Ongoing Assessment: Activity Intolerance

Activity IntoleranceWhat you need to assess for activity intolerance is/are below:








Activities/Interventions Rationale
Determine the patient’s perception of causes of fatigue or activity intolerance These may be temporary or permanent, physical or psychological. Assessment guides treatment.
Assess the patient’s level of mobility This aids in defining what the patient is capable of which is necessary before setting realistic goals.
Assess nutritional status Adequate energy reserves are required for activity.
Assess potential for physical injury which activity, including safety of the immediate environment Injury may be related to falls or overexertion. Obstacles such as throw rugs, children’s toys, and pets can (further) impede one’s ability to ambulate safely.
Assess the need for ambulation aids: bracing, cane, walker, equipment modification for activities of daily living (ADLs) Some aids may require more energy expenditure for patients who have reduced upper arm strength (e.g. walking with crutches). Adequate assessment of energy requirements is indicated.
Assess the patient’s cardiopulmonary status and stability for exercise before activity using the following measures

  • Heart rate





  • Orthostatic BP changes


  • Need for oxygen with increased activity




  • How the Valsalva  maneuver affects heart rate



Heart rate should not increase more than 20 to 30 bpm above resting with routine activities. This number will change depending on the intensiy of exercise the patient is attempting (e.g., climbing one flight of stairs vs walking on a flat surface)
Older patients are more susceptible to drops in blowing pressure with position changes
Portable pulse oximetry can be used to assess for oxygen desaturation. Supplemental oxygen may help companies for the increased oxygen demands.
Vasalva Maneuver, which requires breath holding and bearing down, can cause bradycardia and related reduced cardiac output
Monitor the Patient’s sleep pattern and amount of sleep achieved over the past few days Difficulties sleeping need to be addressed before activity progression can be achieved
Observe and Document response to activity. Report any changes Close monitoring serves as a guide for optimal progression of activity
Assess emotional response to change in physical status Depression resulting from the inability to perform required activities can further aggravate activity intolerance

[source: gulanick/mayers]