Fatigue — AIDS

Nursing Diagnosis: Fatigue

May be related to

• Decreased metabolic energy production, increased energy requirements
• (hypermetabolic state)
• Overwhelming psychological/emotional demands
• Altered body chemistry: side effects of medication, chemotherapy

Possibly evidenced by

• Unremitting/overwhelming lack of energy, inability to maintain usual routines, decreased performance, impaired ability to concentrate, lethargy/listlessness
• Disinterest in surroundings

Desired Outcomes

• Report improved sense of energy.
• Perform ADLs, with assistance as necessary.
• Participate in desired activities at level of ability

Nursing Interventions	Rationale
Assess sleep patterns and note changes in thought processes/behaviors.	Multiple factors can aggravate fatigue, including sleep deprivation, emotional distress, side effects of drugs/chemotherapies, and developing CNS disease.
Recommend scheduling activities for periods when patient has most energy. Plan care to allow for rest periods. Involve patient/SO in schedule planning.	Planning allows patient to be active during times when energy level is higher, which may restore a feeling of well-being and a sense of control. Frequent rest periods are needed to restore/conserve energy.
Establish realistic activity goals with patient.	Provides for a sense of control and feelings of accomplishment. Prevents discouragement from fatigue of overactivity.
Encourage patient to do whatever possible, e.g., self-care, sit in chair, short walks. Increase activity level as indicated.	May conserve strength, increase stamina, and enable patient to become more active without undue fatigue and discouragement.
Identify energy conservation techniques, e.g., sitting, breaking ADLs into manageable segments. Keep travelways clear of furniture. Provide/assist with ambulation/self-care needs as appropriate.	Weakness may make ADLs almost impossible for patient to complete. Protects patient from injury during activities.
Monitor physiological response to activity, e.g., changes in BP, respiratory rate, or heart rate.	Tolerance varies greatly, depending on the stage of the disease process, nutrition state, fluid balance, and number/type of opportunistic diseases that patient has been subject to.
Encourage nutritional intake.	Adequate intake/utilization of nutrients is necessary to meet increased energy needs for activity.Note: Continuous stimulation of the immune system by HIV infection contributes to a hypermetabolic state.
Refer to physical/occupational therapy.	Programmed daily exercises and activities help patient maintain/increase strength and muscle tone, enhance sense of well-being.
Refer to community resources	Provides assistance in areas of individual need as ability to care for self becomes more difficult.
Provide supplemental O2 as indicated.	Presence of anemia/hypoxemia reduces oxygen available for cellular uptake and contributes to fatigue.