00093 Fatigue

Domain 4: activity/rest
Class 3: energy balance
Diagnostic Code: 00093
Nanda label: fatigue
Diagnostic focus: fatigue
Approved 1988 • Revised 1998, 2017, 2020 • Level of evidence 3.2

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « fatigue ” is defined as: overwhelming and sustained sensation of exhaustion and decreased capacity for habitual physical and mental work.

Definite characteristics

  • Apathy
  • Decreased aerobic capacity
  • Decrease in the speed of the march
  • Difficulty in maintaining the usual physical activity
  • Difficulty to maintain the usual routines
  • disinterest in the environment
  • Sopor
  • Express libid alteration
  • Express demoralization
  • Express frustration
  • Expresses lack of energy
  • Express not to feel relief through the usual energy recovery strategies
  • Express tiredness
  • Express weakness
  • Inadequate development of the role
  • Increase in physical symptoms
  • Increase in rest requirements
  • Insufficient physical resistance
  • Introspection
  • lethargy
  • Tiredness

Related factors

  • Alteration of the sleep-vigilia cycle
  • Anxiety
  • Depressive symptoms
  • Limitations of the environment
  • Increased mental effort
  • Increase in physical exercise
  • Malnutrition
  • Non -stimulating lifestyle
  • Pain
  • Loss of physical condition
  • Stressors

Risk population

  • People exposed to negative vital episodes
  • People with very demanding occupations
  • Pregnant women
  • Women who experience childbirth

Associated problems

  • Anemia
  • Chemotherapy
  • Chronic disease
  • Chronic inflammation
  • Dementia
  • Fibromyalgia
  • Deregulation of the hypothalamus-political-adrenal axis
  • Miastenia serious
  • Neoplasms
  • Radiation therapy
  • stroke

Suggestions of use

This label should not be used to describe the temporary fatigue resulting from lack of sleep. Fatigue describes a chronic state that is not relieved by rest. Previous energy levels and patient abilities cannot be recovered immediately, so nursing activities should focus on helping the patient find forms of adaptation. It is important to carefully distinguish between fatigue and intolerance to activity. The lack of energy in fatigue is overwhelming and may even occur when the patient has not performed any activity. Fatigue can be the etiology of other nursing diagnoses, as a deficit of self -care and deterioration of home maintenance. On the other hand, other labels, such as a decrease in cardiac output, could be the etiology of fatigue.

Suggested alternative diagnostics

  • Activity, intolerance to
  • Self -care, deficit of
  • cardiac spending, decrease in
  • Insomnia

NOC Results

  • Energy conservation: personal actions to handle energy in order to start and maintain the activity
  • Psychomotor energy: Personal impulse and energy to carry out the activities of everyday life, nutrition and personal security
  • Nutritional status: Energy: Degree in which nutrients and oxygen provide cell energy
  • Fatigue level: gravity of prolonged and generalized fatigue, as observed or reported
  • Resistance: Ability to maintain activity

Evaluation objectives and criteria

  • The patient adapts to fatigue, as manifested by resistance, energy conservation, nutritional status: energy, and psychomotor energy.
  • The patient demonstrates energy conservation, as the following indicators show (specify from 1 to 5: never, rarely, once, often or usually):
    • Adapt the lifestyle to the energy level
    • Balance activity and rest
    • Maintain adequate nutrition
    • Report adequate resistance to the activity
    • Use the techniques to conserve energy
  • Other examples

    The patient will be able to:

    • Maintain the usual social interaction
    • Identify the psychological and physical factors that can cause fatigue
    • Maintain the capacity to concentrate
    • Pay attention and respond properly to visual, auditory, verbal, tactile and olfactory stimuli
    • Inform that you recover your energy after rest

    NIC Interventions

    • Energy management: Regulation of energy use to treat or prevent fatigue and optimize operation
    • Management of the environment: manipulation of the patient’s environment to obtain therapeutic benefit, sensory attraction and psychological well -being
    • mood management: Provide security, stabilization, recovery and maintenance to a patient who experiences a depressed or abnormally elevated mood
    • Nutrition management: help with, or provide, a balanced food and liquid diet

    Nursing Activities


    • Determine the effects of fatigue on the quality of life
    • (NIC) Energy management:
    • Monitor if the patient shows excessive physical and emotional fatigue samples
    • Monitor the cardiorespiratory response to activity (for example, tachycardia, other arrhythmias, dyspnea, diaphoresis, paleness, hemodynamic pressures and respiratory rate)
    • Control and record the patient’s sleep pattern and how many hours sleep
    • Control the location and nature of discomfort or pain during movement and activity
    • Determine how the patient and his relative perceive the causes of fatigue
    • Control the diet to guarantee adequate energy resources
    • Control the administration and effect of stimulants and depressants

    Patient and family education

    • Instruct the patient about the relationship of fatigue with the process and condition of the disease
    • (NIC) Energy management:
      • Instruct the patient and his relative to recognize the signs and symptoms of fatigue that require a reduction in activity
      • Teach techniques to organize activities and manage time in order to prevent fatigue

    Collaboration activities

    • Recognize the health personnel of the effects of fatigue
    • Channel to family therapy if fatigue has interfered with the functioning of the family
    • Channel to psychiatric assistance if fatigue significantly interferes with patient relationships
    • (NIC) Energy management: consult with dietitian about ways to increase the intake of energy rich in energy


    • Encourage the patient and the family to express feelings related to life changes caused by fatigue
    • Help the patient identify measures that increase concentration; Consider the possibility of initiating tasks after some rest periods and giving priority to those necessary
    • Promote limited social interaction in times of greater energy
    • Encourage the patient to:
      • Inform what activities increase fatigue
      • Inform about the appearance of pain that can produce fatigue (gravity, location, precipitating factors)
    • With the patient and the family, plan activities that reduce fatigue.
      • The plan can include:
      • Help with the activities of everyday life, as necessary; Specify
      • Reduce low priority activities
    • (NIC) Energy management:
      • Reduce the physical discomfort that could interfere with cognitive function and the highway or regulation of activity
      • Help the patient and his relative to establish realistic activity goals
      • Offer quiet recreational activities (such as reading or talking to other people) to favor relaxation
      • Promote bed in bed and limit activities (for example, increasing the number of rest periods), with the protected rest intervals that are chosen
      • Avoid care activities for established rest periods
      • Limit environmental stimuli (for example, light and noise) to facilitate relaxation
      • Limit visits and interruptions, as required

    At home

    • Comment with the patient and the family about ways of modifying the domestic environment to maintain the usual activities and reduce fatigue
    • Evaluate the domestic environment to determine which factors could increase fatigue (stairs, bath distance, cleaning activities)
    • If the etiology of fatigue is chronic pain, channeling a community program for pain management
    • Collaborate with the patient and his family to establish priorities in activities based on realistic expectations of the patient’s abilities
    • Encourage the family to keep the patient involved in family routines (for example, meals) as much as possible
    • Help the patient be assertive when setting limits to the demands of others
    • Channel home health care and household cleaning services

    Babies and Children

    • Evaluate fatigue in children through parents interviews and the registration of changes in sleep, activity, game and meals; Young children cannot verbally express fatigue

    Older people

    • Evaluate comorbidities, such as arthritis, which can contribute to fatigue
    • Evaluate depression as a cause of fatigue; channel the mental care professional if necessary
    • Monitor the side effects of medication that can cause fatigue (beta blockers, analgesics, etc.)