Activity Intolerance | Nursing Diagnosis for Leukemia

Nursing diagnosis: activity intolerance related to generalized weakness; reduced energy stores, increased metabolic rate from massive production of leukocytes, imbalance between oxygen supply and demand (anemia and hypoxia), therapeutic restrictions—isolation, bedrest; effect of drug therapy

Possibly evidenced by
Verbal report of fatigue or weakness
Exertional discomfort or dyspnea
Abnormal heart rate or BP response

Desired Outcomes/Evaluation Criteria—Client Will
Endurance
Report a measurable increase in activity tolerance.
Participate in ADLs to level of ability.
Demonstrate a decrease in physiological signs of intolerance—pulse, respiration, and BP remain within client’s normal range.

Nursing intervention with rationale:
1. Evaluate reports of fatigue, noting inability to participate in activities or ADLs.
Rationale: Effects of leukemia, anemia, and chemotherapy may be cumulative, especially during acute and active treatment phase, necessitating assistance.

2. Encourage client to keep a diary of daily routines and energy levels, noting activities that increase fatigue.
Rationale: Helps client prioritize activities and arrange them around fatigue pattern.

3. Provide quiet environment and uninterrupted rest periods. Encourage rest periods before meals.
Rationale: Restores energy needed for activity and cellular regeneration and tissue healing.

4. Implement energy-saving techniques, such as sitting, rather than standing and use of shower chair. Assist with ambulation or other activities, as indicated.
Rationale: Maximizes available energy for self-care tasks.

5. Recommend small, nutritious, high-protein meals and snacks throughout the day.
Rationale: Smaller meals require less energy for digestion than larger meals. Increased intake provides fuel for energy.

6. Provide supplemental oxygen.
Rationale: Maximizes oxygen available for cellular uptake, improving tolerance of activity.

7. Administer blood and blood components, as indicated.
Rationale: Correcting anemia improves client’s stamina and tolerance for activity.