Nursing Care Plan : Nanda Nursing Diagnosis

Nursing Diagnosis Fatigue


Fatigue An overwhelming, sustained sense of exhaustion and decreased capacity for physical and mental work at usual level


Inability to restore energy even after sleep; lack of energy or inability to maintain usual level of physical activity; increase in rest requirements; tired; inability to maintain usual routines; verbalization of an unremitting and overwhelming lack of energy; lethargic or listless; perceived need for additional energy to accomplish routine tasks; increase in physical complaints; compromised concentration; disinterest in surroundings, introspection; decreased performance; compromised libido; drowsy; feelings of guilt for not keeping up with responsibilities

Related Factors:
  • Boring lifestyle; stress; anxiety; depression
  • Humidity; lights; noise; temperature
  • Negative life events; occupation
  • Sleep deprivation; pregnancy; poor physical condition; disease states (cancer, HIV, multiple sclerosis); increased physical exertion; malnutrition; anemia

NOC Outcomes (Nursing Outcomes Classification)
  • Endurance
  • Concentration
  • Energy Conservation
  • Nutritional Status: Energy

Client Outcomes
  • Verbalizes increased energy and improved well-being
  • Explains energy conservation plan to offset fatigue

NIC Interventions (Nursing Interventions Classification)
  • Energy Management

Nursing Interventions
  • Assess severity of fatigue on a scale of 0 to 10; assess frequency of fatigue, activities associated with increased fatigue, ability to perform activities of daily living (ADLs), times of increased energy, ability to concentrate, mood, and usual pattern of activity.
  • Evaluate adequacy of nutrition and sleep. Encourage the client to get adequate rest. Refer to Imbalanced Nutrition: less than body requirements or Disturbed Sleep pattern if appropriate.
  • Determine with help from the primary care practitioner whether there is a physiological or psychological cause of fatigue that could be treated, such as anemia, electrolyte imbalance, hypothyroidism, depression, or medication effect.
  • Work with the physician to determine if the client has chronic fatigue syndrome.
  • Encourage client to express feelings about fatigue; use active listening techniques and help identify sources of hope.
  • Encourage client to keep a journal of activities, symptoms of fatigue, and feelings.
  • Assist client with ADLs as necessary; encourage independence without causing exhaustion.
  • Help client set small, easily achieved short-term goals such as writing two sentences in a journal daily or walking to the end of the hallway twice daily.
  • With physician's approval, refer to physical therapy for carefully monitored aerobic exercise program.
  • Refer client to diagnosis-appropriate support groups such as National Chronic Fatigue Syndrome Association or Multiple Sclerosis Association.
  • Help client identify essential and nonessential tasks and determine what can be delegated.
  • Give client permission to limit social and role demands if needed (e.g., switch to part-time employment, hire cleaning service).
  • Refer client to occupational therapy to learn new energy-conserving ways to perform tasks.
  • If client is very weak, refer to physical therapy for prescription and use of a mobility aid such as a walker.
  • Identify recent losses; monitor for depression as a possible contributing factor to fatigue.
  • Review medications for side effects. Certain medications (e.g., beta-blockers, antihistamines, pain medications) may cause fatigue in the elderly.

Home Care Interventions
  • Assess client's history and current patterns of fatigue as they relate to the home environment. Fatigue may be more pronounced in specific settings for physical or psychological reason.
  • Assess home for environmental and behavioral triggers of increased fatigue
  • When assisting client with adapting to home and daily patterns, avoid activities of high energy output. Refer to occupational therapy to accomplish this if necessary.
  • Assist client with identifying or creating a safe, restful place within the home that can be used routinely (e.g., a room with familiar, nonthreatening, or nonfrightening belongings).

Client/Family Teaching
  • Share information about fatigue and how to live with it, including need for positive self-talk.
  • Teach strategies for energy conservation
  • Teach client to carry a pocket calendar, make lists of required activities, and post reminders around the house.
  • Teach the importance of following a healthy lifestyle with adequate nutrition and rest, pain relief, and appropriate exercise to decrease fatigue.
  • Teach stress-reduction techniques such as controlled breathing, imagery, and use of music. See Anxiety care plan if appropriate; anxiety is correlated with increased fatigue.

Nursing Diagnosis

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