00019 Urge urinary incontinence

Domain 3: elimination and exchange
Class 1: urinary function
Diagnostic Code: 00019
Nanda label: emergency urinary incontinence
Diagnostic focus: incontinence
Approved 1986 • Revised 2006, 2017, 2020 • Level of evidence 2.3

NANDA Nursing Diagnosis Definition

Nanda nursing diagnosis « emergency urinary incontinence is defined as: involuntary loss of urine associated with, or then, an intense sense of urgency to eliminate.

Definite characteristics

  • Decreased bladder capacity
  • Emergency feeling before a trigger stimulus
  • Involuntary urine loss before reaching the toilet
  • Involuntary urine loss with vesical contractions
  • Involuntary urine loss with vesical spasms
  • Involuntary loss of different amounts of urine between urgent, urgently
  • NICTURIA
  • Urinary frequency

Related factors

  • Alcohol consumption
  • Anxiety
  • Coffee consumption
  • Consumption of carbonated drinks
  • Fecal impact
  • ineffective elimination habits
  • Involuntary relaxation of the sphincter
  • Overweight
  • Pelvic floor disorders
  • prolapse of a pelvic organ

Risk population

  • People exposed to abuse
  • People with a history of urinary urgency in childhood
  • Older adults
  • Women
  • Women who experience menopause

Associated problems

  • Atrophic Vaginitis
  • Obstruction of the bladder probe
  • Depression
  • Diabetes mellitus
  • Nervous system diseases
  • Nervous system trauma
  • Hyperactive pelvic floor
  • Pharmacological preparations
  • Therapeutic regime
  • Urological diseases

Suggested alternative diagnostics

  • Self -care: Use of the toilet, deficit of
  • Urinary elimination, deterioration of the
  • Urinary effort incontinence
  • Functional urinary incontinence
  • Urinary incontinence for overflowing
  • Urinary incontinence reflects
  • Urinary retention

NOC Results

  • Self -care: Use of the toilet: Ability to use the toilet independently, with or without help devices
  • Urinary continence: control of the urine elimination of the bladder

Evaluation objectives and criteria

  • See also Noc of Functional Urinary Incontinence.
  • Demonstrates urinary continence, which is manifested by the following indicators (specify from 1 to 5: never, sometimes, sometimes, often or usually):
  • Respond to urgency in time
  • Identify medications that interfere with urinary control
  • maintains a barriers free to go to the bathroom in a way (urgency urine)

Other examples

  • Describe the urinary management program to restore a satisfactory elimination pattern
  • Experience incontinence episodes less frequently

NIC Interventions

  • Support for self -care: Use of the toilet: Help another person with the elimination
  • Urinary incontinence care: Help to promote continence and maintenance of perianal skin integrity
  • Stimulated elimination: Promotion of urinary continence through the use of verbal reminders of the need to go to the bathroom, and positive social feedback every time it does it properly
  • Teaching: prescribed medication: preparation of a patient to correctly take the prescribed medications, and surveillance of their effects
  • Urinary habit training: establishment of a predictable pattern of bladder emptying, to prevent incontinence in people with limited cognitive capacity and who have functional, urgency or effort incontinence
  • Urinary training: improvement of bladder function in patients with emergency incontinence, by increasing bladder’s ability to retain urine and patient’s ability to avoid urination
  • Medication management: facilitation of the safe and effective use of drugs, with and without recipe

Nursing Activities

  • See also Nursing activities of functional urinary incontinence.

Patient and family education

  • Instruct the patient about the techniques to increase the ability of the bladder, how to initiate the elevation of the pelvic floor when the urgency of urinating feels, and apply an urinary training schedule that expands the interval between the emptiness
  • Monitor the effects of antispasmodic medications, such as dry mouth, which interfere with the ability to speak or eat
  • Instruct the patient and family to report the signs and symptoms of an urinary tract infection (for example, fever, chills, side pain, hematuria, and changes in the consistency and smell of urine) >
  • (NIC) Care of urinary incontinence:
    • Explain the etiology of the problem and the foundation of actions
    • Analyze the procedures and expected results with the patient

Collaboration activities

  • Request the help of physical and occupational therapists, to develop manual ability
  • Consult the doctor on: (a) antispasmodic and anticholinergic medications, and (b) medical management (for example, electrostimulation therapy, investigation of irritating or inflammatory disorders underlying vesical and surgical therapy)

Others

  • Help the patient to urinate before sleeping, and motivate him to get up to urinate during the night to reduce the urgency
  • Provide a bacinilla, a comfortable or an urinal next to the bed, to encourage frequent urine discharges
  • For skin care, consider the following measures:
    • Ensure properly drying the skin
    • Apply a moisture barrier, such as ointment or leather waterproofing
  • (NIC) Care of urinary incontinence: Limit liquids 2 to 3 hours before bedtime, as required

At home

  • The above activities can be used or adapted for home care
  • Help the patient and his family remove obstacles to go to the bathroom at home; For example, have a free road to the bathroom, place the bed as close as possible to the bathroom

Older people

  • In addition to the previous activities, evaluate the patient’s cognitive skills and their effects on the independent use of the toilet
  • Evaluate functional skills and provide assistance devices if necessary