Activity intolerance is a condition in which a person has insufficient physiological or psychological energy to complete necessary or desired activities.
This nursing diagnosis is often seen in patients with chronic illnesses, cardiovascular disorders, respiratory issues, or deconditioning due to prolonged bed rest.
Recognizing and managing activity intolerance is crucial for optimizing patient outcomes and improving quality of life.
Definition of Activity Intolerance
Activity intolerance refers to a patient’s decreased ability to perform activities of daily living (ADLs) due to a lack of energy, physical strength, or cardiovascular endurance.
It can range from mild limitations to a complete inability to engage in physical activities without becoming fatigued.
Causes of Activity Intolerance
Activity intolerance may result from various conditions, including:
- Cardiovascular issues: Conditions like heart failure, myocardial infarction, or hypertension may impair cardiac output, leading to reduced exercise tolerance.
- Respiratory disorders: Chronic obstructive pulmonary disease (COPD), asthma, or pneumonia can reduce oxygenation, limiting activity.
- Musculoskeletal problems: Conditions such as arthritis, muscular dystrophy, or fractures can impede physical movement.
- Prolonged bed rest: Patients who have been immobile for an extended period may experience deconditioning, which diminishes their physical capacity for activity.
- Anemia: Low hemoglobin levels reduce oxygen-carrying capacity, leading to fatigue and reduced activity levels.
- Neurological disorders: Diseases like multiple sclerosis, stroke, or Parkinson’s disease may affect motor function and endurance.
Signs and Symptoms of Activity Intolerance
Common signs and symptoms associated with activity intolerance include:
- Fatigue or generalized weakness
- Shortness of breath (dyspnea) upon exertion
- Rapid or irregular heart rate during or after activity
- Dizziness or lightheadedness with movement
- Inability to perform activities of daily living (ADLs)
- Decreased tolerance to exercise or activity
Nursing Assessment for Activity Intolerance
A comprehensive assessment is critical to determine the severity of activity intolerance and its underlying causes. The nurse should:
- Assess cardiovascular and respiratory status: Monitor heart rate, blood pressure, respiratory rate, and oxygen saturation during and after activity.
- Evaluate the patient’s level of fatigue: Ask about how the patient feels during different activities, noting the onset and duration of fatigue.
- Assess muscle strength and mobility: Determine the patient’s ability to move freely and participate in physical activities.
- Evaluate psychosocial factors: Anxiety, depression, and lack of motivation can contribute to reduced activity tolerance.
Nursing Interventions for Activity Intolerance
The primary goal of nursing interventions is to enhance the patient’s activity tolerance while ensuring safety and comfort. Nurses can implement strategies that gradually improve physical capacity while also addressing underlying factors contributing to the patient’s condition.
5 Nursing Care Plans for Activity Intolerance.
Nursing Care Plan 1: Cardiovascular-Related Activity Intolerance
Nursing Diagnosis:
Activity intolerance related to decreased cardiac output secondary to congestive heart failure.
Related Factors:
- Impaired cardiac output
- Decreased oxygen supply to tissues
Nursing Interventions and Rationales:
- Assess vital signs before and after activity: Monitoring blood pressure, heart rate, and oxygen saturation helps to evaluate the patient’s response to exertion.
- Rationale: Provides data on the patient’s cardiovascular tolerance to activity.
- Encourage gradual increase in physical activity: Start with light activities such as passive range-of-motion exercises, and gradually progress to more vigorous activities as tolerated.
- Rationale: Prevents overexertion and promotes cardiovascular conditioning.
- Provide frequent rest periods during activities: Encourage the patient to take breaks as needed to prevent fatigue.
- Rationale: Resting conserves energy and prevents overexertion.
- Administer oxygen therapy as ordered during activity: Use supplemental oxygen if the patient’s oxygen saturation drops during exertion.
- Rationale: Improves oxygen delivery to tissues, reducing strain on the cardiovascular system.
Desired Outcome:
The patient will demonstrate increased tolerance to activity, as evidenced by stable vital signs and the ability to perform light ADLs without excessive fatigue or dyspnea.
Nursing Care Plan 2: Respiratory-Related Activity Intolerance
Nursing Diagnosis:
Activity intolerance related to impaired gas exchange secondary to chronic obstructive pulmonary disease (COPD).
Related Factors:
- Reduced oxygenation of tissues
- Increased work of breathing
Nursing Interventions and Rationales:
- Monitor respiratory status during and after activity: Observe the patient’s breathing pattern, use of accessory muscles, and oxygen saturation levels.
- Rationale: Detects early signs of respiratory distress and guides adjustments to activity levels.
- Teach controlled breathing techniques (e.g., pursed-lip breathing): Encourage the patient to use breathing techniques to prevent shortness of breath during activity.
- Rationale: Helps improve ventilation and reduces air trapping.
- Administer bronchodilators before planned activities, as prescribed: Give medications to open airways and improve lung function.
- Rationale: Enhances respiratory function and increases activity tolerance.
- Encourage progressive ambulation with assistance: Begin with short walks, gradually increasing distance as the patient’s endurance improves.
- Rationale: Promotes lung expansion and improves physical conditioning.
Desired Outcome:
The patient will demonstrate improved activity tolerance, as evidenced by the ability to walk short distances with minimal dyspnea and stable oxygen saturation levels.
Nursing Care Plan 3: Musculoskeletal-Related Activity Intolerance
Nursing Diagnosis:
Activity intolerance related to limited physical mobility secondary to arthritis.
Related Factors:
- Joint pain and stiffness
- Decreased muscle strength
Nursing Interventions and Rationales:
- Assess joint mobility and range of motion (ROM): Regularly assess the patient’s ability to move joints without pain or stiffness.
- Rationale: Establishes a baseline for mobility and monitors for improvement or deterioration.
- Encourage the use of assistive devices (e.g., walkers or canes): Provide equipment to help the patient with ambulation.
- Rationale: Reduces the risk of falls and promotes independence in mobility.
- Teach the patient energy conservation techniques: Instruct the patient on pacing activities and using labor-saving devices.
- Rationale: Helps prevent overexertion and reduces joint stress.
- Administer analgesics or anti-inflammatory medications as prescribed before activity: Provide pain relief to increase comfort during movement.
- Rationale: Improves the patient’s ability to engage in activities by minimizing pain.
Desired Outcome:
The patient will experience reduced joint pain and stiffness, enabling them to perform ADLs with minimal assistance.
Nursing Care Plan 4: Deconditioning-Related Activity Intolerance
Nursing Diagnosis:
Activity intolerance related to prolonged immobility secondary to bed rest.
Related Factors:
- Muscle weakness
- Reduced physical conditioning
Nursing Interventions and Rationales:
- Encourage gradual mobilization: Begin with passive ROM exercises and active ROM exercises as tolerated.
- Rationale: Prevents further muscle atrophy and gradually improves strength.
- Implement a progressive exercise program: Collaborate with physical therapy to design a structured exercise regimen for the patient.
- Rationale: Improves cardiovascular endurance and muscle strength.
- Encourage frequent position changes in bed: Assist the patient in turning and repositioning every two hours.
- Rationale: Prevents pressure injuries and promotes circulation.
- Monitor for signs of orthostatic hypotension during mobilization: Assess for dizziness or lightheadedness when moving from a lying to a standing position.
- Rationale: Detects cardiovascular compromise related to immobility.
Desired Outcome:
The patient will demonstrate increased strength and endurance, enabling them to participate in activities without excessive fatigue.
Nursing Care Plan 5: Neurological-Related Activity Intolerance
Nursing Diagnosis:
Activity intolerance related to impaired motor function secondary to stroke.
Related Factors:
- Hemiparesis or paralysis
- Decreased muscle coordination
Nursing Interventions and Rationales:
- Assess motor function and coordination during activity: Monitor the patient’s ability to move affected limbs and maintain balance.
- Rationale: Helps determine the level of impairment and guides activity planning.
- Collaborate with physical and occupational therapy: Work with therapists to create a rehabilitation plan to restore mobility.
- Rationale: Multidisciplinary involvement ensures a comprehensive approach to rehabilitation.
- Encourage adaptive devices (e.g., braces or splints): Assist the patient in using equipment to support movement and prevent contractures.
- Rationale: Promotes safety and increases independence in performing ADLs.
- Provide verbal encouragement during activities: Offer positive reinforcement to boost the patient’s confidence and motivation.
- Rationale: Encouragement improves the patient’s willingness to participate in rehabilitation activities.
Desired Outcome:
The patient will show improved coordination and motor function with assistance and the ability to participate in basic self-care activities.
Peer-Reviewed References
- Carpenito, L. J. (2022). Handbook of Nursing Diagnosis (16th ed.). Wolters Kluwer.
- Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2021). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing (15th ed.). Lippincott Williams & Wilkins.
- Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2021). Fundamentals of Nursing (10th ed.). Elsevier Health Sciences.