Urinary Incontinence

Urinary Incontinence 5 Nursing Care Plans

Urinary Incontinence NCLEX Review Care Plans

5 Nursing Care Plans on Urinary Incontinence

Urinary incontinence is a common condition that involves the loss of bladder control. This leads to leaking of urine which can be frequent or occasional.

This leakage can be triggered by movement, or even when the person coughs or sneezes. More often than not, people with urinary incontinence would not have ample time to get to the toilet.

Nursing Stat Facts

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Nursing Stat Facts

This happens because control over the urinary sphincter has either weakened or is completely lost.

Signs and Symptoms of Urinary Incontinence

The symptoms of urinary incontinence may vary on a case-by-case basis. The main symptom, however, is the unintentional leakage of urine.

The general symptom of Urinary Incontinence include:

  • Urine will suddenly leak while one is either coughing, laughing, sneezing, or exercising
  • Sudden and uncontrollable urges to urinate
  • Sleep disturbance with the urge to urinate
  • High frequency in urination
  • Urinating while asleep

Factors Related to Urinary Incontinence

Urinary incontinence usually happens to aged people, but advanced age is not necessarily the main cause of the condition. According to data, 30% of females aged 30-60 are more likely to suffer it than men, with 1.5-5% on the whole.

The data represents a lot of circumstances exclusively for females, such as pregnancy and menopause. However, some other common causes could be for the more general population, such as urinary tract infections (UTI), medications, nerve damage, and even tumors in the urinary tract.

Knowing the triggers to urinary incontinence and how the condition itself manifests can help in creating a nursing care plan for a patient affected by it.

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Nursing Care Plans for Urinary Incontinence

Nursing Care Plan 1

Stroke

Nursing Diagnosis: Urinary Incontinence related to loss of bladder control secondary to stroke as evidenced by leakage of urine and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

InterventionRationale
Advise the patient to only consume fluids 2 to 3 hours before going to bed and mainly urinate before getting some sleep.Having a limited fluid intake before bedtime reduces the need to disturb a patient’s sleep to urinate. It also reduces the chances of accidentally urinating while one is in bed.
Set a toileting schedule with the patient in intervals that will be doable to allow predictable urination.If a patient has a toileting schedule designed with their usual urinating pattern as the baseline, he/she will have reduced chances of having uncontrollable urination.
If the patient has a pad or diaper, check for the need to change on a regular basis (for example, every 2 hours during the day and every 4 hours during night time).To ensure that the patient maintains good hygiene and to prevent skin breakdown.
If the set toileting schedule is not feasible for the patient, catheterizing the patient at regular intervals can also be an alternative method.Having the patient’s bladder on a scheduled basis through catheters can also be done to reduce the episodes of one’s incontinence. However, it is worth noting that there are some risks for infections with indwelling catheters.

Nursing Care Plan 2

Parkinson’s Disease

Nursing Diagnosis: Urinary Incontinence related to loss of bladder control secondary to Parkinsons’ disease as evidenced by leakage of urine, sudden urges to urinate, and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

InterventionRationale
Absorbent pads can be a good measure in helping the patient with Parkinson’s diseaseAbsorbent pads can be very helpful for a patient with Parkinson’s disease. They would need to learn about pad replacement at set intervals to prevent irritating the skin from exposure to moisture and urine.
Demonstrate to the patient or their caregiver on how to perform intermittent catheterization as indicated by the physician.Intermittent catheterization is a method that could help drain the bladder at specific periods.
Try to work with the patient and their families to create a feasible and manageable voiding or urinating program.This helps the patient manage their condition and helps the people surrounding them understand what they are suffering from. Coordinating with their families can promote and add substantial knowledge that could enable them to help the patient in their reasonable ways.
Create a toileting schedule for the patient.A toileting schedule can help reduce a patient’s sudden urge to urinate as it has already been allocated and designated a specific time to do so, thus lessening incontinence episodes.
Explain in thorough but understandable detail the necessity for void and toilet schedules and the need to follow them strictly and accordingly.Consistency and discipline are some of the prime requirements in achieving the ultimate goal of toilet schedules. To achieve these, the nurse must explain the rationale and reasoning behind a toileting schedule to understand why it has been followed.

Nursing Care Plan 3

Multiple Sclerosis

Nursing Diagnosis: Urinary Incontinence related to loss of bladder control secondary to multiple sclerosis as evidenced by leakage of urine and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

InterventionRationale
Create an environment that helps the patient deal with incontinence with methods such as but not limited to removing loose rugs on the floor and improving the lighting in their hallways and bathrooms.Loose rugs and poor lighting can be unhelpful and may pose an additional challenge for patients suffering from incontinence.
Place an appropriate and hygienic urinary receptacle for the patient if toilet and bathroom access is hindered by immobility and distance. Make sure to provide privacy when doing so.There must be an alternative measure to help the patient get to the toilet in no time, and some environmental factors may pose a challenge.
Help the patient through assistance in changing and choosing their clothing that could help them gain easier access for toilet use. Loose-fitting clothes with stretchable waistbands are highly preferred over buttoned and zippered clothes.Clothing, though minimal, can also be a huge barrier for people suffering from incontinence. If the clothing is not as indicated in the intervention notes on the opposite of this cell, the patient may have a hard time removing them as they use the toilet.
Educate the patient and the care provider about the wide benefits of using reusable and disposable pads, pad-pant systems, and replacement underwear that were specifically created for the usage of incontinence patients.Some of the absorbent products used by community-dwelling elderly people were not designed to absorb urine, prevent bad odor and protection from perineal skin infection. Products specifically designed for incontinence patients are more cost-effective in the long run.

Nursing Care Plan 4

Urinary Tract Infection

Nursing Diagnosis: Urinary Incontinence related to loss of bladder control secondary to urinary tract infection as evidenced by leakage of urine and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

InterventionRationale
Perform a dipstick analysis of the urine and observe for a foul odor and its appearance if it looks cloudy or bloody.By performing a dipstick analysis, signs of the urinary tract and kidney infection may be observed. Multistrip dipsticks can provide details of the patient’s pH, nitrite, and leukocyte esterase, indicating the said infections.
Educate the patient of the benefits of continued mobility and pelvic exercises.Through physical activity, the risk of developing infections in the urinary tract can be significantly decreased.
Promote good hygiene practices such as regularly cleaning the perineal area, keeping it free from moisture, good handwashing techniques, and overall proper perineal care.Educating a patient of these easy measures to help their urinary incontinence in terms of reducing adverse risks for skin irritation and breakdown.
If the patient is suffering from an existing perineal skin problem along with the UTI, help and teach the patient to manage them by recommending vitamin-enriched creams and a moisture barrier.By recommending medical and dermatological measures, the patient will have protection for their skin from the leaking urine.

Nursing Care Plan 5

Recurrent cystitis

Nursing Diagnosis: Urinary Incontinence related to loss of bladder control secondary to recurrent cystitis as evidenced by leakage of urine and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

InterventionRationale
Teach the patient on how to perform self-catheterization (if able) and instruct on the proper care of indwelling catheter.This measure can help promote the patient’s independence and autonomy and promote convenience and less hassle towards their nurses and caregivers. Some patients may require an indwelling catheter though it would entirely depend on their abilities and the severity of their incontinence.
If the patient is of an advanced age, anticipate that he/or she is at high risk for dehydration. Monitor the oral fluid intake to prevent such dehydration from happening.Urine loss, acute confusion, and the increase of the dangers of morbidity and mortality may be intensified when dehydration does occur and is especially dangerous to elderly patients who may have compromised immune system.
Instruct the patient on how to perform Kegel exercises.Kegel exercises can help improve and strengthen pelvic floor muscle tone and as well as ureterovesical junction sphincter tone.
If incontinence gets worse, refer the patient to a bladder specialist.A bladder specialist can create a more detailed and specific plan carefully curated to fit the patient’s needs will be met, along with educating them on the latest techniques and products that could help lessen the worst effects of their condition.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

Disclaimer:

Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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