This document outlines a nursing care plan for a patient experiencing activity intolerance. It includes assessments of the patient's physical activity level, nutritional status, need for ambulation aids, and cardiopulmonary status. Nursing interventions include gradually increasing the patient's activity through exercises and walking. The patient will be taught energy conservation techniques and how to recognize signs of overexertion. The goals are for the patient to become more independent in activities of daily living within 2 days and able to perform them normally without assistance within 2 weeks.

1. Patient
Problem
( Actual )
Nursing diagnosis Activity intolerance related to (contributing factor
according to the patient’s condition)
Subjective
Data
 According to the nurse’s observation.
Objective
Data
 According to the patient description.
Objectives
Short
term
 In 2 days, the patient will be more independent in performing his ADLS.
*PS: Objectives are changeable according to the patient condition and the
nurse’s aim.
Long
term
 In 2 weeks, the patient will be able to perform ADLS normally without any
assistance.
*PS: Objectives are changeable according to the patient condition and the
nurse’s aim.
Nursing
intervention
Assessment
 Investigate the patient’s perception of causes of activity intolerance.
- Rationale: Causative factors may be temporary or permanent as well as
physical or psychological. Determining the cause can help guide the nurse
during the nursing intervention.
 Assess the physical activity level and mobility of the patient.
- Rationale: Provides baseline information for formulating nursing goals
during goal setting.
 Assess the patient’s nutritional status.
- Rationale: Adequate energy reserves are needed during activity.
 Assess the need for ambulation aids (e.g., cane, walker) for ADLs.
- Rationale: Assistive devices enhance the mobility of the patient by
helping him overcome limitations.
Nursing Care Plan Example
"Activity Intolerance"

2.  Assess the patient’s baseline cardiopulmonary status (e.g., heart rate,
orthostatic BP) before initiating activity.
- Rationale: In normal adults, HR should not increase more than 20 to 30
beats/min above resting with routine activities. Older patients are more
susceptible to orthostatic drops in BP with position changes.
 Assess emotional response to limitations in physical activity.
- Rationale: Depression over the inability to perform activities can be a
source of stress and frustration.
 Assess for oxygen desaturation during activity.
- Rationale: May determine the use of supplemental oxygen to help
compensate for the increased oxygen demands during physical activity.
 Assess the patient’s daily routine and over-the-counter medication.
- Rationale: Fatigue can limit the patient’s ability to perform needed
activity. It can also be a medication side effect. Pay attention to the
patient’s use of beta-blockers, calcium channel blockers, tranquilizers,
antihistamines, relaxants, alcohol, and sedatives.
Interventions
 Evaluate the need for additional help at home.
- Rationale: Coordinated efforts are more meaningful and effective in
assisting the patient in conserving energy.
 Have the patient perform the activity more slowly, in a longer time with
more rest or pauses, or with assistance if necessary.
- Rationale: Helps in increasing the tolerance for the activity.
 Gradually increase activity with active range-of-motion exercises in bed,
increasing to sitting and then standing.
- Rationale: Gradual progression of the activity prevents overexertion.
 Dangle the legs from the bedside for 10 to 15 minutes.
- Rationale: Prevents orthostatic hypotension.
 Refrain from performing nonessential activities or procedures.
- Rationale: Patient with limited activity tolerance need to prioritize
important tasks first.
 Assist with ADLs while avoiding patient dependency.
- Rationale: Assisting the patient with ADLs allows conservation of energy.
Carefully balance provision of assistance; facilitating progressive

3. endurance will ultimately enhance thepatient’s activity tolerance and self-
esteem.
 Gradually progress patient activity with the following:
 Range-of-motion (ROM) exercises in bed, gradually increasing duration
and frequency (then intensity) to sitting and then standing.
 Deep-breathing exercises three or more times daily.
 Sitting up in a chair 30 minutes three times daily.
 Walking in room 1 to 2 minutes TID.
 Walking down the hall 20 feet or walking through the house, then slowly
progressing walking outside the house, saving energy for the return trip.
- Rationale: Duration and frequency should be increased before intensity
 Provide emotional support and positive attitude regarding abilities.
- Rationale: Patient may be fearful of overexertion and potential damage
to the heart. Appropriate supervision during early efforts can enhance
confidence.
 Provide the patient with the adaptive equipment needed for completing
ADLs.
- Rationale: Appropriate aids will enable the patient to achieve optimal
independence for self-care and reduce energy consumption during
activity.
Health
Teaching
 Instruct patient to plan activities for times when they have the most
energy.
- Rationale: Activitiesshould be planned to coincide with the patient’s peak
energy level. If the goal is too low, negotiate.
 Instruct verbalization of feelings regarding limitations.
- Rationale: This helps the patient to cope. Acknowledgment that living
with activity intolerance is both physically and emotionally difficult.
 Teach the patient and/or SO to recognize signs of physical over activity or
overexertion.
- Rationale: Knowledge promotes awareness to prevent the complication
of overexertion.
 Teach and instruct to perform active ROM
- Rationale: Exercise maintains muscle strength, joint ROM, and exercise
tolerance. Physical inactive patients need to improve functional capacity
through repetitive exercises over a long period. Strength training is
valuable in enhancing endurance of many ADLs.

4.  Teach energy conservation techniques, such as:
 Sitting to do tasks
 Frequent position changes
 Pushing rather than pulling
 Sliding rather than lifting
 Working at an even pace
 Placing frequently used items within easy reach
 Resting for at least 1 hour after meals before starting a new activity
 Using wheeled carts for laundry, shopping, and cleaning needs
 Organizing a work-rest-work schedule
- Rationale: These techniques reduce oxygen consumption, allowing a more
prolonged activity.
Evaluation
Achieved ( ) Partially achieved ( ) Not achieved ( )
Evidence by:
Important Note
"We just recommend examples of nursing care plans. There are many references and
interventions may change according to patient condition. You should consider this, search,
and see more than one reference to reach the best quality for writing the care plan"