Assessment

Subjective: Nanghihina ako...nahihirapan na kong gumalaw as verbalized by the patient. Activity intolerance related to immobility/imbalance between oxygen supply and demand as evidenced by

Rationale
At risk of experiencing insufficient physiological or psychological energy to endure or complete required or desired daily activities

Planning
After 8 hours of nursing intervention the patient will be able to: Participate in prescribed physical activity with appropriate increases in heart rate, blood pressure, and breathing rate; maintains monitor patterns (rhythm and ST segment) within normal limits State symptoms of adverse effects of exercise and reports onset of symptoms immediately Maintain normal skin color and skin is

Intervention
y Assessed patient daily for appropriatene ss of activity and bed rest orders. y Minimized cardiovascular deconditionin g by positioning patient as close to the upright position as possible several times daily.

Rationale
y Inappropriate prolonged bed rest orders may contribute to activity intolerance. y The hazards of bed rest in the elderly are multiple, serious, quick to develop, and slow to reverse. Deconditioning of the cardiovascular system occurs within days and involves fluid shifts, fluid loss, decreased cardiac output, decreased peak oxygen uptake, and increased resting heart rate

Evaluation
Goal met After 8 hours of nursing intervention the patient: Participated in prescribed physical activity with appropriate increases in heart rate, blood pressure, and breathing rate; maintains monitor patterns (rhythm and ST segment) within normal limits Stated symptoms of adverse effects of exercise and reports onset of symptoms immediately. Such as shortness of breath, fatigue, dizziness.

Objective:  92 years old  Status post: CVA  Pneumonia  RR- increased

y Allowing patient to

y Increasing activity helps to maintain

warm and dry with activity Verbalize an understanding of the need to gradually increase activity based on testing, tolerance, and symptoms Express an understanding of the need to balance rest and activity Demonstrate increased activity tolerance

assist with positioning, transferring, and self-care as possible y Ensured that patient change position slowly

muscle strength, tone, and endurance.

Maintained normal skin color and skin is warm and dry with activity Verbalized an understanding of the need to gradually increase activity based on testing, tolerance, and symptoms Expressed an understanding of the need to balance rest and activity Demonstrated increased activity tolerance.

y Monitor for symptoms of activity intolerance. Bed rest in the supine position results in loss of plasma volume, which contributes to postural hypotension and syncope .

y Performed range-ofmotion exercises.

y These factors contribute to contracture and limitation of motion. Inactivity rapidly contributes to muscle shortening and changes in periarticular and

cartilaginous joint structure

Geriatric y Slowed the pace of care. Allowed client extra time to carry out activities. y Encouraged families to help/allow elder to be independent in whatever activities possible. y Encouraging activity not only enhances good functioning of the body's systems but also promotes a sense of worth by providing an opportunity for productivity. Sometimes families believe they are assisting by allowing clients to be sedentary. y Orthostatic hypotension is common in the elderly as a

y Watched for orthostatic hypotension accompanied

by dizziness and fainting.

result of cardiovascular changes, chronic diseases, and medication effects

Czelmar del Rosario BSN 4-1 Group 1a