ASSESSMENT NURSING OUTCOME PLANNING NURSING INTERVENTIONS OUTCOME
DIAGNOSIS IDENTIFICATION
Subjective: Activity At the end of the After 2 weeks of - Assess patient’s activities of daily living, as well as actual At the end of the
“Mabilis po siya intolerance nursing nursing interventions and perceived limitations to physical activity. nursing
mapagod, at related to interventions, the client will be able Rationale: To create baseline of activity levels related to interventions,
madalas din siyang imbalance the client will be to: imbalance in oxygen supply and demand. the client was
nahihilo” as between oxygen able to: able to:
verbalized by the supply and - identify factors that - Assess the risk of falling and enforce applicable strategies.
guardian. demand as - demonstrate increase activity Rationale: To decrease or eliminate accidents that can lead - demonstrate
evidenced by active intolerance; to serious injuries. active
Objective: easy fatiguability participation in participation in
Pale skin and generalized the plan of care; - describe adaptive - Assess the patient’s nutritional status. the plan of care;
General weakness weakness and techniques to Rationale: Adequate energy reserves are needed during and
Decrease muscular perform activity of activity. Nutritional deficiencies can lead to weakness,
tone - increase level of daily living; fatigue, and decreased endurance, making it more difficult - increase level of
activities of daily for a person to tolerate activity. Assessment of a patient’s activities of daily
V/S taken as follow: living. - verbalize and use nutritional status can help identify deficiencies that may be living.
BP: 100/60 mmHg energy-conservation affecting their decreased activity tolerance.
techniques; and
O2sat: 98%
- Assess emotional response to limitations in physical
PR: 97 BPM
- identify methods to activity.
reduce activity Rationale: Depression over the inability to perform
intolerance. activities can be a source of stress and frustration. Physical
activity can make a person feel better, function better, and
sleep better.
- Encourage deep breathing techniques.
Rationale: to boost oxygen delivery to the tissues and
increase cardiac output primarily by raising heart rate.
- Aid in a gradual increase of activities to tolerance as the
client’s strength progress.
Rationale: This develops endurance while preventing
problems caused by prolonged bed rest. All forms of
exercise are recommended to help decrease fatigue, but
the more aerobic the activity the better.
- Allow time for the client to have undisturbed rest.
Rationale: Lessening any interruptions allows the client to
rest and benefit from sleep until the anemia is resolved.
Clients with severe anemia should curtail their activity until
the anemia is partially corrected.
- Allow verbalization of feelings regarding limitations.
Rationale: This helps the client to cope. Acknowledgment
that living with activity intolerance is both physically and
emotionally difficult. Some benefits of physical activity on
brain health happen right after a session of moderate-to-
vigorous physical activity. Benefits include improved
thinking or cognition and reduced short-term feelings of
anxiety.
- Administer iron and other supplements such as
cobalamin, and folate.
Rationale: These may be given to restore hemoglobin and
depleted iron and other deficiencies if necessary.
- Provide education about dietary adjustment and
improvement.
Rationale: Improvements in dietary intake and strength
also may help reduce symptoms. Iron deficiency anemia is
prevalent in geographic locations where little meat is in the
diet.
- Document response to activity.
Rationale: Close monitoring will serve as a guide for the
optimal progression of activity.
