Guiding patients in their Activities of Daily Living (ADLs) ensures their needs are satisfied while lowering the cardiac workload. Involve the patient as much as feasible and as tolerated by them in establishing a sense of control and decreasing helplessness.

Weakness Nursing Care Plan 2

Impaired Physical Mobility

Nursing Diagnosis: Impaired Physical Mobility related to weakness secondary to Guillain-Barre Syndrome as evidenced by ataxia, incapacity to move deliberately within the physical environment, including bed mobility, transfer, and ambulation, reduced range of motion (ROM), diminished muscular control and strength and fall trauma.

Desired Outcomes:

  • The patient’s strength and function of the affected extremity will improve.
  • The patient will show how to employ adaptive devices to improve mobility.
Weakness Nursing InterventionsRationale
Determine the patient’s motor strength or functional level of movement.  Understanding the patient’s motor strength enables the development of the best management plan available.  
Allow the patient to rest in between tasks and think about energy-saving strategies.    Rest intervals are critical for preserving energy and avoiding weariness.  
Assess the patient’s requirement for assistance equipment and create a safe setting, such as a low-profile bed with side rails raised.      The proper use of wheelchairs, canes, transfer bars, and other aids can increase mobility and lessen the danger of falling.  
Instruct the patient to conduct an active, passive, and isotonic range of motion exercises.  This method increases joint mobility, circulation, and muscular tone in the patient.  
Place the patient in a comfortable position. As tolerated, provide regular posture modifications.  This intervention relaxes the body and prevents the formation of decubitus ulcers.  
As directed, administer the patient with anticoagulants (blood thinners).  In preventing deep vein thrombosis, anticoagulants or blood thinners are used for patients with Guillain-Barre syndrome.  
Monitor the patient’s nutritional requirements as they relate to immobility.  Good nutrition also provides the energy needed to participate in exercise or rehabilitation activities.  
Provide padding to bony prominences such as the patient’s elbows and heels.    Maintaining the extremity in a natural position lowers the risk of pressure ulcers.  

Weakness Nursing Care Plan 3

Risk for Falls

Nursing Diagnosis: Risk for Falls related to weakness secondary to osteoporosis.

Desired Outcomes:

  • The patient will be able to avoid the risk of falling.
  • The patient will express a desire to use fall-prevention measures.
  • The patient will use selective preventative measures.
  • The patient and caregivers will incorporate methods to enhance home safety and avoid falls.
Weakness Nursing InterventionsRationale
Place the patient’s beds and sleeping surfaces as close to the floor as possible.              The risk of falls and serious injury is reduced by keeping the beds closer to the floor. In some healthcare institutions, placing the mattress on the floor reduces the likelihood of a fall. Low beds reduce the distance a patient falls when getting out of bed. Although these beds do not prevent falls, they shorten the distance between falls, minimizing trauma and multiple injuries.  
Consider using occupational and physical therapy to help the patient with gait strategies.  Occupational therapy is the therapeutic application of activities of daily living (ADL) in a group or an individual to enhance and develop involvement in roles, behavioral patterns, and routines at households, school, work, society, and other settings. These interventions allow people to incorporate exercise into their daily lives. Group exercises can be highly beneficial to seniors. Observing their peers while conducting the exercises can help them improve their responses and behavior.  
Educate patients on how to ambulate safely at home, including using safety features like handrails in the restroom.  This approach reduces anxiety at home and, as a result, the risk of falls during ambulation in their home setting. Elevated toilet seats can make it easier to get onto and off the toilet.  
Create an individualized care plan to prevent falls. Provide a care plan that is tailored to the patient’s specific requirements.    A multifaceted approach is necessary to plan a personalized fall prevention program for nursing care in any healthcare setting. Avoid relying too heavily on general fall precautions because everyone’s needs differ. To reduce the risk of patients falling, universal fall precautions are implemented for all patients. These standard strategies help create a secure environment that diminishes accidental falls and defines core preventive measures for all patients.  
Improve the patient’s at-home care.    Numerous community service organizations offer financial support to older adults to help them create safe home environments.

Weakness Nursing Care Plan 4

Risk for Injury

Nursing Diagnosis: Risk for Injury related to weakness secondary to musculoskeletal disorders.

Desired Outcomes:

  • Within 8 hours of nursing therapeutic intervention, the patient will identify the factors that significantly raise their risk of injury and illustrate injury-avoidance behavioral patterns.
  • The patient will be free of injuries after 4 hours of therapeutic interventions.
Weakness Nursing InterventionsRationale
Educate patients about home ambulation safety, such as using grab bars in the bathroom and wearing nonslip, well-fitting footwear, and encourage the patient to ask for help.            Home safety should be evaluated, discussed with patients and caregivers, and taken into account frequently when deciding on the patient’s future care to maximize their health outcomes. Educating the patient and caregiver about home environment adjustment is critical in promoting an active and independent lifestyle and preventing injury while experiencing weakness.  
During the transfer, use assistive devices such as cushions, gait belts, and slider boards.  Transferring a patient is a high-risk maneuver because of the possibility of injury to the client and the healthcare provider. Using assistive devices such as slider boards can help patients with mobility issues safely transfer from a bed to a chair. It is frequently used for patients with lower extremity balance and weakness, partial paralysis, and amputated lower limbs.  
Cooperate with a physical therapist to plan strengthening exercises and gait training to enhance mobility and decrease weakness. Communicate directly with occupational therapists for guidance in assisting patients with daily living activities (ADLs).  Gait training in physical therapy has been shown to avoid injury effectively. The collective efforts of individuals who provide either direct or indirect care to patients and the healthcare system result in safety.    
Before performing any procedure, such as elevating the head of the bed or tucking elbows in, consider the fundamentals of appropriate body mechanics.  Proper body mechanics reduces the risk of muscle and bone injury and promotes body movement to allow for physical mobility without putting too much strain on the muscles or using too much energy.  
Assist the patient when sitting and standing up from a chair or chair with an armrest if they are experiencing weakness symptoms. Use wheelchairs and Geri chairs only when necessary for the transportation.  Patients left in a wheelchair or Geri-chair are more prone to falling because they can stand up without locking the wheels or removing the footrests.    

Weakness Nursing Care Plan 5

Self-care Deficit

Nursing Diagnosis: Self-care Deficit related to weakness secondary to multiple sclerosis as evidenced by the lack of strength to perform activities and the inability to eat, bathe, and go to the comfort room independently.

Desired Outcomes:

  • The patient will accomplish ADLs to the best of their ability.
  • The patient will maintain his or her independence in performing ADLs.
  • The caregiver will be able to meet the patient’s personal preferences.
  • The patient will portray the appropriate use of assistive devices.
Weakness Nursing InterventionsRationale
Educate family and significant others on the importance of independence and intervening if the patient becomes weak, incapable of performing tasks, or highly agitated.                This intervention demonstrates concern and care while not impeding the patient’s efforts to achieve independence.  
Provide the patient with commodes or toilet risers.    A bedside commode can help with toileting in the middle of the night if the patient is weak and transferring or ambulation is difficult. If sitting and rising are difficult for the patient, a toilet riser positioned over a regular toilet can help.
Include the relatives and caregivers during the discussion of the patient’s treatment regimen.  Participation of family members, spouses, and other caregivers fosters dedication and awareness of each individual’s contribution to the success of nursing interventions.  
Advise the patient to consult with an occupational therapist.  If a patient is experiencing weakness and struggles to hold eating utensils and bring utensils to their mouth. They may require adaptive utensils or an occupational therapist assessment to make feeding extremely easy.
Assist the patient on his or her weak side during ambulation.  These techniques promote patient safety while also assisting with support and balance.  

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

Disclaimer:

Please follow your facilities guidelines, 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 intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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