M2 · Tires quickly during activity
Actual Movement and self-care
Definition
Ordinary activity causes breathlessness, fast heart rate, or exhaustion.- Heart or lung disease
- anemia
- deconditioning
- poor sleep
- Breathless on small effort
- fast pulse
- tired after walking
- needs rests
📋 Scenario
A patient with heart failure must rest after walking five steps.
Subjective (S): "I get tired after just a few steps."
Objective (O): Short of breath after 5 steps; heart rate rises from 78 to 112; heart failure; needs rest every 10 meters.
Assessment tools for this scenario: CP-MOVE Movement & Self-Care Score
Validated scales to consider: Barthel Index, Katz ADL
**CarePath diagnosis:** Tires quickly during activity related to heart or lung disease, as evidenced by breathless on small effort and fast pulse.
**Interventions and rationale**
| Intervention | Rationale |
|---|---|
| Pace activity. | Spreading activity over time with rests keeps demand on the weak heart lower, so breathlessness, fast pulse and fatigue are less likely to occur. |
| Allow rest. | Rest lets the heart rate and breathing settle and restores energy before the next effort. |
| Check pulse and breathing. | Pulse and breathing show how hard the heart is working and help the nurse decide when to stop or slow down. |
| Increase gradually. | Gradual increases in activity build tolerance step by step, without suddenly overloading a heart that is already weak from heart failure. |
| Teach energy saving. | Energy-saving methods, such as sitting for tasks, let him do what he needs with less effort. |
| Report chest pain. | Chest pain can signal the heart is not getting enough oxygen and needs prompt medical review. |
**Expected outcomes**
- By day 3: walks 20 meters with one rest, heart rate returns to baseline within 3 minutes, no chest pain.
**Linking the data to the diagnosis**
A patient with heart failure says, "I get tired after just a few steps." He becomes short of breath after 5 steps, his heart rate rises from 78 to 112, and he needs rest every 10 meters. These findings show the problem is already present, so an actual statement fits and a risk statement does not. The plan aims to raise his activity tolerance safely. By day 3 the expected outcomes are walking 20 meters with one rest, a heart rate that returns to baseline within 3 minutes and no chest pain.
CarePath diagnosis
Tires quickly during activity related to heart or lung disease, as evidenced by breathless on small effort and fast pulse.
Interventions and rationale
Listed in priority order.
| Intervention | Rationale |
|---|---|
| 1. Pace activity. | Spreading activity over time with rests keeps demand on the weak heart lower, so breathlessness, fast pulse and fatigue are less likely to occur. |
| 2. Allow rest. | Rest lets the heart rate and breathing settle and restores energy before the next effort. |
| 3. Check pulse and breathing. | Pulse and breathing show how hard the heart is working and help the nurse decide when to stop or slow down. |
| 4. Increase gradually. | Gradual increases in activity build tolerance step by step, without suddenly overloading a heart that is already weak from heart failure. |
| 5. Teach energy saving. | Energy-saving methods, such as sitting for tasks, let him do what he needs with less effort. |
| 6. Report chest pain. | Chest pain can signal the heart is not getting enough oxygen and needs prompt medical review. |
Expected outcomes
- By day 3: walks 20 meters with one rest, heart rate returns to baseline within 3 minutes, no chest pain.
Linking the data to the diagnosis
A patient with heart failure says, "I get tired after just a few steps." He becomes short of breath after 5 steps, his heart rate rises from 78 to 112, and he needs rest every 10 meters. These findings show the problem is already present, so an actual statement fits and a risk statement does not. The plan aims to raise his activity tolerance safely. By day 3 the expected outcomes are walking 20 meters with one rest, a heart rate that returns to baseline within 3 minutes and no chest pain.