Fatigue

 

Instructions: Fill out this form, print it, and hand it in with your assessment to your instructor. When you click on Next at the bottom of the page, you see the data you submitted. Please follow the instructions on how to save the data on the next page.

AOL users: Read this instruction.

Definition: an overwhelming sustained sense of exhaustion and decreased capacity for physical and mental work at usual level

1. Your initials (required): 

2. Defining Characteristics- check those that apply to your client:

None- high risk diagnosis  states fatigue, tired  states needs incresed energy to do tasks decreased concentration  drowsy  inability to maintain routines  lethargic, listless  increased sleep, rest requirements

3. Related Factors- check those that apply to your client:

anxiety  depression  stress  malnutrition  infection, fever  impaired oxygen transport  endocrine/metabolic disorder  neuromuscular disorder  electrolyte imbalance treatment, medications  pregnancy  obesity  sleep disorder
 


4. Goal (ultimate, long term) 

5. Outcome Criteria (short term) 

6. Evaluation: Was the outcome criteria met? 

Yes- Give Evidence: 

No- Explain how you would change the plan: 

7A. Interventions 

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7B. Rationale for each intervention

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