Defining Characteristics

• Alteration in affect
  
• Alteration in concentration
  
• Alteration in mood
  
• Alteration in sleep pattern
  
• Compromised health status
  
• Decrease in quality of life
  
• Difficulty initiating sleep
  
• Difficulty maintaining sleep
  
• Dissatisfaction with sleep
  
• Early awakening
  
• Increase in absenteeism
  
• Increase in accidents
  
• Insufficient energy
  
• Nonrestorative sleep pattern (i.e., due to caregiver responsibilities, parenting practices, sleep partner)
  
• Sleep disturbance producing next-day consequences

Related Factors

• Alcohol consumption
  
• Anxiety
  
• Average daily physical activity is less than recommended for gender and age
  
• Depression
  
• Environmental barrier (e.g., ambient noise, daylight/darkness exposure, ambient temperature/humidity, unfamiliar setting)
  
• Fear
  
• Frequent naps
  
• Grieving
  
• Hormonal change
  
• Inadequate sleep hygiene
  
• Pharmaceutical agent
  
• Physical discomfort
  
• Stressors

Original literature support available at www.nanda.org

Domain 4. Activity/Rest      Class 1. Sleep/Rest

00096

Defining Characteristics

• Agitation
  
• Alteration in concentration
  
• Anxiety
  
• Apathy
  
• Combativeness
  
• Confusion
  
• Decrease in functional ability
  
• Decrease in reaction time
  
• Drowsiness
  
• Fatigue
  
• Fleeting nystagmus
  
• Hallucinations
  
• Hand tremors
  
• Heightened sensitivity to pain
  
• Irritability
  
• Lethargy
  
• Listlessness
  
• Malaise
  
• Perceptual disorders
  
• Restlessness
  
• Transient paranoia

Related Factors

• Age-related sleep stage shifts
  
• Average daily physical activity is less than recommended for gender and age
  
• Conditions with periodic limb movement (e.g., restless leg syndrome, nocturnal myoclonus)
  
• Dementia
  
• Environmental barrier
  
• Familial sleep paralysis
  
• Idiopathic central nervous system hypersomnolence
  
• Narcolepsy
  
• Nightmares
  
• Nonrestorative sleep 
pattern (i.e., due to caregiver responsibilities, parenting practices, sleep partner)
  
• Overstimulating environment
  
• Prolonged discomfort (e.g., physical, psychological)
  
• Sleep apnea
  
• Sleep terror
  
• Sleep walking
  
• Sleep-related enuresis
  
• Sleep-related painful 
erections
  
• Sundowner’s syndrome
  
• Sustained circadian asynchrony
  
• Sustained inadequate sleep hygiene
  
• Treatment regimen

Domain 4. Activity/Rest      Class 1. Sleep/Rest

000165

Defining Characteristics

• Expresses desire to enhance sleep

Domain 4. Activity/Rest      Class 1. Sleep/Rest

000198

Defining Characteristics

• Alteration in sleep pattern
  
• Difficulty in daily functioning
  
• Difficulty initiating sleep
  
• Dissatisfaction with sleep
  
• Feeling unrested
  
• Unintentional awakening

Related Factors

• Disruption caused by sleep partner
  
• Environmental barrier (e.g., ambient noise, daylight/darkness exposure, ambient temperature/humidity, unfamiliar setting)
  
• Immobilization
  
• Insufficient privacy
  
• Nonrestorative sleep pattern (i.e., due to caregiver responsibilities, parenting practices, sleep partner)

Domain 4. Activity/Rest      Class 2. Activity/Exercise

00040

Risk Factors

• Alteration in level of consciousness
  
• Mechanical immobility
  
• Pain
  
• Paralysis
  
• Prescribed immobility

Domain 4. Activity/Rest      Class 2. Activity/Exercise

00091

Defining Characteristics

• Impaired ability to move between long sitting and supine positions
  
• Impaired ability to move between prone and supine positions
  
• Impaired ability to move between sitting and supine positions
  
• Impaired ability to reposition self in bed
  
• Impaired ability to turn from side to side

Related Factors

• Alteration in cognitive functioning
  
• Environmental barrier (e.g., bed size, bed type, equipment, restraints)
  
• Insufficient knowledge of mobility strategies
  
• Insufficient muscle strength
  
• Musculoskeletal impairment
  
• Neuromuscular impairment
  
• Obesity
  
• Pain
  
• Pharmaceutical agent
  
• Physical deconditioning

Original literature support available at www.nanda.org

Domain 4. Activity/Rest      Class 2. Activity/Exercise

00085

Defining Characteristics

• Alteration in gait
  
• Decrease in fine motor skills
  
• Decrease in gross motor skills
  
• Decrease in range of motion
  
• Decrease in reaction time
  
• Difficulty turning
  
• Discomfort
  
• Engages in substitutions for movement (e.g., attention to other’s activity, controlling behavior, focus on pre-illness activity)
  
• Exertional dyspnea
  
• Movement-induced tremor
  
• Postural instability
  
• Slowed movement
  
• Spastic movement
  
• Uncoordinated movement

Related Factors

• Activity intolerance
  
• Alteration in bone structure integrity
  
• Alteration in cognitive functioning
  
• Alteration in metabolism
  
• Anxiety
  
• Body mass index >75th 
age-appropriate percentile
  
• Contractures
  
• Cultural belief regarding appropriate activity
  
• Decrease in endurance
  
• Decrease in muscle control
  
• Decrease in muscle mass
  
• Decrease in muscle strength
  
• Depression
  
• Developmental delay
  
• Disuse
  
• Insufficient environmental support (e.g., physical, social)
  
• Insufficient knowledge of value of physical activity
  
• Joint stiffness
  
• Malnutrition
  
• Musculoskeletal impairment
  
• Neuromuscular impairment
  
• Pain
  
• Pharmaceutical agent
  
• Physical deconditioning
  
• Prescribed movement restrictions
  
• Reluctance to initiate movement
  
• Sedentary lifestyle
  
• Sensoriperceptual 
impairment

Original literature support available at www.nanda.org

Domain 4. Activity/Rest      Class 2. Activity/Exercise

00089

Defining Characteristics

• Impaired ability to operate power wheelchair on a decline
  
• Impaired ability to operate power wheelchair on an incline
  
• Impaired ability to operate power wheelchair on curbs
  
• Impaired ability to operate power wheelchair on even surface
  
• Impaired ability to operate power wheelchair on uneven surface
  
• Impaired ability to operate wheelchair on a decline
  
• Impaired ability to operate wheelchair on an incline
  
• Impaired ability to operate wheelchair on curbs
  
• Impaired ability to operate wheelchair on even surface
  
• Impaired ability to operate wheelchair on uneven surface

Related Factors

• Alteration in cognitive functioning
  
• Alteration in mood
  
• Decrease in endurance
  
• Environmental barrier (e.g., stairs, inclines, uneven surfaces, obstacles, distance)
  
• Impaired vision
  
• Insufficient knowledge of wheelchair use
  
• Insufficient muscle strength
  
• Musculoskeletal impairment
  
• Neuromuscular impairment
  
• Obesity
  
• Pain
  
• Physical deconditioning

Original literature support available at www.nanda.org

Domain 4. Activity/Rest      Class 2. Activity/Exercise

000237

Defining Characteristics

• Impaired ability to adjust position of one or both lower limbs on uneven surface
  
• Impaired ability to attain a balanced position of the torso
  
• Impaired ability to flex or move both hips
  
• Impaired ability to flex or move both knees
  
• Impaired ability to maintain the torso in balanced position
  
• Impaired ability to stress torso with body weight
  
• Insufficient muscle strength

Related Factors

• Alteration in cognitive functioning
  
• Impaired metabolic functioning
  
• Insufficient endurance
  
• Insufficient energy
  
• Malnutrition
  
• Neurological disorder
  
• Orthopedic surgery
  
• Pain
  
• Prescribed posture
  
• Psychological disorder
  
• Sarcopenia
  
• Self-imposed relief posture

Original literature support available at www.nanda.org

Domain 4. Activity/Rest      Class 2. Activity/Exercise

000238

Defining Characteristics

• Impaired ability to adjust position of one or both lower limbs on uneven surface
  
• Impaired ability to attain a balanced position of the torso
  
• Impaired ability to extend one or both hips
  
• Impaired ability to extend one or both knees
  
• Impaired ability to flex one or both hips
  
• Impaired ability to flex one or both knees
  
• Impaired ability to maintain the torso in balanced position
  
• Impaired ability to stress torso with body weight
  
• Insufficient muscle strength

Related Factors

• Circulatory perfusion disorder
  
• Emotional disturbance
  
• Impaired metabolic functioning
  
• Injury to lower extremity
  
• Insufficient endurance
  
• Insufficient energy
  
• Malnutrition
  
• Neurological disorder
  
• Obesity
  
• Pain
  
• Prescribed posture
  
• Sarcopenia
  
• Self-imposed relief posture
  
• Surgical procedure

Original literature support available at www.nanda.org

Domain 4. Activity/Rest      Class 2. Activity/Exercise

00090