Activity Intolerance Case Study
Nursing Diagnosis: Activity Intolerance rt generalized weakness pg 118-119
Dt CHF
As Evidenced By:
1. Pt stated that she felt weakness in her legs when trying to stand up and move from bed to chair-verbal report of weakness
2. Pt stated she was tired when she began walking to the bathroom- verbal report of fatigue
3. Pt began to display dyspnea during exertion periods
Goal: Starting 3.10.10 pt will demonstrate increased tolerance to activity by discharge.
Interventions:
1. 1.Starting 3.10.10 allow periods of rest before and after planned exertion periods such as meals, baths, treatments, and physical activity
2. Starting 3.10.10 when getting a pt up, observe for symptoms of intolerance such as nausea, pallor, dizziness, visual dimming and impaired consciousness, as well as vital changes.
3. …show more content…
Starting 3.10.10 provide emotional support and encouragement to the pt to gradually increase activity.
4. Starting 3.10.10 Obtain or use any necessary assistive devices or equipment needed before ambulating such as walkers, canes, crutches, or portable oxygen
Rationale:
1. Both physical and emotional rest helps lower arterial pressure and reduce the workload of heart
2. When getting a pt up to a standing position, 300-800ml of blood pools in the lower extremities. As a result hypoperfusion may occur, including feeling of weakness, nausea, H/A, lightheadedness, blurred vision etc.
3. Fear breathlessness, pain or falling may decrease willingness to increase activity
4. Assistive devices can increase mobility by helping the client overcome limitations.
Nursing Diagnosis: Ackley pg.147 risk for aspiration
Rt presence of tracheostomy and
Dt CHF
As Evidenced By:
1. Pt stated that she felt weakness in her legs when trying to stand up and move from bed to chair-verbal report of weakness
2. Pt stated she was tired when she began walking to the bathroom- verbal report of fatigue
3. Pt began to display dyspnea during exertion periods
Goal: Starting 3.10.10 pt will demonstrate increased tolerance to activity by discharge.
Interventions:
1. 1.Starting 3.10.10 allow periods of rest before and after planned exertion periods such as meals, baths, treatments, and physical activity
2. Starting 3.10.10 when getting a pt up, observe for symptoms of intolerance such as nausea, pallor, dizziness, visual dimming and impaired consciousness, as well as vital changes.
3. …show more content…
Starting 3.10.10 provide emotional support and encouragement to the pt to gradually increase activity.
4. Starting 3.10.10 Obtain or use any necessary assistive devices or equipment needed before ambulating such as walkers, canes, crutches, or portable oxygen
Rationale:
1. Both physical and emotional rest helps lower arterial pressure and reduce the workload of heart
2. When getting a pt up to a standing position, 300-800ml of blood pools in the lower extremities. As a result hypoperfusion may occur, including feeling of weakness, nausea, H/A, lightheadedness, blurred vision etc.
3. Fear breathlessness, pain or falling may decrease willingness to increase activity
4. Assistive devices can increase mobility by helping the client overcome limitations.
Nursing Diagnosis: Ackley pg.147 risk for aspiration
Rt presence of tracheostomy and