ACTIVITY INTOLERANCE
Definition:
Insufficient
physiological or psychological energy to endure or complete required or desired
daily activities
Related factors:
- Bed
rest
- Immobility
- Generalized
weakness
- Sedentary
lifestyle
- Imbalance
between oxygen supply and demand
Defining Characteristics:
Subjective
Report
of fatigue or weakness Exertional discomfort or dyspnea [Verbalizes no desire
and/or lack of interest in activity]
Objective
Abnormal
heart rate or blood pressure response to activity Electrocardiographic changes
reflecting dysrhythmias or ischemia [pallor, cyanosis]
Expected outcomes:
The patient will
- Regain and maintain muscle
mass and strength.
- maximum joint range of motion
(ROM).
- Perform isometric exercises.
- Help perform self-care
activities.
- Maintain heart rate, rhythm,
and blood pressure within expected range during periods of activity.
- State understanding of and
willingness to cooperate in maximizing the activity level.
- Perform self-care
activities to tolerance level
Interventions and
Rationales:
Determine:
Monitor
physiologic responses to increased activity level, including respirations,
heart rate and rhythm, and blood pressure, to ensure that these return to
normal within 2–5 min after stopping exercise.
Perform:
Perform
active or passive ROM exercises to all extremities every 2–4 hr. These
exercises foster muscle strength and tone, maintain joint mobility, and prevent
contractures.
Turn
and reposition patient at least every 2 hr. Establish a turning schedule for
the dependent patient. Post schedule at bedside andmonitor frequency. Turning
and repositioning prevent skin breakdown and improve lung expansion and prevent
atelectasis.
Maintain
proper body alignment at all times to avoid contractures and maintain
optimal musculoskeletal balance and physiologic function.
Encourage
active exercise: Provide a trapeze or other assistive device whenever possible. Such
devices simplify moving and turning for many patients and allow them to
strengthen some upper-body muscles.
Inform:
Teach
about isometric exercises to allow patients to maintain or increase
muscle tone and joint mobility.
Teach
caregivers to assist patients with ADLs in a way that maximizes patients’
potential. This enables caregivers to participate in pa tients’ care
and encourages them to support patients’ independence.
Attend:
Provide
emotional support and encouragement to help improve patient’s
self-concept and motivate patient to perform ADLs.
Involve
patient in planning and decision making. Having the ability to
participate will encourage greater compliance with the plan for activity.
Have
patient perform ADLs. Begin slowly and increase daily, as tolerated. Performing
ADLs will assist patient to regain independence and enhance self-esteem.
Manage:
Refer
to case manager/social worker to ensure that a home assessment has been done
and that whatever modifications were needed to accommodate the patient’s level
of mobility have been made. Making adjustments in the home will allow
the patient a greater degree of independence in performing ADLs, allowing
better conservation of energy
Reference:
Shin,
Y., Yun, S., Jang, H., & Lim, J. (2006). A tailored program for the
promotion of physical exercise among Korean adults. Applied Nursing Research,
19(2), 88–94.
COMMENTS