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Fatigue & Lethargy Nursing Care Plans

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By Gil Wayne BSN, R.N.

Utilize this comprehensive guide to create a holistic nursing care plan and interventions specifically tailored for patients experiencing fatigue. This guide will equip you with a deep understanding of the nursing assessment, diagnosis, and interventions required to effectively manage fatigue and promote the overall well-being of patients. By addressing their individual needs, you can provide the necessary support for their recovery journey.

Table of Contents

What is fatigue?

Almost everybody is overtired or overworked from time to time. Words like lethargic, exhausted, tired, and even ‘fatigue’ are always used when a symptom is difficult for the patient to describe.

Fatigue is a subjective complaint with both acute and chronic conditions. It is the self-recognized state in which an individual experiences an overwhelming sustained sense of exhaustion and decreased capacity for physical and mental work that is not relieved by rest. However, it is important to know that fatigue is not the same as tiredness. Tiredness is temporary. Fatigue is associated with a variety of physical and psychological conditions.

Fatigue can significantly impact a patient’s ability to perform daily activities, affecting their quality of life and overall well-being. It can also lead to decreased motivation, social isolation, and other adverse effects.


Here are the common factors that can cause fatigue:

  1. Physical exertion. Prolonged or excessive physical activity can lead to fatigue as the body’s energy reserves become depleted and muscles become fatigued.
  2. Sleep deprivation. Lack of sufficient sleep or poor sleep quality can result in fatigue, as the body and brain do not have adequate time to rest and rejuvenate.
  3. Medical conditions. Various medical conditions such as anemia, thyroid disorders, chronic pain, and infections can contribute to fatigue by affecting the body’s physiological processes and energy production.
  4. Medications. Certain medications, such as those used for pain management, sedatives, and some antidepressants, may have fatigue as a side effect.
  5. Psychological factors. Mental health conditions like depression, anxiety, and chronic stress can cause or exacerbate fatigue by affecting sleep patterns, energy levels, and overall well-being.
  6. Poor nutrition. Inadequate intake of essential nutrients, dehydration, and imbalances in blood sugar levels can lead to fatigue as the body lacks the necessary fuel for energy production.
  7. Lifestyle factors. Unhealthy lifestyle habits, such as excessive alcohol consumption, smoking, lack of physical activity, and poor stress management, can contribute to fatigue by negatively impacting overall health and well-being.
  8. Environmental factors. Exposure to extreme temperatures, noise, or prolonged exposure to stressful or demanding environments can result in fatigue due to the strain placed on the body and mind.

Signs and symptoms

Priority nursing assessments for fatigue involve evaluating its severity and duration, identifying potential causes, assessing sleep patterns and mental health, and evaluating the impact on daily activities.

  1. Persistent tiredness. The patient experiences a constant feeling of exhaustion and lack of energy, often unrelated to physical activity or sleep.
  2. Difficulty concentrating. The patient’s cognitive impairment, characterized by difficulty focusing, maintaining attention, and processing information, can significantly impact their task performance and decision-making abilities.
  3. Decreased motivation. The patient may lack the drive or enthusiasm to engage in activities they previously enjoyed.
  4. Physical weakness. The patient may experience a sense of weakness, heaviness, or lack of strength in their muscles. This can lead to difficulties with mobility and performing physical tasks.
  5. Sleep disturbances. Fatigue can be accompanied by disruptions in sleep patterns, such as insomnia, frequent awakenings, or unrefreshing sleep. These sleep disturbances can further contribute to feelings of tiredness and fatigue.
  6. Irritability and mood changes. The patient may display increased irritability, mood swings, or emotional instability. These emotional changes can be a result of the physical and mental strain associated with fatigue.
  7. Reduced tolerance to stress. Fatigue can lower the patient’s ability to cope with and manage stressors, making them more susceptible to feeling overwhelmed or emotionally drained.
  8. Physical symptoms. Fatigue can manifest in various physical symptoms, including headaches, muscle aches, dizziness, and general malaise. These symptoms may contribute to the overall feeling of being unwell.

Goals and outcomes

The following are the common goals and expected outcomes for Fatigue.

  • The patient will demonstrate improved energy levels and reduced fatigue, as evidenced by reporting increased ability to engage in daily activities without excessive tiredness.
  • The patient will adopt healthy lifestyle behaviors and self-care strategies to manage fatigue, as evidenced by practicing adequate sleep hygiene, engaging in regular physical activity, and implementing stress reduction techniques.

Nursing assessment and rationales

Nursing assessment is crucial for evaluating the underlying causes and contributing factors of fatigue in patients, as it helps identify physical, psychological, and environmental factors that may be exacerbating fatigue and guides the development of individualized nursing interventions for managing and alleviating fatigue.

1. Evaluate the patient’s description of fatigue: severity, changes in severity over time, aggravating factors, or alleviating factors.
Using an appropriate quantitative scoring scale, 1 to 10 for example, can aid the patient to formulate the amount of fatigue experienced. Further scoring scales can be developed by using pictures or descriptive language. This system allows the nurse to weigh against changes in the patient’s fatigue level over time. It is important to conclude if the patient’s level of fatigue is constant or if it varies over time.

2. Determine possible causes of fatigue, such as last physical illness, pain, emotional stress, depression, side effects of medication, anemia, sleep disorders, imbalanced nutritional intake, and extended responsibilities and demands at home or work.
Identifying the related factors to fatigue can benefit in recognizing potential causes and building a collaborative plan of care.

3. Assess the patient’s ability to perform ADLs, instrumental activities of daily living (IADLs), and demands of daily living (DDLs).
Fatigue can restrict the patient’s ability to participate in self-care and do his or her role responsibilities in the family and society, such as working outside the home.

4. Assess the patient’s nutritional ingestion for adequate energy sources and metabolic demands.
Fatigue may be a symptom of protein-calorie malnutrition, vitamin deficiencies, or iron deficiencies.

5. Evaluate the patient’s outlook for fatigue relief, eagerness to participate in strategies to reduce fatigue, and level of family and social support.
These will promote active participation in planning, implementing, and evaluating therapeutic management to alleviate fatigue. Social support will be essential to assist the patient put into practice changes to decrease fatigue.

6. Observe physiological reactions to activities such as any alterations in BP, respiratory rate, or heart rate.
Tolerance varies significantly, depending on the phase of the disease progression, nutrition condition, fluid balance, and quantity or sort of opportunistic diseases that the patient has been subjected to.

7. Assess the patient’s typical level of exercise and physical movement.
Increased physical exertion and inadequate levels of exercise can add to fatigue.

8. Assess the patient’s sleep patterns for quality, quantity, time taken to fall asleep, and feeling upon awakening and observe an alteration in thought processes or behaviors.
Changes in the patient’s sleep pattern may be a contributing factor in the development of fatigue. Numerous factors can exacerbate fatigue, together with sleep deprivation, emotional distress, side effects of drugs, and progressing CNS disease.

9. Assess the patient’s routine recommendation and over-the-counter drugs.
Fatigue may be a medication side effect or an indication of a drug interaction. The nurse must perform particular notice of the patient’s utilization of beta-blockers, calcium channel blockers, tranquilizers, alcohol, muscle relaxants, and sedatives.

10. Assess the patient’s emotional reaction to fatigue.
The common emotional responses associated with fatigue are anxiety and depression. These emotional conditions can increase the person’s fatigue level and produce a vicious cycle.

11. Review results of laboratory or diagnostic tests such as blood glucose, hemoglobin/hematocrit, BUN, and oxygen saturation (resting and with activity).
Changes in these physiological measures may be associated with other measurement data to recognize possible sources of the patient’s fatigue.

Nursing Interventions and Rationales

The following are the therapeutic nursing interventions for patients experiencing fatigue:

1. Restrict environmental stimuli, especially during planned times for rest and sleep.
Vivid lighting, noise, visitors, numerous distractions, and litter in the patient’s physical surroundings can limit relaxation, disturb rest or sleep, and contribute to fatigue.

2. Encourage the patient to maintain a 24-hour fatigue or activity log for at least 1 week.
Recognizing relationships between specific activities and levels of fatigue can aid the patient to recognize unnecessary energy outflow. The log may indicate times of day when the person feels the least fatigued. This information can help the patient make choices about setting his or her activities to take advantage of episodes of high energy levels.

3. Implement the use of assistive devices for ADLs and IADLs such as a long-handled sponge for bathing, a long shoehorn, a sock-puller, and a long-handled grabber.
Utilization of such devices can lessen energy expenditure and prevent injury with activities.

4. Aid the patient with developing a schedule for daily activity and rest. Emphasize the importance of frequent rest periods.
A plan that balances periods of activity with periods of rest can aid the patient complete preferred activities without contributing to levels of fatigue.

5. Teach energy conservation methods. Collaborate with an occupational therapist as needed.
Patients and caregivers may need to learn skills for delegating tasks to others, setting priorities, and clustering care to use the available energy to complete desired activities. Organization and time management can help the patient conserve energy and reduce fatigue. The occupational therapist can offer the patient assistive devices and educate the patient on energy conservation methods.

6. Assist the patient with setting priorities for preferred activities and role responsibilities.
Setting priorities is one sort of energy conservation method that permits the patient to utilize available energy to complete important activities. Attaining desired goals can develop the patient’s mood and sense of emotional health.

7. Promote sufficient nutritional intake.
The patient will need a properly balanced intake of fats, carbohydrates, proteins, vitamins, and minerals to provide energy resources.

8. Encourage an exercise conditioning program as appropriate.
Fatigue caused by deconditioning and prolonged bed rest can be reduced through improved functional capacity using aerobic and muscle-strengthening exercises.

9. Provide comforts such as judicious touch or massage, and cool showers.
These may reduce nervous energy which leads to relaxation.

10. Encourage verbalization of feelings about the impact of fatigue.
Acknowledgment that living with fatigue is both physically and emotionally challenging helps in coping.

11. Offer diversional activities that are soothing.
This method allows the use of nervous energy in a positive manner and may lessen anxiety.

12. Identify energy conservation methods such as sitting and dividing ADLs into convenient segments. Assist with movement or self-care demands as appropriate.
Weakness can make ADLs almost not possible for patients to finish. Being with the patient prevents the patient from getting harmed during activities.

13. Set practical activity goals with the patient.
This offers a sense of control and feelings of achievement.

14. Stay away from topics that annoy or disturb patients. Converse ways to react to these feelings.
Increased irritability of the CNS can make the patient become easily excited, agitated, and prone to emotional outbursts.

15. Educate the patient and family about task organization methods and time organization methods.
Organization and management of time can assist the patient to save energy and avoiding fatigue.

16. Support the patient in escalating levels of physical activity and exercise.
Exercise can reduce fatigue and assist the patient build stamina for physical activity.

17. Make the patient aware of the signs and symptoms of overexertion with activity.
Changes in heart rate, oxygen saturation, and respiratory rate will reflect the patient’s tolerance for activity.

18. Aid the patient to develop habits to promote effective rest/sleep patterns.
Promoting relaxation before sleep and providing several hours of uninterrupted sleep can contribute to energy restoration.

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

Ackley and Ladwig’s Nursing Diagnosis Handbook: An Evidence-Based Guide to Planning Care
We love this book because of its evidence-based approach to nursing interventions. This care plan handbook uses an easy, three-step system to guide you through client assessment, nursing diagnosis, and care planning. Includes step-by-step instructions showing how to implement care and evaluate outcomes, and help you build skills in diagnostic reasoning and critical thinking.

Nursing Care Plans – Nursing Diagnosis & Intervention (10th Edition)
Includes over two hundred care plans that reflect the most recent evidence-based guidelines. New to this edition are ICNP diagnoses, care plans on LGBTQ health issues, and on electrolytes and acid-base balance.

Nurse’s Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales
Quick-reference tool includes all you need to identify the correct diagnoses for efficient patient care planning. The sixteenth edition includes the most recent nursing diagnoses and interventions and an alphabetized listing of nursing diagnoses covering more than 400 disorders.

Nursing Diagnosis Manual: Planning, Individualizing, and Documenting Client Care 
Identify interventions to plan, individualize, and document care for more than 800 diseases and disorders. Only in the Nursing Diagnosis Manual will you find for each diagnosis subjectively and objectively – sample clinical applications, prioritized action/interventions with rationales – a documentation section, and much more!

All-in-One Nursing Care Planning Resource – E-Book: Medical-Surgical, Pediatric, Maternity, and Psychiatric-Mental Health 
Includes over 100 care plans for medical-surgical, maternity/OB, pediatrics, and psychiatric and mental health. Interprofessional “patient problems” focus familiarizes you with how to speak to patients.

See also

Other recommended site resources for this nursing care plan:

Gil Wayne ignites the minds of future nurses through his work as a part-time nurse instructor, writer, and contributor for Nurseslabs, striving to inspire the next generation to reach their full potential and elevate the nursing profession.

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