Risk for decreased activity tolerance

Domain 4. Activity-rest
Class 2. Activity-exercise
Diagnostic Code: 00299
Nanda label: Risk for decreased activity tolerance
Diagnostic focus: Activity tolerance

Nursing diagnoses are specific clinical statements identifying a symptom or related to a condition that is amenable to therapeutic nursing intervention. The Risk For Decreased Activity Tolerance (RDT) nursing diagnosis is one such diagnosis that focuses on physical, mental, and emotional exhaustion associated with decreased activity ability. This nursing diagnosis is used when there is an increased risk of a patient having difficulty tolerating the normal level of activities due to a combination of factors.

Introduction for Nursing Diagnosis

Risk for Decreased Activity Tolerance (RDT), also known as Risk for Activity Intolerance, is a nursing diagnosis that refers to the likely inability of a person to sustain their routine activities due to physical, emotional, and/or cognitive exhaustion. Patients that are at-risk for this nursing diagnosis typically lack the energy and endurance needed to complete normal daily tasks. A weakened tolerance for activity can lead to a variety of negative consequences such as impaired quality of life and imposed restrictions of mobility.

NANDA Nursing Diagnosis Definition

According to NANDA International, the definition of RDT nursing diagnosis is “The state in which an individual experiences difficulty tolerating an expected level of activity”. The diagnosis is reported in terms of expected activity level, considering age and condition, characteristics of activity intolerance, and intensity. More often than not, patients are at risk of activity intolerance as they age and experience physical, mental and emotional fatigue from everyday stressors. Due to the effects of diminished strength, it is more difficult for the patient to complete daily tasks.

Risk Factors

The two main risk factors for RDT nursing diagnosis are age and chronic disease. Because age leads to physical deterioration, elderly people can suffer from weakened muscles, reduced energy levels, diminished spinal health, and so on. Chronic diseases can also induce this diagnosis due to associated fatigue, pain, restriction of movement, shortness of breath, weight fluctuations, and cognitive decline. Additionally, medications and treatments may have side effects that can limit physical and mental activity.

At Risk Population

Older adults and patients with chronic conditions are the primary populations at-risk for RDT nursing diagnosis. These populations may be seen in any number of settings, including hospitals, assisted-living facilities, and private households. Elderly people may have concerns about their overall health, difficulty managing activities of daily living (ADLs), limited resources, and restricted range of motion. People with chronic conditions may experience fatigue, impaired mobility, depression, memory issues, unsteadiness, and sensitivity to light and noise.

Associated Conditions

RDT nursing diagnosis can often occur along with other diagnoses such as impaired physical mobility, impaired cognition, fatigue, self-care deficit, disturbed sleep patterns, perceived external threat, and altered comfort. Impaired physical mobility, for example, occurs when joint pain or fatigue make it difficult to move around or do basic activities. Impaired cognition is another associated diagnosis and can cause confusion and difficulty concentrating or remembering things. Fatigue and sleep disturbances can be caused by physical, mental, and emotional stress. Perceived external threat involves feeling unsafe or threatened when going out due to fear of violence or unexpected medical conditions. Finally, altered comfort can be caused by pain, difficulty breathing, or general malaise.

Suggestion of Use

To accurately assess the risk for decreased activity tolerance, nurses must take a holistic approach to care. The first step is to recognize the underlying risk factors. Then assess the patient’s current level of physical and mental abilities, potential decrease in their physical ability, and whether it affects their overall ability to perform activities of daily living. After investigating these elements, the nurse should develop a plan that emphasizes safety and comfort while increasing the patient’s activity tolerance.

Suggested Alternative Nanda Nursing Diagnosis

When RDT nursing diagnosis is not applicable, other diagnoses may be used. These include Activity Intolerance, Impaired Physical Mobility, Self-care Deficit, Risk for Impaired Skin Integrity, Risk for Injury, Fatigue, and Sleep Pattern Disturbance. Activity Intolerance is the inability or reduced ability to engage in activities due to fatigue, weakness, or pain. Impaired Physical Mobility is a reduction in the ability to move around due to physical limitations and/or fatigue. Self-care Deficit is the inability to provide one’s own basic needs such as hygiene, nutrition, and mobility. Risk for Impaired Skin Integrity, Risk for Injury, and Fatigue all refer to the potential danger caused by a patient’s decreased physical ability. Finally, Sleep Pattern Disturbance is the inability to get sufficient and restful sleep.

Usage Tips

When assessing for the risk for decreased activity tolerance in a patient, nurses should consider the patient’s age, health condition, medications, as well as current activities, baseline level of function and physical capabilities. Additionally, ensure that consciousness, circulation, and respiration assessments are carried out and factor in psychological and environmental assessments as well. Depending on the patient’s risk factors, implement preventative measures through activity and environment modifications while also taking into account the patient’s lifestyle and interests when planning interventions.

NOC Outcomes

The main NOC outcomes related to the Risk For Decreased Activity Tolerance nursing diagnosis are Endurance, Activity Tolerance, Bed Mobility, Strength, and Stress Tolerance. Endurance is the amount of time a patient can sustain a given activity. Activity Tolerance is the maximum level of physical activity a patient can do without feeling exhausted or fatigued. Bed Mobility focuses on how easily and safely a patient can transfer from a bed to another piece of equipment or the floor. Strength measures the patient’s muscle strength and coordination in lifting, pushing and pulling objects. Stress Tolerance assesses the patient’s ability to handle stressful situations and make the necessary adjustments according to their capabilities.

Evaluation Objectives and Criteria

When evaluating the effectiveness of interventions to promote activity tolerance, certain objectives and criteria need to be taken into consideration. The endurance and activity tolerance levels of the patient are monitored, with things like time and intensity of activity being kept track of. Bed mobility is assessed separately, with criteria measuring the patient’s ability to transfer from the bed without assistance or experiencing fatigue. Strength is evaluated according to the patient’s capacity for performing activities such as lifting and pushing. Lastly, the stress tolerance is monitored according to the patient’s reaction to stressful situations, such as reacting calmly to a change in plans or helping to adjust quickly to a sudden task.

NIC Interventions

The primary NIC interventions related to Risk For Decreased Activity Tolerance nursing diagnosis include Energy Management, Exercise Promotion, Education, Physical Activity Planning and Group Processes. Energy Management focuses on techniques to increase energy levels, such as stretching or slow breathing techniques. Exercise Promotion involves developing an exercise regimen to increase activity tolerance. Education is used to educate patients on the importance of physical activity, what activities can and cannot be done, and the use of assistive devices. Physical Activity Planning helps to determine the type of activities that are appropriate for the patient based on their individual capabilities. Finally, Group Processes involve providing support through social environments, such as encouraging peer interaction or discussing issues related to the diagnosis.

Nursing Activities

Nursing activities related to RDT nursing diagnosis focus on promoting activity tolerance, minimizing fatigue, and ensuring safety. Some of the primary nursing activities include monitoring the patient’s tiredness and fatigue level, providing adequate rest periods and keeping the environment comfortable. Nurses should also assess physical and mental capabilities, monitor and manage medications, engage the patient in meaningful activities, and encourage the use of assistive devices where appropriate. Additionally, nurses must ensure proper nutrition and hydration, recommend exercise programs tailored to the patient’s needs, and offer support and encouragement. Lastly, nurses can provide education to the patient and caregivers regarding the importance of activity tolerance and strategies they can use to help manage fatigue.

Conclusion

Risk For Decreased Activity Tolerance (RDT) nursing diagnosis is a diagnosis that focuses on physical, mental, and emotional exhaustion associated with decreased activity toleration. Age and chronic diseases are the primary risk factors for dissatisfaction with activity level, with older adults and patients with chronic conditions seen as vulnerable populations. Nurses must take a holistic approach to care when assessing for the risk for decreased activity tolerance, implementing preventative measures and interventions that support a patient’s physical and mental wellbeing. Ultimately, proper assessment and evaluation help nurses gain insight into the patient’s condition and determine the most appropriate course of action for them.

5 FAQs

• What is Risk For Decreased Activity Tolerance (RDT) nursing diagnosis? RDT nursing diagnosis is a description of a state in which an individual experiences difficulty tolerating an expected level of activity. This diagnosis is typically associated with physical, emotional, and/or cognitive exhaustion.
• Who is at risk for RDT nursing diagnosis? Older adults and patients with chronic conditions are the primary populations at-risk for RDT nursing diagnosis.
• What are some associated conditions with RDT nursing diagnosis? Some associated conditions with this diagnosis include impaired physical mobility, impaired cognition, fatigue, self-care deficit, disturbed sleep patterns, perceived external threat, and altered comfort.
• What are some nursing activities related to RDT nursing diagnosis? Primary nursing activities related to this diagnosis focus on promoting activity tolerance, minimizing fatigue, and ensuring safety. Some of the activities include monitoring the patient’s tiredness and fatigue level, providing adequate rest periods and keeping the environment comfortable.
• What are some evaluation criteria for Risk For Decreased Activity Tolerance? When evaluating the effectiveness of interventions to promote activity tolerance, certain objectives and criteria need to be taken into consideration. These include endurance and activity tolerance levels, bed mobility, strength and stress tolerance.

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