ERROL JAY D.

MERIOLES ASSESSMENT Subjective Pakiramdam ko pagod pa din ako kahit anong tulog ko as verbalized by the client wala na akong lakas gawin yung mga dati kong ginagawa as verbalized by the client Objective: -inability to maintain usual routines -compromised concentration -overwhelming lack of energy -listlessness -disinterest in surrounding 7/10 fatigue rating T: PR: BP: DIAGNOSIS Fatigue related to decrease metabolic energy production secondary to altered body chemistry: insufficient insulin as evidence by -inability to restore energy after sleep -inability to maintain usual routines -increase physical complaints -compromised concentration -overwhelming lack of energy -listlessness -disinterest in surrounding NSG. ANALYSIS Fatigue according to NANDA is an overwhelming sustained sense of exhaustion and decrease capacity for physical and mental work status. It is the feeling of extreme tiredness or weakness that can make it difficult for you to perform ordinary tasks. One of the more common symptoms of diabetes is a high level of glucose in the blood. This is brought on by the fact that when the body doesnt produce insulin, the cells are unable to absorb glucose. As a result, it remains in the bloodstream, which winds up pushing up the blood-glucose levels. Fatigue is also associated with diabetes; this symptom is PLANNING INTERVENTION 1. Assess causative or contributing factors RATIONALE EVALUATION

After 8 hours of nursing care, teachings and intervention the patient will be able to report improved sense of energy and display an improved ability to participate in desired activities.

1. Identifying the related factors with fatigue can aid in determining possible causes and establishing a collaborative plan of care

a. Assess vital signs

b. Determine presence of sleep disturbance

c. Ascertain clients belief about what is causing the fatigue 2. Obtain client description of fatigue 3. Ask the client to rate the fatigue (1-10 scale) and its affect on ability to participate in desired activities 4. Discuss with client the need for activity. Plan schedule with client and identify activities that lead to fatigue.

After 8 hours of nursing care, teachings and intervention the client was able to report improved a. To evaluate fluid sense of status and cardiopulmonary energy and response to activity displayed improved b. Fatigue can be a ability to consequence of participate in sleep deprivation desired c. To know the clients activities.
perception.

2. To assist in
evaluating impact on clients life

3. To assist in evaluating

4. Education may provide motivation to increase activity level even though client may feel too weak initially

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likewise a result of glucose not being absorbed from the bloodstream. Since glucose is the bodys major source of energy, a person will feel tired if his or her body doesnt have any fuel to burn. Source: Nurse pocket guide by doenges, moorhouse, murr http://health.howst uffworks.com/disea sesconditions/diabetes /lack-of-insulinaffect-yourbody.htm

5. Alternate activity with periods of rest 6. Provide uninterrupted sleep

5. Prevents excessive fatigue 6. Prevents excessive fatigue 7. To check physiologic levels of tolerance after an activity 8. Client will be able to accomplish more with a decrease expenditure of energy

7. Monitor Vital sign before and after activity 8. Discuss ways of conserving energy -sit instead of stand during daily care or other activities -carry several small loads instead of one big load -combine and simplify activity -take frequent short rest or breaks during activities -ask for or accept assistance - Plan steps of activity before beginning so that all needed materials are on hand

9. Increase client participation in ADLs as tolerated

9. To increase self esteem regarding on the things they can do. 10. To conserve energy for other task and to extend active time

10. Assist with ambulation and other self care needs and encourage use of assistive device as needed 11. Provide diversional activities.

11. Participating in pleasurable activities can refocus energy and diminish feeling of fatigue.