Comfort - Chronic Fatigue
A pregnant client is prescribed iron supplements to treat iron-deficiency anemia. Which foods should the nurse instruct the client to ingest to help with this health problem? A.Broccoli and potatoes B.Yogurt and milk C.Beans and meat D.Apples and bananas
A.Broccoli and potatoes Rationale: The foods that are important for the pregnant client to add for iron-deficiency anemia include broccoli and potatoes. Broccoli and potatoes are high in vitamin C, which increases iron absorption. Any foods high in vitamin C should be encouraged to be added to the diet of a client taking iron supplements. Yogurt, milk, beans, meat, apples, and bananas are healthy foods that provide other necessary macro- and micronutrients necessary to maintain a healthy pregnancy.
The healthcare provider is not sure about the cause of fatigue in a client whose symptoms are inconsistent and prescribes tests to narrow down possible causes. For which health problem should the nurse expect tests to be prescribed for this client? (Select all that apply.) A.Hormone levels B.Hypertension C.Liver dysfunction D.Kidney functioning E.Anemia
A.Hormone levels C.Liver dysfunction D.Kidney functioning E.Anemia Rationale: Diagnostic tests are often ordered to find the underlying cause of fatigue. Typical causes of fatigue include anemia; changes in endocrine, kidney, or liver function; and infection. There is no test for hypertension.
The nurse prepares an educational program on the effect of exercise on fatigue for a group of staff nurses. Which medical diagnosis should the nurse identify as responding positively to exercise as an intervention to combat fatigue? (Select all that apply.) A.Multiple sclerosis B.Fibromyalgia C.Cancer D.Obstructive sleep apnea E.Chronic fatigue syndrome
A.Multiple sclerosis B.Fibromyalgia C.Cancer D.Obstructive sleep apnea Rationale: Clients with cancer, obstructive sleep apnea, multiple sclerosis, and fibromyalgia respond positively to exercise to combat fatigue. Clients with chronic fatigue syndrome should use caution before beginning exercise.
A client is being prescribed tests for chronic fatigue syndrome. Which is a basic characteristic required in the diagnosis of this health problem? A.Not caused by a primary health condition B.Lasting more than 1-year minimum C.No response to antidepressants D.Response to certain sedatives
A.Not caused by a primary health condition Rationale: Chronic fatigue syndrome lasts more than 6 months minimum, not 1 year. It is not caused by a primary health condition, and it is not relieved by stress reduction. Response to medications has nothing to do with the diagnosis.
The healthcare provider prescribes erythropoietin for a client experiencing chronic fatigue. What should the nurse realize as the purpose for this medication? A.Stimulate red blood cell production B.Stimulate the release of stored ferritin C.Stimulate white blood cell production D.Increase the affinity of iron to hemoglobin
A.Stimulate red blood cell production Rationale: For a client with chronic fatigue, erythropoietin is used to stimulate red blood cell production. Clients with fatigue related to iron-deficiency anemia will receive iron supplements and/or erythropoietin to stimulate the production of hemoglobin and red blood cells. Erythropoietin does not stimulate white blood cells or the release of stored ferritin, nor does it increase the affinity of iron to hemoglobin.
The nurse prepares to complete a physical assessment of a client with fatigue. On which area will the nurse focus during this assessment? (Select all that apply.) A.Health education B.Hydration C.Body mass index D.Mobility E.Muscle strength
B.Hydration D.Mobility E.Muscle strength Rationale: The physical assessment of a client with fatigue includes assessment of mobility, hydration, and muscle strength. It does not measure health education or body mass index.
The nurse plans care for an adolescent female client experiencing fatigue caused by anemia. Which independent intervention should the nurse select for this client? (Select all that apply.) A.Suggest the use of a pedometer. B.Identify foods rich in nutrients, including iron. C.Administer medications for iron-deficiency anemia. D.Point out methods of good sleep hygiene habits. E.Encourage the client to take a yoga class.
A.Suggest the use of a pedometer. B.Identify foods rich in nutrients, including iron. D.Point out methods of good sleep hygiene habits. E.Encourage the client to take a yoga class. Rationale: Independent interventions include identifying foods rich in nutrients, encouraging the client to take a yoga class, suggesting the use of a pedometer, and pointing out methods of good sleep hygiene habits. Administering medications for iron-deficiency anemia is a collaborative intervention.
An older client reports feeling tired most of the time. Which response indicates that the nurse understands the relationship of fatigue in an older client? A."I would like to review your diet and exercise routine." B."An infection may be the cause of your fatigue." C."It is normal to experience fatigue when you are older." D."I would like to review your TSH levels."
A."I would like to review your diet and exercise routine." Rationale: Poor nutritional intake and lack of exercise can contribute to fatigue in the older adult. There is no assessment data available that supports an abnormal TSH level or infection. While it is normal for an older adult to experience fatigue, it is important to assess the client for the underlying cause of fatigue before assuming it is due to age.
The nurse reviews collected data and suspects that a client is experiencing chronic fatigue. Which finding supports this health problem? (Select all that apply.) A.Quick resolution B.No response to night of sleep C.Mental or physical exhaustion D.Temporary condition E.No response to sedatives
B.No response to night of sleep C.Mental or physical exhaustion Rationale: Chronic fatigue produces mental or physical exhaustion, with no response to a night of sleep. It does not involve sedatives or other medications. It is not a temporary condition, nor does it resolve quickly.
An older adult client with difficulty ambulating and nocturia reports an onset of fatigue since taking a new medication for high blood pressure. Which is a likely contributor to this client's fatigue? A.Hypotension effect B.Hypertension medication C.Lack of mobility D.Ongoing nocturia
B. Hypertension Medication Rationale: A likely contributor to the fatigue would be the new hypertension medication. The report of fatigue did not indicate hypotension. Ongoing nocturia and lack of mobility have been a stable situation, rather than a recent change.
The nurse completes the assessment of a client with chronic fatigue syndrome. Which nursing diagnosis should the nurse identify as being appropriate for this client? (Select all that apply.) A.Fluid Volume: Excess B.Activity Intolerance C.Sleep Deprivation D.Injury, Risk for E.Coping: Readiness for Enhanced
B.Activity Intolerance C.Sleep Deprivation E.Coping: Readiness for Enhanced Rationale: Nursing diagnoses appropriate for a client with chronic fatigue syndrome include Coping: Readiness for Enhanced; Activity Intolerance; and Sleep Deprivation. The other diagnoses are not associated with chronic fatigue syndrome. (NANDA-1 ©2014)
The nurse has recommended exercise to a client with a complaint of fatigue. The client states, "Exercising does not make sense when I am feeling so tired. All I want to do is just relax on the couch." Which response by the nurse provides the most accurate information? A."A high-intensity program will help combat your fatigue." B."A mild to moderate exercise program has proven to be effective in reducing fatigue." C."A moderate exercise program is a form of cognitive behavioral therapy." D."Exercising will help you sleep throughout the night so you are refreshed in the morning."
B."A mild to moderate exercise program has proven to be effective in reducing fatigue." Rationale: The response by the nurse that provides the most accurate information is "A mild to moderate exercise program has proven to be effective in reducing fatigue." A sedentary lifestyle can lead to fatigue and other health complications. Clients who report persistent fatigue should be encouraged to begin a healthcare provider-approved mild to moderate exercise regimen. Higher intensity exercise does not appear to produce a greater reduction in fatigue, so clients should be instructed to avoid intense workouts that may increase feelings of fatigue. An exercise program is not a form of cognitive behavioral therapy and exercise may not necessarily help the client sleep throughout the night.
A client having a routine physical states, "I don't understand why I am so tired—I only work 8-hour days sitting at my desk and rest when I get home. What can I do to increase my energy level?" Which intervention should the nurse select to address the client's feeling of fatigue? A.Refer the client to an alternative healthcare provider. B.Request a sleep study from the healthcare provider. C.Collaborate with the healthcare provider to implement a graded exercise program. D.Request a referral to a neurologist.
C.Collaborate with the healthcare provider to implement a graded exercise program. Rationale: The client with a sedentary position and lifestyle may benefit from a graded exercise program. This type of exercise program gradually builds up stamina for exercise, which will contribute to the feeling of increased energy. It is not necessary to request a referral to a neurologist. A sleep study is prescribed for clients to rule out a sleep disorder and is not necessary at this point in time. A nurse does not make referrals to alternative healthcare providers.
The nurse completes the health history with a client who is pregnant and works as a computer mainframe programmer. For which nonmodifiable risk factor is this client prone to experiencing fatigue? A.Medications B.Stressful job C.Female gender D.Physical inactivity
C.Female gender Rationale: Being a woman is a nonmodifiable risk factor for fatigue. A stressful job, medications, and physical inactivity are modifiable risk factors for fatigue.
The home care nurse is planning nursing interventions for a client with chronic fatigue syndrome who is unable to get out of bed most of the time. Which intervention should be delayed until the client's condition improves? A.Encourage the client to participate in decision making. B.Teach effective coping techniques. C.Help the client to surpass the previous day's exercise. D.Include the family in the decision-making process.
C.Help the client to surpass the previous day's exercise. Rationale: Considering that the client is unable to get out of bed most of the time, helping the client to surpass the previous day's exercise is unrealistic. The other interventions are appropriate for this client's current health status.
The nurse is caring for a client who reports chronic fatigue. Which test aids in determining whether the client's fatigue is caused by an underlying biological factor? A.White blood cell (WBC) count B.Chemistry panel C.Hematocrit and hemoglobin tests D.Magnetic resonance imaging (MRI)
C.Hematocrit and hemoglobin tests Rationale: Hematocrit and hemoglobin lab tests will determine whether the client has iron-deficiency anemia, leading to fatigue. While the client may have the additional tests performed, the other tests do not help to determine the cause of the client's fatigue.
The nurse encourages the parents of a child with fatigue to keep a journal about the child's behavior. Which items should the parents include in that diary? (Select all that apply.) A.Temper tantrums B.Favorite toys C.Morning wake time D.Breakfast and other meals E.Evening sleep time
C.Morning wake time D.Breakfast and other meals E.Evening sleep time Rationale: The child's diary should include the time the child falls asleep and wakes up, as well as breakfast and other meals. Temper tantrums and favorite toys are not relevant to record.
The nurse is caring for a client experiencing chronic fatigue. The client states, "I don't know why I cannot get this under control, I feel useless." Which can the nurse implement in the plan of care to increase the client's self-worth? A.Assess the client's social support network. B.Establish a rapport with the client's family and encourage them to participate in the plan of care. C.Facilitate the process of setting long-term goals with the client. D.Encourage the client to become involved in the decision making.
D.Encourage the client to become involved in the decision making. Rationale: For clients with chronic conditions, inadequate coping mechanisms may contribute to prolonged feelings of fatigue. Therefore, the nurse should encourage the client to be involved in the decision-making process to increase their feelings of self-worth. Assessing the client's social support network and establishing a rapport with the client's family and encouraging them to participate in the plan of care are important to address ineffective coping. Short- and long-term goals are important to establish. The short-term goals will provide the client a sense of accomplishment.
A female client seeks medical attention for fatigue, weight gain, muscle weakness, and joint stiffness. Which etiology is most likely associated with the client's clinical manifestations? A.Iron-deficiency anemia B.Chronic fatigue C.Chronic fatigue syndrome D.Hypothyroidism
D.Hypothyroidism Rationale: The etiology most likely associated with this client's symptoms is hypothyroidism. Hypothyroidism can be confirmed with a laboratory test and treated with a thyroid hormone supplement. Chronic fatigue is mental or physical exhaustion associated with a chronic condition or situation that is not resolved quickly, such as a chronic illness or poor lifestyle. Iron-deficiency anemia is not associated with weight gain or muscle weakness. Other mental health and physiological disease processes must be ruled out prior to diagnosing a client with chronic fatigue syndrome.
A client at 10 weeks' gestation is experiencing fatigue. What information should the nurse provide to this client about this health problem? A."You are not sleeping well during this stage of the pregnancy, which can contribute to the fatigue." B."The fatigue you are feeling will continue throughout the pregnancy." C."The fatigue you are experiencing is due to the rapid growth of the fetus." D."The fatigue should lesson in your second trimester."
D."The fatigue should lesson in your second trimester." Rationale: The fatigue in the first trimester is due to the fact that the body uses large amounts of energy to build the placenta. Hormonal changes can also contribute to fatigue. The fatigue should lesson in the second trimester, and if it persists, it may be a sign of iron deficiency anemia. The fetus experiences rapid growth in the third trimester, contributing to physical stress and disrupted sleep, which results in fatigue. Sleep disruption in the first trimester is not the primary cause of fatigue.
