Fatigue | Nursing Care Plan for Total Nutritional Support

Nursing diagnosis: Fatigue related to Decreased metabolic energy production; increased energy requirements—hypermetabolic states, healing process, Altered body chemistry: medications, chemotherapy

Possibly evidenced by
Overwhelming lack of energy, inability to maintain usual routines or accomplish routine tasks
Lethargy, impaired ability to concentrate

Desired Outcomes/Evaluation Criteria—Client Will
Endurance
Report increased sense of well-being and energy level.
Demonstrate measurable increase in physical activity.

Nursing intervention with rationale:
1. Monitor physiological response to activity, including changes in blood pressure (BP) or heart and respiratory rates.
Rationale: Tolerance varies greatly, depending on the stage of the disease process, nutritional state, and fluid balance.

2. Establish realistic activity goals with client.
Rationale: Provides for a sense of control and feelings of accomplishment.

3. Plan care to allow for rest periods. Schedule activities for periods when client has most energy. Involve client and caregiver in planning schedule.
Rationale: Frequent rest periods are needed to restore or conserve energy. Planning allows client to be active during times when energy level is higher, which may restore a feeling of well-being and a sense of control.

4. Encourage client to do self-care when appropriate, such as sitting up in chair and walking. Increase activity level, as indicated.
Rationale: Increases strength and stamina and enables client to become more active without undue fatigue.

5. Provide passive and active range-of-motion (ROM) exercises to bedridden clients.
Rationale: The development of healthy lean muscle mass depends on the provision of both isotonic and isometric exercises. Prevents muscle wasting.

6. Keep bed in low position and walkways clear of furniture; assist with ambulation.
Rationale: Protects client from injury during activities.

7. Assist with self-care needs, as necessary.
Rationale: Generalized weakness may make activities of daily living (ADLs) almost impossible for client to complete.

8. Provide supplemental O2, as indicated.
Rationale: Presence of anemia or hypoxemia reduces O2 available for cellular uptake and contributes to fatigue and decreased immune response.

9. Refer to physical or occupational therapy.
Rationale: Programmed daily exercises and activities help client maintain or increase strength and muscle tone and enhance sense of well-being.