Is my diagnosis correct?

[Idaho Murse]

Activity Intolerance related to adult respiratory distress syndrome and morbid obesity as evidenced by insufficient energy and lack of oxygen

I would like to get some feedback on this. patient is a morbid obese person with a history of acute respiratory failure, and can not walk more than 10 feet without needed to rest.

[Daytonite, BSN, RN]

activity intolerance related to adult respiratory distress syndrome and morbid obesity as evidenced by insufficient energy and lack of oxygen

activity intolerance is defined as

insufficient physiological or psychological energy to endure or complete required or desired daily activities

(page 134,

nanda international nursing diagnoses: definitions and classifications 2009-2011

). the related factors on nursing diagnostic statements

cannot

be medical diagnoses. that is a nanda rule. so, unless your nursing instructors say differently you need to reword the related factor to comply with the spirit of this diagnosis. the taxonomy actually lists five suggestions for etiologies (causes) of this problem:

• bed rest
  
  
• generalized weakness
  
  
• imbalance between oxygen supple/demand
  
  
• immobility
  
  
• sedentary lifestyle
  
  

my guess is that it is because of the imbalance between oxygen supply and demand as a result of the adult respiratory distress syndrome. i wouldn't discount the obesity contributing as well.

your evidence (the aeb items) has to be the signs and symptoms of the

activity intolerance

.

insufficient energy and lack of oxygen

merely redefine the diagnosis and don't really tell us about the patient. when someone reads your nursing diagnostic statement they should get a clear picture in their mind of what is going on with the patient. however, your description in your second paragraph did a pretty good job of it:

cannot walk more than 10 feet without needed to rest

. defining characteristics (signs and symptoms) that are listed in the taxonomy for this diagnosis are:

• abnormal blood pressure response to activity
  
  
• abnormal heart rate response to activity
  
  
• ekg changes reflecting arrhythmias
  
  
• ekg changes reflecting ischemia
  
  
• exertional discomfort
  
  
• exertional dyspnea
  
  
• verbal report of fatigue
  
  
• verbal report of weakness
  
  

your patient not being able to walk more than 10 feet without needing to rest is one of the defining characteristics of this diagnosis that you customized to the patient for the plan of care.

your diagnostic statement should read

activity intolerance r/t imbalance between oxygen supply and demand secondary to adult respiratory distress syndrome and obesity aeb inability to walk more than 10 feet without needing to rest.

[Idaho Murse]

Actually thank you very much. That cleared up quite about that I was confused about. I appreciate all the effort you went through to respond to my post.