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
- 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)
- Energy Conservation
- Nutritional Status: Energy
- Verbalizes increased energy and improved well-being
- Explains energy conservation plan to offset fatigue
NIC Interventions (Nursing Interventions Classification)
- 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.