Nursing Interventions of Activity Intolerance and Rationale
- Monitor physiologic responses to increased activity level, including respirations, heart rate and rhythm, and blood pressure, to ensure that these return to normal within 2–5 min after stopping exercise.
- Perform active or passive ROM exercises to all extremities every 2–4 hr. These exercises foster muscle strength and tone, maintain joint mobility, and prevent contractures.
- Turn and reposition patient at least every 2 hr. Establish a turning schedule for the dependent patient. Post schedule at bedside and monitor frequency. Turning and repositioning prevent skin breakdown and improve lung expansion and prevent atelectasis.
- Maintain proper body alignment at all times to avoid contractures and maintain optimal musculoskeletal balance and physiologic function.
- Encourage active exercise: Provide a trapeze or other assistive device whenever possible. Such devices simplify moving and turning for many patients and allow them to strengthen some upper-body muscles.
- Teach about isometric exercises to allow patients to maintain or increase muscle tone and joint mobility.
- Teach caregivers to assist patients with ADLs in a way that maximizes patients’ potential. This enables caregivers to participate in patients’ care and encourages them to support patients’ independence.
- Provide emotional support and encouragement to help improve patient’s self-concept and motivate patient to perform ADLs.
- Involve patient in planning and decision making. Having the ability to participate will encourage greater compliance with the plan for activity.
- Have patient perform ADLs. Begin slowly and increase daily, as tolerated. Performing ADLs will assist patient to regain independence and enhance self-esteem.
- Refer to case manager/social worker to ensure that a home assessment has been done and that whatever modifications were needed to accommodate the patient’s level of mobility have been made. Making adjustments in the home will allow the patient a greater degree of independence in performing ADLs, allowing better conservation of energy.
