Case Presentation - Activity Intolerance

Fundamentals of Nursing Practice
Presented by Group 1A
Patient was born Patient got into Patient was
with no health an accident and diagnosed
conditions or injured her foot. with iron
illnesses. deficiency
anemia
19
Female
None
Batangas
After being diagnosed with iron-deficiency anemia in
2014, the patient frequently feels symptoms like
dizziness, fatigue, weakness, shortness of breath, and
pallor. Recently, according to the patient, these
symptoms are heightened as she is unable to
accomplish her usual tasks. According to her, she thinks
that these are due to over-fatigue and sleep
deprivation caused by her busy online class schedule.
Since then, the patient has been taking medication for
her condition, which is Ferrous Fumarate-Folic Acid.
However, she still feels fatigue and dizziness when given
heavier tasks such as cardio exercises, lifting, running,
etc.
According to the patient, she has no allergies,
has not had any problems or complications
since birth, and that she is completely
immunized up until now. However, she
stated that she was hospitalized in 2011
because of a gunshot wound on her right
foot during her middle school term as a
grade 4 student because of an accident in
her neighborhood. The patient reports that
upon her last check up in June 2021, the only
health complication she currently has is
iron-deficiency anemia.
As stated by the patient, her paternal side is healthy
but her father has been diagnosed with hepatitis. The
maternal side of the patient has more genetic
diseases, with lung cancer from her grandmother and
diabetes and heart disease from her grandfather. The
heart disease was inherited by the patient’s uncle
through her grandfather. The patient’s mother did not
inherit anything, but is anemic.
Before hospitalization, the client stated that she was generally healthy in
regards to her lifestyle and food intake but she has been experiencing
frequent headaches, dizziness and fatigue due to hot temperature, the
humidity of her environment and excessive exposure to electronic
gadgets. The client views her illness at a pain scale of 5/10 and alleviates
her pain by taking medications such as Advil or ibuprofen and perceives
that her pain scale decreases to 2/10. In spite of her headaches, she
verbalized that she is an occasional drinker but does not have any other
vices. She maintained her healthy lifestyle by eating foods that are rich in
protein such as meat, eggs and chicken. As to her skin condition, it
appears that she has a pale appearance upon presenting to the
interview stating that she is anemic and tries to get as much adequate
sleep in her free time.
The health perception and management
describe how the client responds to her health,
well-being and lifestyle and how she manages
it on a regular basis. Lifestyle choices may
have positive and negative effects on health. In
addition to the client’s health perception and
management, she is anemic and that triggers
negative factors such as headaches and
sudden fatigue. The client appears pale or
exhibits pallor due to the deficiency in oxygen-
INTERPRETATION:
rich hemoglobin near the skin’s surface and
Deviation from normal protein.
DATE AND TIME FOOD AND AMOUNT/MEASURE ENERGY (KCAL)
BEVERAGE INTAKE
07/09/21 Breakfast - 9 am
● Coffee 1 cup/ 8 oz
● Pandesal 3 pcs/ 3 oz 80 Kcal
Lunch - 11:30 am
● White rice/ Adobo 4.7 oz/12 oz 867 Kcal
Dinner - 7 pm
● White rice/ Adobo
Water intake a day 4.7 oz/12 oz 867 Kcal
● 5 glasses of water
25 oz
Lunch - 11:30 am
● White rice/ Tinola 4.7 oz/12 oz 800 Kcal
Dinner - 7 pm
● White rice/ Tinola
25 oz
BEVERAGE INTAKE
Lunch - 11:30 am
● White rice/ Sinigang 4.7 oz/12 oz 850 Kcal
Dinner - 7 pm
● White rice/ Sinigang
25 oz
Lunch - 11:30 am
● White rice/ Pinakbet 4.7 oz/12 oz 850 Kcal
Dinner - 7 pm
● White rice/ Pinakbet
25 oz
BEVERAGE INTAKE
Lunch - 11:30 am
● White rice/ Sisig 4.7 oz/12 oz 887 Kcal
Dinner - 7 pm
● White rice/ Sisig
25 oz
Lunch - 11:30 am
● White rice/ Bulalo 4.7 oz/12 oz 900 Kcal
Dinner - 7 pm
● White rice/ Bulalo
25 oz
BEVERAGE INTAKE
Lunch - 11:30 am
● White rice/ Kare-kare 4.7 oz/12 oz 890 Kcal
Dinner - 7 pm
● White rice/ Kare-kare
25 oz
Interpretation: Deviation from Normal
Analysis: The client does not take any supplements. She consumes 5 glasses of water a
day, which is not adequate enough and may lead to risks of fluid volume deficit. Patient’s
weight is constant and does not fluctuate. The patient’s food intake involves a balance
between carbohydrates, iron-rich food, and fruits and vegetables. Every day, she has
breakfast, lunch, and dinner. The patient eats the most during lunch and least during
dinner. The client does not experience any difficulties when eating.
The client claims that she has no discomfort while urinating
and that her urine is light yellow in color. In addition, the
client stated that she defecates twice a day (morning
and evening) and does not use laxatives. She doesn't
have any problems releasing stool. Finally, she consumes
five glasses of water per day.
Assisting the elimination pattern of the client is a
crucial and essential process that has important
medical significance as well as psychosocial effects
on the client's quality of life. Assistance for healthy
elimination patterns is needed to ensure patients
are having regular soft bowel movements and
adequate urination and to identify abnormal
patterns such as flatulence, constipation, diarrhea,
incontinence, fecal impaction, hemorrhoids as well
as polyuria, anuria, and other abnormalities which
INTERPRETATION: can be signs of underlying medical conditions.
Normal (Sharma & Bhutta, 2021)
According to the client, she claims that she is living a sedentary lifestyle
due to online classes and not having the chance to go out of her
house because of Covid-19. But she considers household chores as
one of her main exercises during the pandemic. The client stated
that she is tasked to wash the dishes every day. When she wakes up,
she goes to her laptop or cell phone to check if there are any
activities that she needs to do during the day and right after
checking, she cooks breakfast for her family. After they eat their
dinner, she is tasked to sweep and mop the floor. She also stated
that she gives her dogs a bath twice a week. Before sleeping, her
routine is to wash her face and do her skin care.
Date Time of the Day Activity Estimated time of
Activity/Exercise
9:30 am -10:00 am Checking for activities 30 minutes
10:20 am - 10:50 am Cooking of Breakfast 30 minutes
11:00 am - 2:00 pm Completing of 3 hours

07/08/2021 requirements for the
day
2:00 pm - 3:00 pm Taking the dogs for a 1 hour

bath
4:00 pm - 7:00 pm Reading lectures 3 hours
9:00 pm - 10:00 pm Sweeping and 1 hour

mopping of the floor
2:00 am - 3:00 am Night routine 50 minutes

Activity/Exercise

day


Activity/Exercise

day


Activity/Exercise

day


Activity/Exercise

day


Activity/Exercise

day


Activity/Exercise

requirements for the
07/14/2021 day
2:00 pm - 3:00 pm Taking the dogs for a 1 hour

bath


The patient reported decreased energy
compared to usual. She has no regular exercise
but is physically active due to her daily
household chores. She does not engage in any
leisure or child-play activities. The patient is
usually able to do activities normally and without
struggle but for the past week, she reports a
difficulty in achieving her usual tasks. Moreover,
she also observes proper posture and has no
problem with Range of Motion (ROM) joints.
Respiration rate is 15 breaths per minute. Blood
INTERPRETATION: pressure is 90/60. A bit pale in appearance
Deviation from normal (pallor).
The client claims that he or she does not have any hearing
or visual impairments. Furthermore, the client said that
she had 20/20 vision and that she had an eye exam
around August of 2019. The client claims there is no loss
of taste or difficulty with scent. She is acutely aware of
her surroundings and has a complete grasp on the
concept of time. She also claims that she has no trouble
following orders, recalling tasks, or making decisions.
Environmental perception is usually characterized as
being aware of or thinking about the environment, as
well as the process of apprehending the environment
through the senses (Zube, 2021). And, as the client
mentioned, she has no issues with her five senses.
Furthermore, cognitive functioning encompasses a
wide range of cognitive domains, including memory,
language, vasoconstriction, perception, attention, and
executive processes (Lezak et al., 2004). The client
expresses that she has no trouble following directions,
INTERPRETATION: remembering responsibilities, or making decisions.
Normal
M T W Th F Sat Sun
Time went to 3:30 AM 3:30 AM 3:30 AM 3:30 AM 3:30 AM 4:00 AM 4:00 AM
bed
Approximate 6 HOURS 6 HOURS 6 HOURS 6 HOURS 6 HOURS 6 HOURS, 30 6 HOURS, 30

time asleep MINS MINS
Wake up NONE NONE NONE NONE NONE NONE NONE

period/ sleep
interruptions
(how long)
Time woke- 9:30AM 9:30 AM 9:30 AM 9:30 AM 9:30 AM 9:30 AM 9:30 AM

up the next
morning
Feeling after NORMAL. NORMAL. NORMAL. NORMAL. NORMAL. NORMAL. NORMAL.

waking up
Naps (time NONE NONE NONE NONE NONE 3:00 PM - 3:00 PM -

slept & woke
up; duration)
5:00 PM 5:00 PM
Activities School works, School works, School works, School works, School works, Scrolling Scrolling
done before modules, and modules, and modules, and modules, and modules, and through social through social
bedtime studying studying studying studying studying media media
Bedtime Skin care, oral Skin care, oral Skin care, oral Skin care, oral Skin care, oral Skin care, oral Skin care, oral
rituals and body and body and body and body and body and body and body
hygiene hygiene hygiene hygiene hygiene hygiene hygiene
before bed. before bed. before bed. before bed. before bed. before bed. before bed.
The client describes herself as an optimistic, kind individual. She
states that she is constantly in a good mood and feels good
about herself. She affirms that she is free of insecurities. What
causes her worry and anxiety are the pressures of academics
and approaching deadlines. Additionally, she stated that she
is not distressed by her current condition. The client maintains
eye contact, speaks with a normal tone and pace, has proper
body posture, and is assertive with her thoughts.
An individuals' body image views are determined by
their subjective impressions, not an objective vantage
point. Self-perceptions of one’s physical appearance
entail mental images of how one looks. These
perceptions are by no means accurate representations.
As the client stated, she has no insecurities and feels
good about herself. Within Maslow's hierarchy of
motives and theory of personality development, self-
esteem needs relate to individuals' wants to have a
stable and realistically positive perception of
themselves (Maslow 1943).
INTERPRETATION:
Normal
The client lives with her family. Her parents and brother make up her
family. The client claims that her family lives together, but her
relatives occasionally stay at their home. The client often performs
household chores and organizes their groceries. She manages her
responsibilities effectively, yet it may be stressful at times. The
client claims to have social groups from several schools. She has
close friends, some of them are classmates. The client claims that
she seldom feels lonely, but that she is able to get over it quickly.
She also mentioned that she does well in school and does not feel
isolated in her neighbourhood.
As the client stated, she has strong bonds with her
nuclear and extended family. According to the
Cultural Atlas (2021), for the majority of Filipinos,
family is the foundation of social life. Although the
nuclear family is the primary family unit, connections
between extended family members are usually
strong. People may be encouraged to establish
relationships with their aunts and uncles that are as
strong as their relationships with their parents. The
client also stated that she has various social groups
and close friends. Adolescents may identify with
social groups to build a social identity and a positive
self-concept, as well as an improved level of self-
INTERPRETATION:
autonomy from parents (Brown and Lohr, 1987).
Normal
The client claims that she does not have an active sexual
lifestyle. The client only has one sexual partner. The
client does not have any sexually transmitted
disease/s. The client also stated she does not
experience any difficulties or problems during her
period. She also stated that before her period, she
experiences Premenstrual Syndrome also known as
PMS wherein she experiences mood swings,
headache, and menstrual cramps.
The client stated that she had PMS before her
menstruation started. Premenstrual syndrome affects
95% of reproductive-age women. PMS psychological
symptoms include irritability, sadness, crying, and
anxiety. Physical symptoms of PMS include stomach
bloating, breast soreness, and headaches (Kwan &
Onwude, 2015). Sexual health was a highly significant
element of quality of life for many participants, even
those in poor health, in this major research of US
adults' evaluations of the significance of sexual health
INTERPRETATION: and satisfaction with sex life (Flynn et al., 2016).
Normal
The client claims that she learned to love herself more and
realized her self-worth after her breakup with her partner
because of their toxic relationship. She finds it comfortable
talking about her problems with her best friends because she
doesn’t feel judged when opening up to them and doesn’t also
make her feel like a burden when they try to comfort her and
give her helpful advice. She feels the most stress during her
weekdays wherein it is also her school days because of the
online class that usually starts in the morning and ends at
7pm in the evening. She tried to consume alcoholic beverages
for her to be able to cope up with the stress that she is
experiencing.
According to (Stoll, 2020), there are 10 ways to cope
up with stress and one of which is connecting with
supportive people wherein when you talk face to face
with another person, it releases hormones that
reduce stress so you should lean on those good
listeners in our life. Relating it with the client, she
claims to have her best friends to be with her in her
toughest times and she finds it comfortable being
with them wherein she doesn’t feel judged. Having
this kind of people with her can let her cope with the
stress that she is having as she has people to talk
with her problems and at the same time, have
INTERPRETATION: someone who always gets her back especially in
situations that she needs them the most.
Normal
The client claims to live on her own and become more independent for her future
after the pandemic to have a sense of responsibility and be self-sufficient as
possible. She also said that she can achieve this plan by means of managing
her time wisely and practicing independence at an early age so that when the
time comes and she needs to live on her own, she would then know what to do
and not depend on anyone anymore. She also mentioned about her inspirations
which are her family and her loved ones wherein she becomes stronger and
better because of them. She usually gets the things that she wants because she
worked hard and prayed for them to be a reality and earn it in the best possible
way she can. Coming from a family of religious members, she too is religious
and believes in God’s plans. She has faith and prays to God more often
whenever she experiences problems and difficulties in her daily living.
INTERPRETATION:
Normal
According to (Hammond, 2013), there are 11 reasons why you need to be more
independent and one of which is boosting one’s own self-confidence and self-
esteem. Having self-confidence and self-esteem means that you trust yourself
to be competent in the situations you confront and also gives a positive outlook
on yourself. Relating it with the client, she claims to become more independent
and also live on her own after the pandemic for her future and learning to
become independent instills confidence in herself more because she believes in
the knowledge and capacities that she possesses to deal with any challenge
that will come along her way. She also is religious so she has faith in God that
He will guide her to the right path when she is already on her own and trusts
that one day, she will become successful and after it, she will give back to her
family and friends. It’s never bad for her to rely on others for help but being a
strong independent woman helps her to trust in her own capabilities and to
God not being afraid of the problems that she will be facing ahead and also
knows how to handle and control things on her own.
ASSESSMENT NORMAL FINDINGS ACTUAL FINDINGS INTERPRETATION
AND ANALYSIS
Signs of Distress in No apparent distress There is a presence DEVIATION FROM
posture and facial noted with good of distress from the NORMAL
expression posture and normal client's facial
facial expression. expression due to Analysis:
her headache. She Studies often
verbalized her pain mention that
on a scale of 5/10. headaches such as
migraine and
tension headaches
are caused by lack
of sleep and sleep
deprivation. Upon
the age of the client
she is needed to
have 7-9 hours of
sleep in order to
prevent having
frequent headaches.
AND ANALYSIS
Signs of Health and Healthy appearance The client showed a DEVIATION FROM
illness restless appearance NORMAL
due to her busy
schedule and Analysis:
verbalized that her Heat-induced headaches can
cause dehydration especially
headaches were when exposed to high
temperature because the body
caused by humidity system needs more water to
and hot make up for the body sweats that
have been produced. Dehydration
temperature. is said to trigger migraines and
Eyebags and dark headaches. Humidity or weather
conditions can also produce
spots under the changes in serotonin levels and
hormonal changes. In regards to
client’s eyes are also the eye bags and dark circles of
visible. the client, it may be a cause of
dehydration and sleep
deprivation due to oversleeping or
lack of sleeping hours. Lack of
sleeping hours causes fluid to
build up underneath the eyes that
causes it to be swollen.
AND ANALYSIS
Signs of Health and Varies from light to Upon observation, DEVIATION FROM
illness deep brown, from The client has a NORMAL
ruddy pink to light pale-like
pink. appearance. Analysis:
Paleness or pallor is the
unusual lightness of skin
color from the client’s
normal skin complexion
that is caused by either
the reduction of blood
flow and oxygen or
decreased number of
blood cells. Factors that
cause pallor are illness,
emotional shock, stress
and anemia.
AND ANALYSIS
Nails Convex curvature; The client’s nails are DEVIATION FROM
the angle between round with a NORMAL
the nail and nail bed characteristic of
at 160° convex curvature Analysis:
and 160° nail bed. Paleness of nails or
Highly vascular and brittle nails are
pink in light-skinned Her fingernails common signs of
while brown or black appear in pale or anemia and pallor
for dark-skinned white color than the where the body
normal color of the lacks hemoglobin
Blanch test: Prompt nail bed which is and a protein that
return of pink or the pink. has the purpose to
usual color in less carry oxygen starting
than four seconds The client’s nail color from the lungs to the
has returned to its rest of the body.
normal state/color in
less than two
seconds.
HEIGHT, WEIGHT, BMI
NORMAL ACTUAL INTERPRETATION
FINDINGS FINDINGS AND ANALYSIS
HEIGHT Proportionate to 5 ft. 3 inches NORMAL

Weight
WEIGHT Proportionate to 110 pounds (49.89

Height kg)
BODY MASS Body Mass Index

INDEX (BMI) Underweight: less than
19.5 kg/m2
18.5
Normal Weight: 18.5 to

24.9
Overweight: 25 to 29.9
Obese: 30 and above

VITAL SIGNS
MEASUREMENTS NORMAL FINDINGS ACTUAL FINDINGS INTERPRETATION
AND ANALYSIS
Temperature 36.5°C - 37.5°C 37.2°C NORMAL
Pulse Rate 60-100 bpm 89 bpm NORMAL
Respiratory Rate 12-20 cpm 15 cpm NORMAL
Blood Pressure Less than 120 systolic 90 / 60 mmHg DEVIATION FROM

and less than 80 NORMAL
diastolic
Analysis:
Hypotension is where the arterial
blood pressure is abnormally low.
This commonly happens when the
nervous system is deprived of an
adequate blood supply that leads
to dizziness and lightheadedness.
If a blood pressure drops too low
it means that the body system
does not get enough oxygen and
nutrients that can cause heart
palpitations, blurry vision, muscle
pain, nausea and shock.
Oxygen Saturation 95% - 100% 98% NORMAL

AND ANALYSIS
Romberg’s test Client maintains position As for the position of the DEVIATION FROM
for 20 seconds without client through the NORMAL
swaying. Romberg’s test. I have
observed that there is a Analysis:
minimal swaying on her The client might have a
head. balance disorder.
Dizziness upon standing
from her current lying
position in a sudden
amount of time marks
that the client has a low
blood pressure or
hypotension.
Problem: Activity Intolerance
Rank: 1 (High Priority)
Justification: The ability to execute basic activities throughout

the day is crucial for the wellbeing of a patient. According to
North American Nursing Diagnosis Association (2012), activity
intolerance is a state in which a person has insufficient
physiological or psychological energy to endure or complete
necessary or desired daily activities.
Moreover, based on Maslow’s Hierarchy of Needs, meeting

physiological needs is the most important. This makes activity
intolerance the highest priority among the given problems.
Problem: Fluid Volume Deficit
Rank: 2 (Medium Priority)
Justification: Dehydration is when the body loses more fluid

than intake and when your body does not have enough fluid to
be able to function normally.
Fluid volume deficits usually occur when the gastrointestinal

tract loses fluid and causes risks such as vomiting, diarrhea,
sweating, decreased intake, and inability to intake fluid normally.
These problems can add up to more severe problems. (Wayne,
2019) Additionally, in Maslow’s Hierarchy of Needs, physiological
needs are amongst the top priority.
Problem: Sleep Deprivation
Rank: 3 (Medium Priority)
Justification: Sleep is a basic physiological need, according to

Psychologist Abraham Maslow who categorised sleep in the first
set of needs, at the bottom of the pyramid or hierarchy of needs.
Without sleep, it is impossible to function effectively every day.
For a few days, sleep deprivation could go on, but not after that.
The body needs sleep. The mind needs rest. Sleep is required for
bodily nourishment, rejuvenation and to keep the metabolism
functioning well. Without adequate sleep, the individual's
cognitive capacities diminish and his/her emotional intelligence
gets reduced.
Problem: Excessive Stress
Rank: 4 (Low Priority)
Justification: According to the Cleveland Clinic (2021), stress is

the reaction of a person when changes in his/her environment,
herself, or in anything that involves the person itself occurs.
Stress responses help the body adjust to new situations but
stress becomes a problem when stressors become too much to
the point that the person is not having periods of relaxation.
According to Maslow’s Hierarchy of Needs, Esteem Needs is one

of the lowest priorities on the hierarchy of needs. This makes
excessive stress a low priority among the rest of the problems
(RNspeak, 2021).
Problem: Ineffective Health Maintenance
Rank: 5 (Low Priority)
Justification: Falling under the Safety & Security Needs of

Maslow’s Hierarchy, ineffective health maintenance is less of a
priority compared to the other identified problems because
Physiologic Needs are more prioritized.
According to NANDA (2012), ineffective health maintenance

refers to the inability to follow measures needed to help to
maintain health, which is one of the problems encountered by
the client.
Objective Cues: Subjective Cues:
• Vital Signs: • The patient verbalized,
- BP: 90/60 “Nanghihina po ako at
- PR: 89 nahihilo. Napapagod po
- RR: 15 ako agad sa mga gawain
- Temperature: 37.2 sa bahay at sa online
- O2 Stat: 98% classes.”
- Weight: 49.89kg
- Height: 162cm • The patient gave a pain
rating of 5/10 for the
• Facial Grimace headache she was
• Pallor experiencing.
• The patient has been
diagnosed with iron-
deficiency anemia in 2014
Stem:
• Activity intolerance (insufficient physiological or
psychological energy to endure or complete required or
desired daily activities)
Related to:
• Insufficient sleep and rest periods
As evidenced by:
• Headache
• Facial grimace
• Dizziness
• Fatigue
• Weakness
• Abnormal blood pressure
Scientific Analysis:
Hemoglobin is a major component of red blood cells, the
predominant cell present in blood. Because of hemoglobin’s
importance in oxygen transportation, anemia (too few red blood
cells that contain too little or abnormal hemoglobin) interferes
with oxygen delivery to the tissues, leading to fatigue and activity
intolerance.
(Berman, 2020)
Situational Analysis:
Activity intolerance is defined as the lack of sufficient
physiological or psychological energy to complete required or
desired daily activities. Activity intolerance is also often related to
generalized weakness and sleep or rest deprivation.
(Simple Nursing, 2020)
In this specific case, the patient reported that she has not been
getting sufficient sleep and rest due to her daily activities and
routines. These factors are likely to be the root causes of activity
intolerance that she is experiencing.
Short-Term Goal:
After 2 hours of nursing intervention, the patient
will demonstrate relaxation and improvement of
her vital signs. The client will also exhibit her
ability to get sufficient sleep, and enough
tolerance to perform activities appropriately.
Long-Term Goal:
After 1 day of nursing intervention, the patient will
be able to increase and achieve desired activity
level progressively with no intolerance symptoms
noted such as headache, facial grimace,
dizziness fatigue, weakness, and abnormal blood
pressure.
OBJECTIVES INTERVENTIONS RATIONALE
After 1 hour of nursing Independent: - Dramatic changes in
intervention, the patient will - Taking the vital signs of heart rate and rhythm,
verbalize relief from the patient changes in usual blood
discomfort (weakness, pressure, and
dizziness, headache, progressively worsening
fatigue). fatigue result from an
imbalance of oxygen
supply and demand.
- Asking the client about her - Asking the client’s

usual level of energy. potential problems,
energy level, and ability
Dependent: to perform needed or
- Administering medication desired activities is
for pain relief and crucial in identifying
maintenance for lowered potential problems.
blood pressure
After 30 minutes of nursing Independent:
intervention, the patient will - Assess usual daily activities - Many factors can cause or
identify factors that cause of the patient contribute to fatigue,
stress and fatigue. having potential to
interfere with client’s ability
to perform at a desired
level of activity. This
provides a comparative
baseline and information
about needed education
or interventions regarding
quality of life.
- Position the client - Reducing intensity level or

comfortably discontinuing activities
that cause undesired
physiological changes will
prevent overexertion.
After 30 minutes of health Independent:
teaching, the patient will - Advise client about the - Providing information about
verbalize and demonstrate importance of taking the effect of lifestyle on
energy-conservation medication for maintenance activity tolerance will be
techniques and healthy on time helpful in reducing risk factors
lifestyle practices. - Encourage proper nutrition, by modifying them.
adequate fluid intake, and
getting sufficient rest and
sleep
- Instruct client to avoid - Proper performance of

activities that may trigger unfamiliar activities in
discomfort alternate ways of doing
familiar activities will conserve
energy and promote safety.
After a day of nursing Independent:
intervention, the patient - Encourage progressive - Ascertain the client’s
will be able to maintain activity/self-care when ability to stand and move
activity levels within tolerated. Provide about and the degree of
capabilities. assistance if needed. assistance necessary or
use of equipment to
determine current status
and needs associated
with participation in
needed/desired activities.
After a day of nursing Independent:
intervention, the patient - Reassessment of the - Reassessment or
will exhibit an patient’s condition and check-ups provide a
improvement in her vital vital signs baseline for comparison
signs and ability to and an opportunity to
accomplish activities. track changes.
Dependent:
- Advice client to consult - Identifying and
a doctor for evaluation discussing symptoms for
and medicinal counselling which the client needs to
if symptoms recur seek medical
assistance/evaluation will
help in providing timely
intervention.
EVALUATION MET PARTIALLY MET UNMET
The client
manifested/showed
relaxation and
improvement of her
vital signs, ability to get
✓
sufficient sleep, and
enough tolerance to
perform activities
appropriately.
EVALUATION
(Effectiveness) YES NO
The patient verbalized relief
from discomfort (weakness, ✓
dizziness, headache, fatigue).
The patient identified factors ✓
that cause stress and fatigue.
The patient verbalized and
demonstrated energy- ✓
conservation techniques and
healthy lifestyle practices.
The patient was able to
maintain activity levels within ✓
capabilities.
The patient exhibited an
improvement in her vital signs ✓
and ability to accomplish
activities.
EVALUATION YES NO
Efficiency
The strategies were suitable ✓
for the given time -frame
Appropriateness:
The selected strategies/ ✓
interventions were
appropriate to the patient’s
needs
Adequacy: ✓
The specific learning
objectives and its content
were enough to meet the
client’s needs
Acceptability:
The strategies/ interventions ✓
were acceptable for the
patient
● T Heather Herdman, Shigemi Kamitsuru, & North.
(2014). NANDA International, Inc. Nursing
Diagnoses : Definitions & Classification 2015-2017.
Wiley Blackwell.
● Berman, A. T. (2020). Kozier & Erb’s Fundamentals

of Nursing : concepts, process and practice.
Prentice Hall.
● Drzezo, N. (2016, June 12). Risk-prone Health Behavior. Nurse Key.
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Presented by:
Agor, Kevin Christian C.
Agulto, Fatima V.
Agustin, Alexander Allan D.M. IV
Alcantara, Kathreen Claire, DV.
Amihan, Ashley Mae A.
Arguelles, Jan Jericho T.
Bacorro, Sofia Isabelle G.
Basuel, Donovan
CREDITS: E.
This presentation template was created by
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Please keep this slide for attribution
Clinical Instructor: Ms. Anabella Garcia Javier

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Fundamentals of Nursing Practice

Interpretation: Deviation from Normal

9:30 am -10:00 am Checking for activities 30 minutes

10:20 am - 10:50 am Cooking of Breakfast 30 minutes

11:00 am - 2:00 pm Completing of 3 hours

2:00 pm - 3:00 pm Taking the dogs for a 1 hour

4:00 pm - 7:00 pm Reading lectures 3 hours

9:00 pm - 10:00 pm Sweeping and 1 hour

2:00 am - 3:00 am Night routine 50 minutes

9:30 am -10:00 am Checking for activities 30 minutes

10:20 am - 10:50 am Cooking of Breakfast 30 minutes

11:00 am - 2:00 pm Completing of 3 hours

4:00 pm - 7:00 pm Reading lectures 3 hours

9:00 pm - 10:00 pm Sweeping and 1 hour

2:00 am - 3:00 am Night routine 50 minutes

9:30 am -10:00 am Checking for activities 30 minutes

9:30 am -10:00 am Checking for activities 30 minutes

10:20 am - 10:50 am Cooking of Breakfast 30 minutes

11:00 am - 2:00 pm Completing of 3 hours

4:00 pm - 7:00 pm Reading lectures 3 hours

9:00 pm - 10:00 pm Sweeping and 1 hour

2:00 am - 3:00 am Night routine 50 minutes

9:30 am -10:00 am Checking for activities 30 minutes

9:30 am -10:00 am Checking for activities 30 minutes

10:20 am - 10:50 am Cooking of Breakfast 30 minutes

11:00 am - 2:00 pm Completing of 3 hours

4:00 pm - 7:00 pm Reading lectures 3 hours

9:00 pm - 10:00 pm Sweeping and 1 hour

2:00 am - 3:00 am Night routine 50 minutes

9:30 am -10:00 am Checking for activities 30 minutes

9:30 am -10:00 am Checking for activities 30 minutes

10:20 am - 10:50 am Cooking of Breakfast 30 minutes

11:00 am - 2:00 pm Completing of 3 hours

4:00 pm - 7:00 pm Reading lectures 3 hours

9:00 pm - 10:00 pm Sweeping and 1 hour

2:00 am - 3:00 am Night routine 50 minutes

9:30 am -10:00 am Checking for activities 30 minutes

9:30 am -10:00 am Checking for activities 30 minutes

10:20 am - 10:50 am Cooking of Breakfast 30 minutes

11:00 am - 2:00 pm Completing of 3 hours

4:00 pm - 7:00 pm Reading lectures 3 hours

9:00 pm - 10:00 pm Sweeping and 1 hour

2:00 am - 3:00 am Night routine 50 minutes

9:30 am -10:00 am Checking for activities 30 minutes

9:30 am -10:00 am Checking for activities 30 minutes

10:20 am - 10:50 am Cooking of Breakfast 30 minutes

11:00 am - 2:00 pm Completing of 3 hours

2:00 pm - 3:00 pm Taking the dogs for a 1 hour

4:00 pm - 7:00 pm Reading lectures 3 hours

9:00 pm - 10:00 pm Sweeping and 1 hour

2:00 am - 3:00 am Night routine 50 minutes

Approximate 6 HOURS 6 HOURS 6 HOURS 6 HOURS 6 HOURS 6 HOURS, 30 6 HOURS, 30

Wake up NONE NONE NONE NONE NONE NONE NONE

Time woke- 9:30AM 9:30 AM 9:30 AM 9:30 AM 9:30 AM 9:30 AM 9:30 AM

Feeling after NORMAL. NORMAL. NORMAL. NORMAL. NORMAL. NORMAL. NORMAL.

Naps (time NONE NONE NONE NONE NONE 3:00 PM - 3:00 PM -

HEIGHT Proportionate to 5 ft. 3 inches NORMAL

WEIGHT Proportionate to 110 pounds (49.89

BODY MASS Body Mass Index

Normal Weight: 18.5 to

Obese: 30 and above

Temperature 36.5°C - 37.5°C 37.2°C NORMAL

Pulse Rate 60-100 bpm 89 bpm NORMAL