The nurse is developing a plan of care for the client who has activity intolerance

Table of Contents Show

Nursing Care Plan for: Impaired Physical Activity, Alteration in Activity Intolerance, Inability to Ambulate, and Limited Range of Motion (ROM)
Expected outcome
The Patient Assessment
Assessment Steps
Intervention
Intervention Steps

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This free nursing care plan is for the following conditions: Impaired Physical Activity, Alteration in Activity Intolerance, Inability to Ambulate, and Limited Range of Motion (ROM)

What are nursing care plans? How do you develop a nursing care plan? What nursing care plan book do you recommend helping you develop a nursing care plan?

This care plan is listed to give an example of how a Nurse (LPN or RN) may plan to treat a patient with those conditions.

Important Disclosure: Please keep in mind that these care plans are listed for Example/Educational purposes only, and some of these treatments may change over time. Do not treat a patient based on this care plan.

Care Plans are often developed in different formats. The formatting isn’t always important, and care plan formatting may vary among different nursing schools or medical jobs. Some hospitals may have the information displayed in digital format, or use pre-made templates. The most important part of the care plan is the content, as that is the foundation on which you will base your care.

Nursing Care Plan for: Impaired Physical Activity, Alteration in Activity Intolerance, Inability to Ambulate, and Limited Range of Motion (ROM)

If you want to view a video tutorial on how to construct a care plan in nursing school, please view the video below. Otherwise, scroll down to view this completed care plan.

As the nurse on day shift, you receive a patient who is 65 years old and is post-opt day 3 from a right femur repair. The patient has not be out of bed since the day before surgery. The patient’s right leg is in a cast from thigh to ankle. The patient’s range of motion in all other extremities is rated about 3-4 and 2 in right lower extremity. The patient complains of being “so tired” and during upper body strengthening exercises the patient complains of be being “so short of breath” and states “I haven’t felt this weak since I gave birth to my first child 40 years ago”. Pt vitals signs are: HR 89, BP 120/80, O2 Saturation 97% on RA, Temp. 98.8, and Pain 8 on 1-10 scale stating pain in right leg.

Impaired physical activity related to limited range of motion as evidence by patient reporting activity intolerance, limited strength, and pain rating of 8 on 1-10 scale.

The patient complains of being “so tired” and during upper body strengthening exercises the patient complains of be being “so short of breath” and states “I haven’t felt this weak since I gave birth to my first child 40 years ago”.

-The patient will be able to ambulate with assistance to bedside chair within 24 hours.-The patient will report an increase level of energy within 24 hours to the nurse.

-The patient’s range of motion (ROM) will increase to 5 in right and left upper extremities along with left lower extremities and increase to a 4 in right lower extremity.

-Patient’s pain rating will be less than 3 on 1-10 scale within 8 hours.

-The nurse will have the patient perform every 2 hours upper and lower body strengthening exercises.-The nurse will consult physical therapy per md order to assist patient with activity intolerance.

-The nurse will within 24 hours assist the patient to the bedside chair.

-The nurse will assess the patient’s energy level every shift and range of motion in upper and lower extremities.

-The nurse will administer Lortab 7.5/325mg PO every 4 hours as needed for pain rating greater than 3.

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:

Related factors

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
Pain
Depression
Lack of motivation
Severe stress
Cognitive deficiency

Characterized by

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

Expected outcome

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:

Assessment Steps

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

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:

Intervention Steps

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.