Assessment Diagnosis
Activity Intolerance related After 6 hours of nursing
to generalized weakness as
evidenced by the verbal
report of “Just a little more
tired than usual lately.”
Planning
Independent:
intervention, the patient will
be able to report a
measurable increase in
activity tolerance.
Intervention
Independent:
Establish guidelines and
goals of activity with the
patient and/or SO.
Evaluate the need for
additional help at home.
Have the patient perform the
activity more slowly, in a
longer time with more rest or
pauses, or with assistance if
necessary.
Gradually increase activity
with active range-of-motion
exercises in bed, increasing
to sitting and then standing.
Dangle the legs from the bed
side for 10 to 15 minutes.
Refrain from performing
nonessential activities or
procedures.
Assist with ADLs while
avoiding patient dependency.
Rationale Evaluation
After 6 hours of nursing
intervention, the patient is
Motivation and cooperation able to report a measurable
are enhanced if the patient
increase in activity tolerance.
participates in goal setting.
Coordinated efforts are more
meaningful and effective in
assisting the patient in
conserving energy.
Helps in increasing the
tolerance for the activity.
Gradual progression of the
activity prevents overexertion.
Prevents orthostatic
hypotension.
Patient with limited activity
tolerance need to prioritize
important taks first.
Assisting the patient with
ADLs allows conservation of
energy. Carefully balance
provision of assistance;
facilitating progressive
endurance will ultimately
enhance the patient’s activity
tolerance and self-esteem.

Encourage physical activity
consistent with the patient’s
energy levels.
Instruct patient to plan
activities for times when they
have the most energy.
Helps promote a sense of
autonomy while being
realistic about capabilities.
Activities should be planned
ahead to coincide with the
patient’s peak energy level. If
the goal is too low, negotiate.

This helps the patient to

Encourage verbalization of cope. Acknowledgment that
feelings regarding limitations. living with activity intolerance
is both physically and
emotionally difficult.

Duration and frequency

Gradually progress patient should be increased before
activity with the following: - intensity.
Range-of-motion (ROM)
exercises in bed, gradually
increasing duration and
frequency (then intensity) to
sitting and then standing. -
Deep-breathing exercises
three or more times daily. -
Sitting up in a chair 30
minutes three times daily. -
Walking in room 1 to 2
minutes TID. - Walking down
the hall 20 feet or walking
through the house, then
slowly progressing walking
outside the house, saving
energy for the return trip. Exercise maintains muscle
strength, joint ROM, and
Encourage active ROM exercise tolerance. Physical
exercises. Encourage the
patient to participate in
planning activities that
gradually build endurance.
inactive patients need to
improve functional capacity
through repetitive exercises
over a long period of time.
Strength training is valuable
in enhancing endurance of
many ADLs.

Appropriate aids will enable

the patient to achieve optimal
independence for self-care
and reduce energy
Provide the patient with the
consumption during activity.
adaptive equipment needed
for completing ADLs.

Knowledge promotes
awareness to prevent the
complication of overexertion.
Teach the patient and/or SO
to recognize signs of physical These techniques reduce
overactivity or overexertion. oxygen consumption,
allowing a more prolonged
activity.
Teach energy conservation
techniques, such as: - Sitting
to do tasks - Frequent
position changes - Pushing
rather than pulling - Sliding
rather than lifting - Working at
an even pace - Placing
frequently used items within
easy reach - Resting for at
least 1 hour after meals
before starting a new activity -
Using wheeled carts for
laundry, shopping, and
cleaning needs - Organizing a
work-rest-work schedule