Nursing Diagnoses for Fatigue

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

Characteristics: 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.
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