- Activity Intolerance Related to low haemoglobin and Imbalance between oxygen supply/demand as evidenced by Exertional dyspnoea and Generalized weakness
- Decreased Cardiac Output related to decreased oxygenated blood in the heart and difficulty of the heart muscle to pump as evidenced by blood pressure fluctuations and cardiac arrhythmias
- Fatigue related to diminished oxygen-carrying capacity of the blood as evidenced by difficulty maintaining usual physical activity
| Assessment | Nursing Diagnosis | Planning/Outcomes | Intervention | Evaluation |
| Subjective data: -Patient’s report of decreased activity/weakness -Shortness of breath with exertion -Exertional discomfort Objective data: -Abnormal blood pressure and heart rate response to activity -Changes to ECG -Signs of pain with movement/activity -Difficulty engaging in activity -Increased oxygen demands | Activity Intolerance Related to low haemoglobin and Imbalance between oxygen supply/demand as evidenced by Exertional dyspnoea and Generalized weakness | Patient will report the ability to perform activities of daily living without dyspnea or extreme fatigue. Patient will identify interventions to reduce activity intolerance. | 1. Encourage adequate rest periods. Activity intolerance may be aggravated by fatigue. Adequate rest periods can reduce fatigue and promote activity tolerance. 2. Encourage the patient to ask for help. The patient may be reluctant to ask for help with self-care or household responsibilities. Explain that this increases their risk of injury and will further worsen activity intolerance and fatigue. Help them identify tasks that can be delegated. 3. Instruct on activities that require minimal exertion. Slowing down may be difficult if the patient is accustomed to an active lifestyle. Instruct on low-impact ways the client can stay active such as short walks, stretching, or light yoga. 4. Administer medications as indicated. Medications like iron supplements and erythropoietin replacement can help improve low hemoglobin and iron, reducing symptoms of fatigue and activity intolerance. | Patient reported the ability to perform activities of daily living without dyspnea or extreme fatigue. Patient identified interventions to reduce activity intolerance. |
| Subjective data: Verbalizes Dizziness and fainting Objective data: -Cardiac arrhythmias -Chest pain -Diminished pulses -Cool, clammy skin -Dizziness and headache -Fainting -Weakness -Fatigue -Pallor -Cyanosis | Decreased Cardiac Output related to decreased oxygenated blood in the heart and difficulty of the heart muscle to pump as evidenced by blood pressure fluctuations and cardiac arrhythmias | Patient will demonstrate blood pressure and heart rate within normal limits. Patient will manifest normal sinus rhythm on ECG. Patient will have no complaints of dizziness, fainting, or weakness. | 1. Reduce cardiac stress. Low hemoglobin can impair cardiac output by causing tachycardia and increased stroke volume. Decrease the workload of the heart by minimizing activity. 2. Treat the underlying cause. Control blood loss and manage the cause of low hemoglobin. Replace red blood cells and iron through supplements, blood transfusions, and bone marrow transplants if necessary. 3. Anticipate a possible blood transfusion. A severe decrease in hemoglobin requires a blood transfusion to improve the cardiac output and assist in circulating oxygenated blood throughout the body. 4. Administer medications as ordered. Intravenous iron therapy or an erythropoietin-stimulating agent can be given to improve the hemoglobin levels of patients with conditions such as anemia or renal disease. | Patient demonstrated blood pressure and heart rate within normal limits. Patient manifested normal sinus rhythm on ECG. Patients have no complaints of dizziness, fainting, or weakness. |
| Subjective data: Verbalizes Tiredness and expressed Weakness Objective data: -Difficulty maintaining usual routines -Expresses a lack of energy -Expresses weakness -Expresses tiredness -Insufficient physical endurance -Lethargy | Fatigue related to diminished oxygen-carrying capacity of the blood as evidenced by difficulty maintaining usual physical activity | Patient will demonstrate interventions to reduce fatigue. Patient will identify factors that aggravate feelings of tiredness and weakness. | 1. Set realistic goals. Help the patient plan tasks and set limits for each day. Have them prioritize and complete the most important tasks when energy reserves are highest. 2. Administer medications as needed. Patients with low hemoglobin may be given erythropoietin-stimulating drugs to help generate more red blood cells. 3. Provide supplemental oxygen. If cells and tissues are not receiving adequate oxygenation, supplemental oxygen may be required. 4. Eat iron-rich foods. If the patient has iron-deficiency anemia, they may need to increase iron in the diet by eating red or organ meats, fish, green leafy vegetables, beans, and nuts. | Patient demonstrated interventions to reduce fatigue. Patient identified factors that aggravate feelings of tiredness and weakness. |