activity and fatigue pt 1

What are some benefits of exercise?

Improves heart health, insulin sensitivity, lung and brain function, releases endorphins, boosts self-esteem, and lowers mortality rates.

What is activity tolerance?

The amount of physical activity one can perform without experiencing pain or injury.

What is fatigue?

A subjective feeling of lack of energy, often described as needing to recharge like a battery.

List the types of fatigue.

Physiologic, psychological, pathologic, pharmacological, and unknown.

What are some physiologic causes of fatigue?

Heat waves or working long shifts.

What is chronic fatigue syndrome (CFS)?

A vague, nonspecific syndrome characterized by persistent, unexplained fatigue.

What are the symptoms of Myalgic Encephalomyelitis (ME)?

Aches and pains in muscles, joint pain without swelling, new or severe headaches, sore throat, night sweats, and lymph node tenderness.

What differentiates acute fatigue from chronic fatigue?

Acute fatigue has a rapid onset (

What are some chronic diseases associated with chronic fatigue?

Fibromyalgia, depression, and Irritable Bowel Syndrome (IBS).

What are the required symptoms for a CFS/ME diagnosis?

Alterations in sleep, decreased ability to engage in prior activities, and increased symptoms following physical or mental activity.

What is the treatment approach for CFS/ME?

Education, emotional support, symptom management, and structured activity programs.

What can psychological monotony lead to in terms of fatigue?

It can contribute to fatigue due to lack of variety in activities.

What is a contracture?

A permanent shortening of tissue that can occur quickly with immobility.

What is postural hypotension?

A significant drop in blood pressure when a person stands up from a sitting or lying position.

What nursing intervention can help prevent postural hypotension?

Have the patient sit and dangle their legs before standing.

What effect does immobility have on bone health?

It leads to the breakdown of both compact and cancellous bone, and an increase in yellow marrow.

What is Virchow's Triad?

A triad of factors that increases the risk of Deep Vein Thrombosis (DVT): venous stasis, hypercoagulability, and blood vessel damage.

How does immobility affect the respiratory system?

It decreases tidal volume and forced vital capacity, increases mucus pooling, and impairs respiratory function.

What is a recommended nursing intervention for improving respiratory health in immobile patients?

Encourage coughing and deep breathing exercises every hour.

What hormonal changes occur due to immobility in terms of reproductive health?

A decrease in circulating sex hormones can negatively affect bone health and fertility.

venous stasis

reduced skeletal muscle pump

Hypercoagulability

poor blood flow and pooling leads to clots

decreased tidal volume

- Due to structural changes to ribcage and costovertebral joints in supine position, more pressure put on lungs - 78% of tidal exchange is due to motion of the ribcage, weight of body on ribcage reduces tidal volume

mucus pooling

- due to gravity - reduction in mucus + reduction in airway size leads to labored breathing - great risk for respiratory tract infection (RTI)

blood shifts from legs to chest

- inc in intracardiac pressure - ANP is then released which inc urine output and dec blood volume, causes ADH to make the body hold onto water. - ADH and ANP usually work well together but during bedrest, it is disrup

Water loss and cardiac deconditioning

- no encouragement of lymph to blood to circulate - blood shifts from legs to chest - inc in sodium excretion by kidneys

Cardiovascular potential consequences

- postural hypotension - cardiac muscle atrophy - water loss + cardiac reconditioning - diastolic vol dec then SV dec - CRP + cystatin C inc - hematocrit inc and eryhtrocyte count dec

stroke volume decrease caused by

ANP diuresis in kidneys dec plasma volume and therefore blood volume

cardiovascular postural hypotension

where blood pressure drops significantly when a person stands up from a sitting or lying position

Musculoskeletal blunted baroreceptors

baroreceptors see low blood volume —> tell arteries to dilate —> stand up; sudden rush of blood/increased vol —> no slowing of sudden flow of blood bc still dilated (rain stick analogy

Musculoskeletal bone

- osteoclasts breakdown bone - compact and cancellous bone types are both lost during immobility - yellow marrow (fattier) inc w immobility - red marrow

Musculoskeletal contracture

- these can happen very quickly (<8 hrs) w immobility - foot drop caused by contracture or deformity

Musculoskeletal potential consequences pt 2

- tendons, ligaments, cartilage require movement to stay healthy - contracture is a permanent shortening of tissue - bone - blunted baroreceptors

Musculoskeletal potential consequences pt 1

- lower limbs tend to atrophy - fast twitch muscles (arm + legs) are lost quicker but slow twitch also lost - dec glycogen storage which is what feeds muscles

Musculoskeletal nursing interventions

- encourage active ROM in lower limbs - repositioning every 2 hrs - pt can engage in assisted resistance training esp in lower legs prevents clots

CFS structured activity program

- inc depression w less structure - ex covid

CFS overall management

- eating well - getting right nutrients

CFS treatment of symptoms eliminate factors like

- late caffeine consumption - doom scrolling

CFS emotional support

support group/ involve community

CFS education

awareness of condition can be validating

psychological ex

monotony (lack of variety)

pathologic ex

cancer

pharmacological ex

chemotherapy

unknown ex

- CFS - very vague - non specific syndrome