Activity Intolerance: Nursing Assessment & Intervention

Activity Intolerance

Most children and adults can gain from some form of activity, exercise, or play. Physical exercise or activity improves individual health and decreases risks of developing many diseases or conditions like cardiovascular diseases, diabetes or hypertension, and many more. Meaning, insufficient or lack of activity or exercise improves the risks hence putting one’s life in danger. Activity intolerance affects a lot of people today. Everyone is unique in terms of their ability to work out or play sports. However, if a person cannot do any physical activity without extreme bodily distress, they could have activity intolerance. This article will guide you through the nursing assessment- causes, symptoms, medication, and risk factors. 

Definition of Activity Intolerance

It is a state in which an individual or a patient has inadequate physiological or mental capacity to undergo or finalize the required or preferred everyday activities. It is a nursing diagnosis that is approved by the North America Nursing Diagnosis Association (NANDA). It occurs mostly due to impairment and acute or chronic disease. Activity intolerance is a tremendous hassle with the elderly, who had cardiopulmonary, diabetic, or orthopedic troubles earlier. 

The developing age creates a reduced muscle power and function. It is regularly blended with fatigue. However, these are distinct phrases with separate goals. Fatigue can motive tiredness within the patient, but the activity intolerance is to decorate the patient’s tolerance and patience of alertness. 

Causes Of Activity Intolerance
  • Lack of motivation
  • Depression
  • Inadequate sleep
  • Medication
  • Age-related conditions especially elderly
  • Lack of regular healthy activities
  • Sedentary lifestyle
  • Extended bed rest
  • Severe stress 
  • Cognitive deficiency 
  • Anemia and malnourishment
  • Obesity
Symptoms Of Activity Intolerance
  • Inability to carry out simple activities
  • Unusual blood pressure or heart rate level in reaction to the activity
  • Abnormal irritation or shortness of breath during an activity
  • Premature signs of dizziness, fatigue, or weakness
Nursing Care Plan of Activity Intolerance

The NCP should have the assessment, diagnosis, and intervention of the activity intolerance. Before this, there are goals or expected outcomes for the patient at the end of this therapeutical strategy. They include:

  • The patient can keep normal cardiovascular and respiration features during an activity level.
  • The patient can exhibit and use efficient strength conservation/ management techniques.
  • The patient can offer tremendous verbal remarks in reaction to the activity level.
  • The patient can carry out fundamental activities without enormous debilitation or lack of power. 
  • The patient will record the onset of ache at some point in physical activity right away. 

Nursing Assessment

This is the valuation of a patient using the selected abilities to take all history, physical examination, and laboratory tests to diagnose and initiate an intervention plan. When conducting an assessment, numerous techniques, practices, and strategies may be implemented consisting of the following:

  1. Ascertain and compare the patient’s cardiopulmonary condition earlier and imitating the scheduled activities to discover the dominant matters and trace the amended or discarded status. Heart rate should not grow more significant than 20 to 30 beats per minute above resting with normal adults’ recurring activities. Older patients are extra liable to orthostatic drops in blood pressure with changes in position.

  2. Examine the patient for signs and symptoms associated with activity intolerance when waking or carrying out demanding responsibilities, including impaired cognitive function, dizziness, body ache, and abnormal modification in critical signs, including heart rate or blood pressure.
    • Do this by:
      • Taking the resting pulse, blood pressure, and respiration
      • Observe the rhythm, rate, and quality of the pulse. The patient should perform the activity if the signs are typical.
      • Acquire the vital signs instantly after activity. 
      • Retake the vital signs after the patient rests for 3 minutes.
      • Discontinue if the patient comes up with dizziness, chest pain, decrease pulse rate, and systemic blood pressure.
      • Decrease the time is taken and intensity of the activity if the pulse takes 3 to 4 minutes to return.

  3. Monitor and compare sleep length, quality, and patterns. Identify and cope with capable sleep deficiencies to maximize recovery or activity development whilst decreasing the possibility of mistakes. Sleep deprivation and problems in the course of sleep can affect the patient’s activity level. These desires are to be addressed earlier before successful activity development can be achieved.

  4. Observe and verify ache degree before and a final touch of exercise. If the patient is experiencing an uncomfortable quantity of ache, reconsider the interest and decide whether or not the pain may be handled earlier than the activity is executed. 

  5. Assess the bodily fitness stage and capable accidents or illness. Consider if the fitness situation is intense or minor and long-term or short-term.

  6. Perceive and determine emotional replies to complete exercise to discover and cope with the potential stress responses, mental conflicts, and depression. Depression over the incapability to carry out exercise may be the cause of frustration and stress. 

  7. Communicate, interview and discuss concerns regularly with the patient-related to their activity intolerance to cope with issues and decide the foundation cause of activity intolerance. Causative elements can be brief or permanent as well as psychological or physical. Determining the purpose can assist the nurse through the intervention.

  8. Observe and file skin integrity all through the day to test for signs and symptoms and fitness fame. 

  9. Monitor and file the patient’s fitness often and discuss the records to discover abnormalities, overall performance improvements or declines. Close tracking will function as a manual for superior development of the activity. 

  10. Assess and compare dietary fitness behavior to pick out nutritional desires and food-associated concerns. Enough energy reserves are required during activity. 

  11. Assess the mobility degree earlier before the exercise, stretching, or different interventions to ensure that the patient does not injure or over-pressure themselves. 

Nursing Intervention

These are followed to enhance the condition of the patient or to stop the activity intolerance. Interventions are controlled by the patient themselves or with the aid of using the clinical team. The interventions include: 

  1. Encouraging activity progressively by coming up with the patient’s exercising programs and making sure they are observed frequently to stop muscle atrophy and enhance their cardiovascular system. Physical activity can also have a tremendous impact on the patient’s mental status. The patient will possibly tolerate it a greater deal if the exercises are elevated slowly. It offers greater time for the body to adjust. 

  2. Encourage the patient to carry out a light range of motion exercises. Regular workout keeps muscle strength, flexibility as well as tendon and joint alignment.  Over a period of time, recurrent exercise will assist tolerance, which is critical to conduct activities of daily living (ADLs)

  3. Arrange relaxation intervals earlier than straining activities. Rest duration permits the patient to preserve energy. It allows for the heart rate and respiratory to normalize and also determine desirable performance during sessions. 

  4. Helping the patient as much as necessary, however as low as possible. There has to be stability among helping the patient when required and fostering independence as much as possible. As the patient’s abilities change, the caregiver has to modify the quantity of help provided. The best manner to continue the patient’s independence and vanity is to assist most effective whilst necessary. 

  5. Confer with the dietician to fulfill the patient’s dietary needs. A dietician can alter the dietary requirements to the patient’s situation. Sufficient consumption of nutrients enables the preservation of pores and skin integrity, muscle strength, and immune function. 

  6. Remove the nonessential activities or strategies to preserve energy output for crucial activities and ensure that the patient has enough rest. Adequate relaxation intervals without many interruptions permit higher sleep exceptional and might also cause elevated participation in physical activity and different activities, including ADLs.

  7. Provide the possibility for the patient to point out their negative and positive emotions or feelings. Patients undergo hard instances with their ailments and come across loads of change. It is useful for the patient to vent and communicate their emotions approximately. 

  8. Watch out for signs of intolerance while waking up the patient. Symptoms can consist of pallor, nausea, visible impairment, lack of consciousness, dizziness, and critical signs and symptoms change. Progressive mobility can also additionally lower signs. Sitting the patient at the bedside, dangling the legs, standing up for few minutes before walking, and sitting up on the chair are tremendous interventions to counteract symptoms and signs of deconditioning. 

  9. Customary exercise over time will enhance activity level, endurance, and strength.

  10. Deliberate occupation and physical therapy. This remedy will assist with ordinary exercise.

  11. Teach the patient the importance of healthy living, lifestyle choices, and the significance of everyday exercises in life.

  12. If the patient is bedridden or cannot sit upright, position them in an upright manner for numerous instances in a day. Upright positioning assists in stopping decondition of the coronary heart and lungs. Lying for an extended length of time may also reduce cardiac output, prolong resting heart rate and orthostatic hypotension. Note and tackle restrictive clothing and items that may affect good blood flow, physical comfort, and oxygen levels.

  13. Educate the family/caregivers and the patient on;
    • Energy conservation measures
    • Signs and symptoms of physical exhaustion
    • Significance of continuing activities
    • Proper use of equipment

  14. Evaluate the home environment before discharging the patient.

Also read Albuterol Nursing Implications & Considerations

Activity Intolerance: Nursing Assessment & Intervention

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