Nursing Diagnosis:Fatigue

May be related to

  • Decreased metabolic energy production, increased energy requirements (hypermetabolic state and effects of treatment)
  • Overwhelming psychological/emotional demands
  • Altered body chemistry: side effects of pain and other medications, chemotherapy

Possibly evidenced by

  • Unremitting/overwhelming lack of energy, inability to maintain usual routines, decreased performance, impaired ability to concentrate, lethargy/listlessness
  • Disinterest in surroundings

Desired outcomes

  • Report improved sense of energy.
  • Perform ADLs and participate in desired activities at level of ability.

Cancer Nursing Care Plan- Fatigue

Nursing actions Rationale
Have patient rate fatigue, using a numeric scale, if possible, and the time of day when it is most severe. Helps in developing a plan for managing fatigue.
Plan care to allow for rest periods. Schedule activities for periods when patient has most energy. Involve patient/SO in schedule planning. Frequent rest periods and/or naps are needed to restore/conserve energy. Planning will allow patient to be active during times when energy level is higher, which may restore a feeling of well-being and a sense of control.
Establish realistic activity goals with patient. Provides for a sense of control and feelings of accomplishment.
Assist with self-care needs when indicated; keep bed in low position, pathways clear of furniture; assist with ambulation. Weakness may make ADLs difficult to complete or place the patient at risk for injury during activities.
Encourage patient to do whatever possible, e.g., self-bathing, sitting up in chair, walking. Increase activity level as individual is able. Enhances strength/stamina and enables patient to become more active without undue fatigue.
Monitor physiological response to activity, e.g., changes in BP or heart/respiratory rate. Tolerance varies greatly depending on the stage of the disease process, nutrition state, fluid balance, and reaction to therapeutic regimen.
Perform pain assessment and provide pain management. Poorly managed cancer pain can contribute to fatigue.
Encourage nutritional intake. (Refer to ND: Nutrition: altered, less than body requirements.) Adequate intake/use of nutrients is necessary to meet energy needs and build energy reserves for activity.
Provide supplemental oxygen as indicated. Presence of anemia/hypoxemia reduces O2 available for cellular uptake and contributes to fatigue.
fer to physical/occupational therapy. Programmed daily exercises and activities help patient maintain/increase strength and muscle tone, enhance sense of well-being. Use of adaptive devices may help conserve energy.
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