CUES

Subjective:

NURSING
DIAGNOSIS
Deficient

PLANNING

INTERVENTION

RATIONALE

At the end of the Independent:

nursing
Assess, document To compare and
note the progress in
interventions, the
and monitor vital
rehydration
or
client will have
signs.
decline
to
restored normal
dehydration.
fluid volume as

Poor skin turgor and

evidence by good Assess skin turgor
dry
mucous
skin turgor, moist
and
mucous
membranes signal
mucous
membranes
decreased
fluid
membranes, vital
volume.
signs
within

Dark
scant
and
normal
limits, Assess the color
dark-colored urine
and
decreased
and amount of
with
decreased
perspiration.
urine and specific
specific
gravity
gravity
denotes
fluid
volume deficit.
To note if patient is
Assess
fluid
in need of taking in
intake and output.
more fluids.
To
determine
if
Assess the fluid
there
is
equal
status in relation
intake and output of
to dietary intake.
fluids.
Encourage
to
To help restore a
drink prescribed
normal fluid volume
amount of fluid.
in the body.
Monitor
electrolyte
results.
Provides
hygiene.

A deficient fluid
volume may alter
electrolyte levels.
oral
Dry
mucous
membranes,
especially an oral
cavity, may cause

EVALUATION

peeling and oral

hygiene may also
promote interest in
drinking.

Dependent:
Administer
IV
fluids per doctors To help restore a
order
normal fluid volume
in the body

CUES
Subjective:

NURSING
DIAGNOSIS

PLANNING

INTERVENTION

RATIONALE

EVALUATION

Activity Intolerance Nursing Care Plan

Activity intolerance is a nursing diagnosis that is defined by NANDA as a state in which an individual has
insufficient physiological or psychological energy to endure or complete necessary or desired daily activities.
Factors that can lead to activity intolerance may include side effects of medication, extended bed rest, living
a sedentary lifestyle, regular restrictions to healthy activity levels, improper oxygen supply / demand
balance, pain, deprived or low-quality sleep, depression, lack of motivation and severe stress.
Activity intolerance may also be caused by age related conditions, especially among elderly patients.
Here is a list of some factors that may be related to activity intolerance:

RELATED FACTORS

Generalized weakness / age

Sedentary lifestyle / deconditioned state

Inadequate sleep / insufficient rest

Extended bed rest / muscular decline/ immobility

Imposed activity restriction

Imbalance between oxygen supply and demand

Pain

Depression

Lack of motivation

Severe stress

Cognitive deficiency

CHARACTERIZED BY
Activity intolerance may be characterized by a number of symptoms or signs such as:

Early signs of fatigue, dizziness and/or weakness

Abnormal discomfort or dyspnea during activity

Inability to perform basic activities

Abnormal blood pressure or heart rate level in response to activity level

EXPECTED OUTCOME
The goal or expected outcome of a proper care plan is to restore the patients ability to perform regular
activities in a healthy manner without experiencing any signs or symptoms of activity intolerance.
The expected outcome of a successful care plan may include:

Patient is able to provide positive verbal feedback in response to activity level

Patient is able to display and use effective energy management/conservation techniques

Patient is able to perform basic activities without excessive exhaustion or loss of energy

Patient is able to display physiological improvements over time

Patient is able to maintain regular cardiovascular and respiratory functions during activities

The following part of the discussion will focus on assessment techniques and intervention strategies that can
be applied to patients in order to help assist them in reducing and/or recovering from their activity
intolerance.

ASSESSMENT
Prior to and throughout a patients intervention plan it is important to perform regular assessments in order to
identify potential problems that may have led to activity intolerance as well as identify any issues that may
arise throughout the intervention.
When performing an assessment there are a number of techniques, strategies and practices that can be
implemented including the following:
1. Assess physical health level and potential injuries and/or illnesses. Identify if the health condition is severe
or minor and short-term or long-term.

1. Measure and evaluate patients cardiopulmonary status prior to and following scheduled activities to
identify primary concerns and track the status of improvement / decline.
2. Regularly interview, communicate and discuss with the patient concerns related to their activity
intolerance in order to address problems and determine the route cause of their activity intolerance.
3. Monitor and evaluate sleep quality, length and patterns. Identify and address potential sleep deficiencies
in order to maximize recovery / activity progress while reducing the opportunities for errors to occur.

4. Observe and assess emotional responses to performed activities in order to identify and address potential
stress responses, depression or mental / emotional conflicts.
5. Assess mobility level prior to exercise, stretching or other interventions to ensure the patient does not
injure or over-stress him / herself.
5. Assess and evaluate nutritional health habits to identify dietary needs and food related concerns.
6. When first waking or performing demanding tasks observe patients for symptoms related to activity
intolerance such as dizziness, impaired cognitive function and physical pain/stress as well as abnormal
changes in vital signs i.e. blood pressure and heart-rate.

7. Monitor and record patient health regularly and refer to the data in order to identify abnormalities,
performance improvements or performance declines.
8. Observe and record skin integrity throughout the day to check for symptoms and health status.
9. Observe and assess pain level prior to and upon completion of activities. If the patient is experiencing an
uncomfortable amount of pain reassesses the activity and determine whether or not the pain can be treated
prior to the activity being performed.

INTERVENTION
Intervention plans or treatments are designed to help patients improve their condition and reduce or
eliminate their activity intolerance.
Interventions may either be independent (managed by the patient alone) or collaborative (managed with the
aide of a medical professional).
Some interventions that may be performed to assist patients dealing with activity intolerance may include:
1. Encourage physical activity, develop proper patient exercise programs and ensure they are followed
regularly to help prevent muscle atrophy and strengthen the patients cardiovascular system. Physical activity
can also have a positive effect on the patients psychological status.

2. Evaluate patient recovery speed between sessions in order to ensure proper scheduling and prevent
additional overload or stress while the patient is still recovering from their previous sessions.
3. Allow and encourage proper rest periods in between individual exercises to ensure optimal performance
during sessions.
4. Eliminate nonessential activities or procedures to conserve energy output, conserve strength for important
activities and ensure adequate rest.
4. Assist patients with planning and scheduling activities and provide direct feedback on performance and
improvements.
5. Help patient develop a proper diet plan and eating habits to help them improve their overall health status.
6. Minimize cardiovascular deconditioning through proper resting positions and postural exercises.
7. Assist with ADLs (activities of daily living) regularly as indicated by the physician or supervisor.
8. If appropriate maintain gradual progression of activities to improve performance overtime.
9. Educate patients on lifestyle choices, healthy habits and the importance of regular physical activity in daily
life.

10. If patients are feeling symptoms of activity intolerance such as dizziness or their condition has worsened
encourage them to stop their activity until they recover and reevaluate their exercise program.
11. Encourage patient to develop good breathing habits in order to improve cardiovascular functions and
reduce stress levels.
12. Observe and address restrictive clothing and items that may impact proper blood flow, oxygen levels and
physical comfort.