Nurse's Pocket Guide

FATIGUE
• Discuss lifestyle changes/limitations imposed by fatigue state.
• Interview parent/caregiver regarding specific changes
observed in child/elder. These individuals may not be able to
verbalize feelings or relate meaningful information.
• Note daily energy patterns (i.e., peaks/valleys). Helpful in
determining pattern/timing of activity.
• Measure physiological response to activity (e.g., changes in
blood pressure or heart/respiratory rate).
• Evaluate need for individual assistance/assistive devices.
• Review availability and current use of support systems/
resources.
• Perform/review results of testing, such as the Multidimensional
Assessment of Fatigue (MAF); Piper Fatigue Scale; Global
Fatigue Index, as appropriate. Can help determine manifestation,
intensity, duration, and emotional meaning of fatigue.
NURSING PRIORITY NO.3.To assist client to cope with fatigue and
manage within individual limits of ability:
• Accept reality of client reports of fatigue and do not underestimate
effect on client’s quality of life. For example, clients
with MS are prone to more frequent/severe fatigue following
minimal energy expenditure and require a longer recovery
period than is usual; post-polio clients often display a
cumulative effect if they fail to pace themselves and rest
when early signs of fatigue develop.
• Establish realistic activity goals with client and encourage forward
movement. Enhances commitment to promoting optimal
outcomes.
• Plan interventions to allow individually adequate rest periods.
Schedule activities for periods when client has the most
energy to maximize participation.
• Involve client/SO(s) in schedule planning.
• Encourage client to do whatever possible (e.g., self-care, sit up
in chair, go for walk, interact with family, play game). Increase
activity level, as tolerated.
• Instruct in methods to conserve energy:
Sit instead of stand during daily care/other activities.
Carry several small loads instead of one large load.
Combine and simplify activities.
Take frequent short rest breaks during activities.
Delegate tasks.
Ask for/accept assistance.
Say “no” or “later.”
Plan steps of activity before beginning so that all needed
materials are at hand.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
310 Cultural Collaborative Community/Home Care