Cues and Evidence Subj: Mabilis akong mapagod as verbalized by the patient.

Obj: Pale and weak in appearance Easily get tired Lack of energy

Nursing Diagnosis Activity in tolerance related to imbalance between oxygen supply and demand secondary to disease process (Leukemia) Insufficient physiological or psychological energy to endure or complete required or desired daily.

Objectives
At the end of 6 hours duty client will:

Nursing Interventions
Assess the presence of factors contributing to fatigue.

Rationale
it affects the patient ability to participate in activities

Evaluation
Partially Met: the client will be able to tolerate daily activities, such as games, running, jumping patient will verbalized the decrease signs of intolerance will perform activity of daily living normally

demonstrate decrease in physiological signs of tolerance Report a measurable increase in activity intolerance Participate Activity of Daily Living to level ability

Evaluate reports Effects of of fatigue, noting leukemia, anemia, inability to and chemotherapy participate in may be activities or ADLs. cumulative, especially during acute and active treatment phase, necessitating assistance. Helps client prioritize activities and arrange them around fatigue pattern.

Encourage client to keep a diary of daily routines and energy levels, noting activities that increase fatigue.

Implement energy- Maximizes saving techniques, available energy such as sitting, for self-care tasks. rather than standing

 Recommend Smaller meals small, nutritious, require less energy high-protein meals for digestion than and snacks larger meals. throughout the Increased intake day. provides fuel for energy. Provide quiet environment and uninterrupted rest periods. Encourage rest periods before meals. Provide quiet environment and uninterrupted rest periods. Encourage rest periods before meals.

Encourage patient to enhance sense to maintain of well being positive attitude, suggest used of relaxation techniques