00016 Impaired urinary elimination

Domain 3: elimination and exchange
Class 1: urinary function
Diagnostic Code: 00016
Nanda label: deterioration of urinary elimination
Diagnostic focus: elimination
Approved 1973 • Revised 2006, 2017, 2020 • Level of evidence 3.1

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « deterioration of urinary elimination is defined as: dysfunction in urinary elimination.

Definite characteristics

  • Dysuria
  • Frequent urination
  • NICTURIA
  • Difficulty in starting urine jet
  • Urinary incontinence
  • Urinary retention
  • Urinary urgency

Related factors

  • Alcohol consumption
  • Alteration of environmental factors
  • Coffee consumption
  • Limitations of the environment
  • Fecal impact
  • Incorrect posture in the toilet
  • ineffective elimination habits
  • Insufficient intimacy
  • Involuntary relaxation of the sphincter
  • Obesity
  • prolapse of a pelvic organ
  • smoking
  • Aspartamo use
  • Weakened bladder musculature
  • Weakness of the pelvic support structure

Risk population

  • Older adults
  • Women

Associated problems

  • Anatomical obstruction
  • Diabetes mellitus
  • Sensitive-Motor deterioration
  • Urinary tract infection

Suggestions of use

Use a more specific label whenever possible. To review specific results of each patient, evaluation criteria and nursing interventions, see the following diagnoses.

Suggested alternative diagnostics

  • Urinary effort incontinence
  • Urinary emergency incontinence
  • Urinary emergency incontinence, risk of
  • Functional urinary incontinence
  • Urinary incontinence for overflowing
  • Urinary incontinence reflects
  • Urinary retention

NOC Results

  • Urinary elimination: accumulation and discharge of urine

Evaluation objectives and criteria

  • demonstrates urinary elimination, as manifested by the following indicators (specify from 1 to 5: seriously, substantially, moderately, slightly or not compromised):
    • Elimination pattern
    • empty the bladder completely
    • Recognition of urgency

Other examples

  • Urinary continence
  • Demonstration of adequate knowledge about medicines that affect urinary function
  • Urinary elimination not compromised:
    • Smell, quantity, and urine color, within the expected range
    • Absence of hematuria
    • urination without pain, difficulty or urgency
    • bun, serum creatinine concentration and specific wnl density
    • Proteins, glucose, ketones, pH and WNL electrolytes of the urine

NIC Interventions

  • Urinary catheterization: Introduction of a probe in the bladder for temporal or permanent drainage of urine
  • Exercise of the pelvic muscle: training and strengthening of the lifting muscle of the anus and the urogenital muscles through voluntary and repetitive contraction, to reduce urinary incontinence of effort, urgent or combined
  • Stimulated elimination: Promotion of urinary continence through verbal reminders of the need to go to the bathroom and positive social feedback every time it does it properly
  • Urinary training: improvement of bladder function in patients with emergency incontinence, by increasing bladder’s ability to retain urine and patient ability to avoid urination
  • Management of the urinary e cio: maintenance of a pattern
  • Urinary elimination optimal

Nursing Activities

Valuations

  • (NIC) Urinary elimination management:
    • Monitor urinary elimination, including its frequency, consistency, smell, volume and color, as required
    • Obtain an urine sample, taken by half of urination, to perform an analysis when required

Patient and family education

  • (NIC) Urinary elimination management:
    • Teach the patient the signs and symptoms of urinary tract infection
    • Teach the patient and the family to register the volume of urine, as required
    • Instruct the patient to immediately respond to the need to urinate, when required
    • Teach the patient to drink 240 mi of liquids with meals, between meals and at dusk

Collaboration activities

  • (NIC) Urinary elimination Management: channel with the doctor if there are signs and symptoms of urinary tract infection

At home

  • The above activities can be used or adapted for home care

Older people

  • Be aware that very old people do not usually present the classic symptoms of urinary tract infection, and that such a disease can quickly become sepsis; Perform urine analysis before any sudden change in urine elimination
  • Advise patients the consumption of a glass of blueberry juice daily
  • Keep in mind that older people may need more time to move from bed to the bathroom