Activity intolerance is a nursing diagnosis defined by NANDA. It’s a state in which an individual has insufficient physiological or psychological energy to endure or complete necessary or desired daily activities.
Numerous factors lead to activity intolerance.
It includes medication side effects, extended bed rest, a sedentary lifestyle, and restrictions to healthy activity levels.
Improper oxygen balance, pain, sleep deprivation, depression, low motivation, and severe stress also lead to activity intolerance.
Finally, activity intolerance may result from age-related conditions, especially among elderly patients.
Here is a list of factors that may be related to activity intolerance:
- Generalized weakness/age
- Sedentary lifestyle / deconditioned state
- Inadequate sleep / insufficient rest
- Extended bed rest / muscular decline/ immobility
- Imposed activity restriction
- An imbalance between oxygen supply and demand
- Lack of motivation
- Severe stress
- Cognitive deficiency
Activity intolerance includes the following symptoms or signs.
- Early signs of fatigue, dizziness, and weakness
- Abnormal discomfort or dyspnea during activity
- Inability to perform basic activities
- Abnormal blood pressure or heart rate level in response to activity level
A proper care plan’s goal or expected outcome is to restore the patient’s ability to perform regular activities healthily without experiencing any signs or symptoms of activity intolerance.
The expected outcome of a successful care plan may include:
- The patient can provide positive verbal feedback in response to the activity level
- The patient can display and use effective energy management/conservation techniques
- The patient can perform basic activities without excessive exhaustion or loss of energy
- The patient can demonstrate physiological improvements over time
- The patient can maintain regular cardiovascular and respiratory functions during activities
The following part of the discussion will focus on assessment techniques and intervention strategies to help patients reduce and recover from their activity intolerance.
The Patient Assessment
Before and throughout a patient’s intervention plan, it is essential to perform regular assessments to identify potential problems that may have led to activity intolerance and identify any issues that may arise throughout the intervention.
When performing an assessment, several techniques, strategies, and practices can be implemented, including the following:
1. Assess physical health level and potential injuries and illnesses. Identify if the health condition is severe or minor and short-term or long-term.
2. Measure and evaluate patients’ cardiopulmonary status before and following scheduled activities to identify primary concerns and track improvement/decline status.
3. Regularly interview, communicate, and discuss concerns with the patient about their activity intolerance to address problems and determine the root cause.
4. Monitor and evaluate sleep quality, length, and patterns. Identify and address potential sleep deficiencies to maximize recovery/activity progress while reducing the opportunities for errors to occur.
5. Observe and assess emotional responses to performed activities to identify and address potential stress responses, depression, or mental/emotional conflicts.
6. Assess the mobility level before exercise, stretching, or other interventions to ensure the patient does not injure or over-stress themself.
7. Assess and evaluate nutritional health habits to identify dietary needs and food-related concerns.
8. When first waking or performing demanding tasks observe patients for symptoms related to activity intolerance such as dizziness, impaired cognitive function, and physical pain/stress, as well as abnormal changes in vital signs, i.e., blood pressure and heart rate.
9. Monitor and record patient health regularly and refer to the data to identify abnormalities, performance improvements, or performance declines.
10. Observe and record skin integrity throughout the day to check for symptoms and health status.
11. Observe and assess pain level before and upon completion of activities.
If the patient is experiencing an uncomfortable amount of pain, reassess the activity, and determine whether you can treat the pain before they perform the nativity.
Intervention plans or treatments help patients improve their condition and reduce or eliminate their activity intolerance.
Interventions may be independent (managed by the patient alone) or collaborative (aided by a medical professional).
To Illustrate, you can perform the following interventions to assist patients dealing with activity intolerance include:
1. Encourage physical activity, and develop proper patient exercise programs. It helps prevent muscle atrophy and strengthens the patient’s cardiovascular system.
Physical activity can also positively affect the patient’s psychological status.
2. Evaluate patient recovery speed between sessions to ensure proper scheduling and prevent additional overload or stress while the patient is still recovering from their previous sessions.
3. Allow and encourage proper rest periods between individual exercises to ensure optimal performance during sessions.
4. Eliminate nonessential activities or procedures to conserve energy output, conserve strength for essential activities, and ensure adequate rest.
4. Assist patients with planning and scheduling activities and provide feedback on performance and improvements.
5. Help patients develop a proper diet plan and eating habits to improve their health.
6. Minimize cardiovascular deconditioning through proper resting positions and postural exercises.
7. Assist with ADLs (activities of daily living) regularly as indicated by the physician or supervisor.
8. If appropriate, maintain the gradual progression of activities to improve performance over time.
9. Educate patients on lifestyle choices, healthy habits, and the importance of regular physical activity in daily life.
10. If patients feel symptoms of activity intolerance such as dizziness or their condition has worsened, encourage them to stop their activity until they recover and reevaluate their exercise program.
11. Encourage the patient to develop good breathing habits to improve cardiovascular functions and reduce stress levels.
12. Observe and address restrictive clothing and items that may impact proper blood flow, oxygen levels, and physical comfort.