Sedentary lifestyle related to lack of time as manifested by occupational status as a call center supervisor and stays at home to rest.

SB: Sedentary lifestyle is a medical term used to denote a type of lifestyle with no or irregular physical activity. A person who lives a sedentary lifestyle may colloquially be known as a couch potato. It is commonly found in both the developed and developing world. Sedentary activities include sitting, reading, watching television and computer use for much of the day with little or no vigorous physical exercise. A sedentary lifestyle can contribute to many preventable causes of death. A lack of physical activity is one of the leading causes of preventable death worldwide. A sedentary lifestyle and lack of physical activity can contribute to or be a risk factor for: One response that has been adopted by many organizations concerned with health and environment is the promotion of active travel, which seeks to promote walking and cycling as safe and attractive alternatives to motorized transport. (http://www.freebase.com/view/en/sedentary_lifestyle/-/base/pethealth) Interventions:
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Determined current activity level and plan progressive exercise program tailored to the individuals physical condition, goals, and choice. Rationale: Commitment on the part of the client enables the setting of more realistic goals and adherence to the plan. Discussed benefits of Exercise R; nforming the patient of the benefits will motivate them to engage in physical Activities

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Discussed appropriate warm-up exercises, cool-down activities, and specific techniques to avoid injury. Rationale: Preventing muscle injuries allows client to stay active. Time spent recuperating from exerciseinduced injuries may result in relapse to sedentary habits. Recommend keeping a graph of activity as exercise program advances. Rationale: Provides visual record of progress and positive reinforcement for efforts. Reviewed necessity for and benefits of regular exercise. Rationale: Exercise promotes weight loss by reducing appetite, increasing energy, toning muscles, and enhancing cardiac fitness and sense of well-being and accomplishment. Planned care for maximal activity within the clients ability. R: To promote wellness.

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Taught an at-home sleep routine like maintaining a daily schedule for waking, sleeping, resting, and playing. R: To promote healthy lifestyle at home.

Desired Outcome: Within 8 hours og nursing intervention, patient will be able to understand the importance of regular exercise to weight loss and general well- being.

Actual Outcome: After 8 hours of nursing intervention, patient was able to identify some necessary precautions and safety concerns to maintain a good health status.

Fatigue related to disease states as manifested by lack of energy, drowsy and tired appearance. SB: Fatigue may be the result of one or more environmental causes such as inadequate rest, improper diet, work and home stressors, or poor physical conditioning, or one symptom of a chronic medical condition or disease process in the body. (www.healthatoz.com)
1. Determined the ability to participate in activities/level of mobility. R: Fatigue can limit the persons ability o participate in self-care and to perform his responsibilities. 2.Assessed presence/degree of sleep disturbances. R: Changes in the persons sleep pattern may be a contributing factor in the development of fatigue. 3.Assessed patients nutritional intake of calories, protein, minerals and vitamins. R: Fatigue may be a symptom of protein malnutrition, vitamin deficiencies, or iron deficiencies. 4. Provided environment conducive to relief of fatigue (e.g. lowering of temperature of air conditioner, minimize noise and bright lighting) R: Temperature and level of humidity are known to affect exhaustion. 5.Avoided over-stimulation/under stimulation R: Over-stimulation increases fatigue 6.Placed care with consistent rest periods between activities. R: To conserve energy 7. Stress the importance of frequent rest periods. R:Energy reserves may be depleted unless thepatient respects the bodys need for increased rest.

Desired Outcome: Within 8 hours of nursing intervention, the patient will report improved sense of energy, perform ADLs , participate in desired activities at level of tolerance, and identify ways of minimizing fatigue such as taking naps in the afternoon, perform ADLs and participate in desired activities at level of own ability. Actual Outcome:
After 8 hours of nursing intervention, the patient still appeared tired and drowsy with

minimal effort to perform ADLs. The patient still needed assistance in performing ADLs such as feeding, changing clothes and going to the toilet.

Partial Self- Care Deficit r/t weakness and fatigue as manifested by muscle strength of 3/5 of both upper and lower extremities and docs order of CBRsTP.
Scientific basis: Self-care deficits are often exacerbated because of the increased disease activity. It is important to help client to maintain as much independence as possible during periods of acute flares, so both self-esteem and physical functions are enhanced. (Medical-Surgical Nursing, Black and Hawks, 7th Ed., Vol. 2, p. 2356-2357). Clients with physical or cognitive impairments needs assistance with all or some aspects of the personal hygiene. Assessment of the clients physical and cognitive status determines specifically what aspects of hygiene care can be performed independently, those that require total assistance. (Fundamentals of Nursing by Potter and Perry, 6th Ed., p. 1014).

1. Assessed abilities and level of deficit for performing ADLs. R: Aids in anticipating and planning for meeting individual needs. 2. Avoided doing things for patient that he can do for himself; however, provided assistance as necessary. R: Patients may become dependent, and although assistance is helpful in preventing frustration, it is important for patient to do as much as possible for self to maintain self-esteem and promote recovery. 3. Determined individual strengths and skills of the patient. R: To assess degree of disability. 4. Arranged necessary things within patients reach. R: To conserve energy. 5. Provided a well-ventilated, warm and calm environment. R: To reduce environmental stimuli and provide comfort. 6. Encouraged presence of S.O. in assisting with clients needs. R: Provides an opportunity for S.O. in client care. 7. Encouraged to verbalize need for assistance in performing self-care. R: To lessen fatigue and promote safety. 8. Provided communication among those who are involved on caring for/assisting the client.

R: Enhances coordination and continuity of care. 9. Provided privacy for personal care activities. R: To remove client from insecurities. Desired Outcome: Within 8 hours of nursing intervention, the patient will be able to perform self-care activities within level of own ability and maintain proper hygiene with minimal support and supervision. Actual Outcome: After 8 hours of nursing intervention, The patient still needed assistance in performing

ADLs such as feeding, and grooming.