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FATIGUE Nursing Care Plan

Causative factors related to fatigue may be psychological such as stress, anxiety, boring lifestyle or depression. It is also maybe environmental (noise, lights, humidity, temperature) or situational (occupation, negative life events). But mostly fatigue is due to physiological such as increased physical exertion, sleep deprivation, pregnancy, disease states, and malnutrition. Below is a sample of nursing care plan for patients with fatigue.

ASSESSMENT
Subjective:
 “I’m so tired, I need some rest,” as verbalized by the patient.

Objectives:
The patient is lethargic and drowsy. He/she is not interested to his/her environment and he/she didn't want to socialize with others. Vital signs are taken and noted as follows: Body temperature is 36.5 degrees Celcius, blood pressure is 120/80 mmHg, respiratory rate is 17 cycles per minute, and pulse rate of 88 beats per minute.

DIAGNOSIS
Fatigue related to lethargy as manifested by lack of energy and disinterest in the surroundings. (Lethargy is a condition when a person is irritable, can't stay still and can't find his/her comfort).

PLANNING
After 8 hours of nursing intervention, the patient will report improve sense of energy.

INTERVENTION
Ascertain client’s belief of about what is causing the fatigue. Assess vital signs to evaluate the fluid status and cardiopulmonary response to activity. Determine presence of sleep disturbances because fatigue can be a  consequences of sleep deprivation. Interview parent or relatives regarding specific changes. Note daily energy patterns. Measure physiological response to activity: changes in blood pressure, heart rate and respiratory rate. Evaluate need for individual assistance. Established realistic activities with the client and encourage forward movement.

Instruct in methods to conserve energy such as sitting instead of standing during daily care, carry several small leads instead of big one, combine and simplify activity. Take frequent short rest breaks during activities and delegate task for assistance. Encourage use of activities device to conserve energy for other tasks. Avoid exposure to extreme temperature and humidity which can negatively impact energy level. Provide pleasurable activities. Discuss routines to promote restful sleep. Promote overall health measures: nutrition, adequate fluid intake and appropriate vitamin supplementation.

Note the age, gender and developmental stage, although, some studies show a prevalence of fatigue in adolescent girls, the condition may be present in any person at any age. Identify presence of physical and psychological conditions such as factors said above. Review medication regimen or use. Certain medications, including prescription (especially beta - adrenergic blockers), over-the-counter, herbal supplements, and combinations of drugs or substances, are known to cause and exacerbate fatigue. Note recent lifestyle changes, including conflicts (expanded responsibilities or job related conflicts); maturational issues such as adolescent with eating disorder); and developmental issues such as new parenthood, loss of spouse. Assess psychological and personality factors that may affect reports of fatigue level. Evaluate aspect of "learned helplessness" that may be manifested by giving up. This can perpetuate a cycle of fatigue, impaired functioning, and increased anxiety and fatigue. Obtain client descriptions of fatigue like lacking energy or strength, tiredness, weakness lasting over length of time. Note presence of additional concerns such as irritability, lack of concentration, difficulty making decisions, problems with leisure, relationship difficulties. These assist in evaluating impact on client's life. Rate client's fatigue from 1-10 and note its effects on ability to participate in desired activities. Discuss lifestyle changes or limitations imposed by fatigue state. Interview parent regarding specific changes observed in child or elder, this client may not be able to verbalize feelings or relate meaningful information. 

EVALUATION
After 8 hours of nursing intervention, the patient reported improved sense of energy.

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