- Disease processes
- Deficient nutrient intake
- Lack of sleep
- Medical treatments such as chemotherapy
- Environmental stressors
- Sudden life events, lifestyle changes
- Exposure to natural elements such as heat or cold
- Living conditions
Subjective Data: patient’s feelings, perceptions, and concerns. (Symptoms)
- Verbalization of not being able to keep up with responsibilities
- Verbalization of feeling of having no energy
- Reports of increases physical aces
- Verbalization of difficulty concentrating
Objective Data: assessment, diagnostic tests, and lab values. (Signs)
- Lack of participation in daily activities
- Frequent sleeping
- Lack of interest in surroundings
- Increased need for sleep and rest
- The patient will be able to name the causes of fatigue
- The patient will name factors that worsen and improve symptoms of fatigue
- The patient will verbalize increased energy
- The patient will show increased engagement in daily activities
- The patient will describe energy-conserving techniques
|Inquire about the characteristics of fatigue. |
The time of the day, the patient feels tired the most
Factors that worsen fatigue
Factors that help improve symptoms of fatigue
Scale the level of fatigue from 0 to 10
Ability to perform daily duties
Ability to focus
With this information, the nurse can perhaps identify a pattern. Knowing the nature of fatigue helps in creating an individualized care plan.
|Consider the chief complaint and review the past medical history. |
The patient’s current condition may contribute to feeling tired. Comorbidities and other illnesses could also play a role in the patient’s symptoms of lack of energy.
|Assess for possible reasons for fatigue. |
Lack of sleep
Lack of exercise
Underlying illness such as heart disease
Fatigue can be caused by physical, mental, or emotional stressors. Knowing the exact reason and contributing factors helps in the planning of care.
|Review the home medication list and current ordered medications. |
Often medications can cause side effects that can contribute to feeling tired. Fatigue could also be a drug interaction between medications.
|Ask about usual activity level and ability to exercise. |
This information provides a baseline. A change in activity level could contribute to fatigue.
|Review the patient’s lab values. |
Hemoglobin and hematocrit
Blood urea nitrogen
Anemia, low blood sugar, and other physiological changes due to underlying disease can cause fatigue.
|Monitor the patient’s vital signs. |
Heart rhythm changes
Increased/decreased heart rate
Increased respiratory rate Pain
Symptoms of fatigue can show in the patient’s vital signs and become more prominent as tiring worsens.
|Assess the nutritional status. |
Adequate calorie intake from good sources can affect someone’s level of fatigue. Inadequate food intake can lead to deficiencies that can cause fatigue. Deficient vitamins and iron can lead to feeling tired.
|Evaluate the patient’s sleeping pattern, such as |
Difficulty falling asleep
Difficulty staying asleep
Taking naps during the day
Early rising and going to bed late
Inadequate amounts of sleep can lead to fatigue.
|Assess the availability of social support. |
A support system can be crucial when it comes to implementing changes. The patient will need help in making necessary changes to reduce fatigue.
|Observe the patient’s physical response to activities. |
Fatigue can hinder the patient in fulfilling his or her duties at home and work.
Nursing Interventions for Fatigue
|Allow the patient to express feelings about fatigue. |
The patient’s point of view can give valuable insight into his or her awareness and motivation to improve fatigue symptoms.
|Encourage the patient to keep a log of activities along with the energy level at the time. |
Keeping track of activities with emotions and energy level helps the patient become more aware of contributing factors to their fatigue. Nurses can use this information to develop strategies with the patient to reduce situations that increase fatigue.
|Assist in developing a schedule that supports the most energetic hours of the day and allows for rest when needed. |
Planning daily activities and rest periods might reduce anxiety. Planning small increments might promote motivation and help complete daily tasks. Tasks can be decided between several days, such as housework.
|Advise to take frequent rest periods, especially before more challenging activities. |
Frequent rest periods provide a balance that allows the patient to complete desired tasks without getting any more tired.
|Encourage to participate in regular exercises. |
Strengthening exercises help with conditioning in increasing activity tolerance. Physical therapy and occupational therapy may be consulted.
|Assist in setting priorities when planning daily tasks. |
This exercise will help the patient be able to distinguish between essential and non-essential tasks. It will take time to gauge how long specific tasks take and which ones need to be completed first. Planning out the day helps prevent any last-minute rushing and helps conserve energy.
|Provide small frequent meals with a soft texture. |
It takes less energy to consume several small portions than three full meals. Soft foods require less chewing and conserve energy.
|Advise to stick to a regular sleep schedule. |
Getting up and going to bed at the same times each day helps the body to restore energy more effectively.
|If the patient is bed-bound or chair-bound, support the patient to help keep posture. |
Some patients are too weak to maintain a healthy posture when sitting up. The use of pillows, body aligners, and other tools helps keep a comfortable patient positioning, which might help with energy conservation.
|Teach energy-conserving techniques. |
Time management, organization skills, and delegating certain tasks may help the patient to accomplish tasks and conserve energy at the same time.
|Collaborate with the attending physician about optimizing medications. |
Certain medications such as sleep medications, sedatives, pain medications, and others can contribute to fatigue. Adjustments in frequency and dosing could improve symptoms of fatigue.
|Teach family members and caregivers signs of overexertion. |
Increased heart rate
Increased blood pressure
Increased respiratory rate
Increased oxygen demand
Regular checks of vital signs and an overall observation of the patient’s general appearance will reveal their activity level.
More Care Plans
Gulanick, M., & Myers, J. (2014). Nursing care plans (8th ed.). Elsevier.
Ignatavicius, D., & Workman, M. (2016). Medical-surgical nursing (8th ed.). Elsevier.
Silvestri, L. (2014). Saunders comprehensive review for the NCLEX-RN examination. Elsevier/Saunders.
Ackley, B., & Ladwig, G. (2014). Nursing diagnosis handbook (10th ed.). Maryland Heights, Miss.: Mosby Elsevier.