Urinary incontinence (UI) is the involuntary leakage of urine that can significantly impact a patient’s quality of life, affecting their physical, psychological, and social well-being. Urinary incontinence nursing diagnosis focuses on assessment, management, and prevention strategies to help patients regain bladder control and maintain dignity.
Causes (Related to)
Urinary incontinence can develop due to various factors affecting bladder function and control:
- Physiological factors:
- Weakened pelvic floor muscles
- Neurological disorders
- Urinary tract infections
- Enlarged prostate
- Pregnancy and childbirth
- Post-menopausal changes
- Medical conditions:
- Diabetes
- Multiple sclerosis
- Parkinson’s disease
- Stroke
- Spinal cord injuries
- Environmental factors:
- Limited mobility
- Medication side effects
- Cognitive impairment
- Barriers to bathroom access
Signs and Symptoms (As evidenced by)
Subjective: (Patient reports)
- Involuntary urine leakage
- Frequent urination
- Urgency to urinate
- Nocturia
- Social isolation
- Embarrassment
- Anxiety about accidents
Objective: (Nurse assesses)
- Wet undergarments
- Skin irritation in the perineal area
- Frequent toileting attempts
- Use of incontinence products
- Documented episodes of incontinence
- Changes in fluid intake patterns
- Signs of urinary tract infection
Expected Outcomes
- The patient will demonstrate improved bladder control
- The patient will identify and manage triggers for incontinence
- The patient will maintain skin integrity
- The patient will demonstrate proper pelvic floor exercises
- The patient will report increased confidence in social situations
- The patient will experience fewer incontinence episodes
- The patient will maintain adequate hydration despite the condition
Nursing Assessment
Evaluate Incontinence Pattern
- Document frequency and timing
- Identify triggers
- Assess the volume of leakage
- Note associated activities
Assess Physical Factors
- Pelvic floor strength
- Mobility status
- Cognitive function
- Manual dexterity
- Skin condition
Review Medical History
- Current medications
- Chronic conditions
- Surgical history
- Previous treatments
- Neurological status
Monitor Fluid Balance
- Intake patterns
- Output measurements
- Bladder diary review
- Hydration status
Evaluate Environmental Factors
- Bathroom accessibility
- Available assistance
- Home environment
- Social support system
Nursing Care Plans
Nursing Care Plan 1: Functional Incontinence
Nursing Diagnosis Statement:
Functional Incontinence related to impaired mobility and environmental barriers as evidenced by the inability to reach the toilet in time and frequent episodes of incontinence.
Related Factors:
- Limited mobility
- Environmental barriers
- Cognitive impairment
- Medication side effects
Nursing Interventions and Rationales:
- Implement a scheduled toileting program
Rationale: Establishes routine and prevents accidents - Modify the environment for easy bathroom access
Rationale: Reduces barriers to toileting - Provide assistive devices
Rationale: Improves independence in toileting
Desired Outcomes:
- The patient will demonstrate decreased episodes of incontinence
- The patient will utilize assistive devices effectively
- The patient will maintain skin integrity
Nursing Care Plan 2: Stress Incontinence
Nursing Diagnosis Statement:
Stress Incontinence related to weakened pelvic floor muscles as evidenced by urine leakage with coughing, sneezing, or physical activity.
Related Factors:
- Pregnancy/childbirth history
- Obesity
- Chronic cough
- Age-related changes
Nursing Interventions and Rationales:
- Teach Kegel exercises
Rationale: Strengthens pelvic floor muscles - Promote weight management
Rationale: Reduces pressure on the bladder - Demonstrate proper body mechanics
Rationale: Minimizes strain on the pelvic floor
Desired Outcomes:
- The patient will perform Kegel exercises correctly
- The patient will report decreased incontinence episodes
- The patient will maintain a healthy weight
Nursing Care Plan 3: Urge Incontinence
Nursing Diagnosis Statement:
Urge Incontinence related to detrusor muscle overactivity as evidenced by sudden, strong urge to urinate and inability to delay voiding.
Related Factors:
- Neurological disorders
- Bladder irritants
- UTIs
- Anxiety
Nursing Interventions and Rationales:
- Implement bladder training
Rationale: Improves bladder control - Identify and avoid triggers
Rationale: Reduces urge episodes - Teach relaxation techniques
Rationale: Helps manage urgency
Desired Outcomes:
- The patient will demonstrate improved bladder control
- The patient will identify and avoid triggers
- The patient will successfully use relaxation techniques
Nursing Care Plan 4: Impaired Skin Integrity
Nursing Diagnosis Statement:
Risk for Impaired Skin Integrity related to chronic exposure to moisture as evidenced by perineal skin irritation and breakdown.
Related Factors:
- Frequent exposure to urine
- Poor hygiene
- Inadequate barrier protection
- Friction from incontinence products
Nursing Interventions and Rationales:
- Implement skin care protocol
Rationale: Prevents skin breakdown - Educate on proper cleansing techniques
Rationale: Maintains skin integrity - Apply barrier products
Rationale: Protects skin from moisture
Desired Outcomes:
- The patient will maintain intact skin
- The patient will demonstrate proper skincare
- The patient will use protective products correctly
Nursing Care Plan 5: Disturbed Body Image
Nursing Diagnosis Statement:
Disturbed Body Image related to loss of bladder control as evidenced by expressed feelings of embarrassment and social isolation.
Related Factors:
- Loss of bodily function control
- Social stigma
- Decreased self-esteem
- Fear of accidents
Nursing Interventions and Rationales:
- Provide emotional support
Rationale: Builds confidence and self-esteem - Connect with support groups
Rationale: Reduces isolation - Teach coping strategies
Rationale: Improves social functioning
Desired Outcomes:
- The patient will express improved self-image
- The patient will participate in social activities
- The patient will utilize effective coping strategies
References
- Bardsley A. An overview of urinary incontinence. Br J Nurs. 2016 Oct 13;25(18):S14-S21. doi: 10.12968/bjon.2016.25.18.S14. PMID: 27734727.
- Kataria K, Ilsley A. Urinary incontinence in older adults: what you need to know. Br J Hosp Med (Lond). 2021 Apr 2;82(4):1-8. doi: 10.12968/hmed.2020.0518. Epub 2021 Apr 6. PMID: 33914642.
- Kennedy KL, Steidle CP, Letizia TM. Urinary incontinence: the basics. Ostomy Wound Manage. 1995 Aug;41(7):16-8, 20, 22 passim; quiz 33-4. PMID: 7662091.
- Trowbridge ER, Hoover EF. Evaluation and Treatment of Urinary Incontinence in Women. Gastroenterol Clin North Am. 2022 Mar;51(1):157-175. doi: 10.1016/j.gtc.2021.10.010. Epub 2022 Jan 7. PMID: 35135660.
- Turpie ID, Skelly J. Urinary incontinence: current overview of a prevalent problem. Geriatrics. 1989 Sep;44(9):32-8. PMID: 2670684.
