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.
If you like nursing care plan right in your hand, I highly recommend this handbook Nursing Care Plans: Diagnoses, Interventions, and Outcomes, 8e
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