Mixed urinary incontinence

Mixed urinary incontinence

Domain 3. Elimination and exchange
Class 1. Urinary function
Diagnostic Code: 00310
Nanda label: Mixed urinary incontinence
Diagnostic focus: Incontinence

Nursing Diagnosis Mixed Urinary Incontinence

Introduction
Mixed urinary incontinence is a condition that involves the unintentional loss of urine and this condition affects people of all ages. It may occur due to physical conditions, neurological disorders, or pregnancy. People who suffer from this condition may experience leakage of urine from different directions, such as from urine flow suddenly stops or from pressure on the bladder. This type of incontinence can have a significant negative impact on an individual’s quality of life, leading to social, emotional, and psychological issues.

NANDA Nursing Diagnosis Definition

The National Association of Nursing Diagnosis (NANDA) defines mixed urinary incontinence as, “the involuntary loss of urine accompanied by clinical signs and symptoms of both stress and urge urinary incontinence.” This refers to the frequencies, volume and circumstances associated with the leaks.

Defining Characteristics

Defining characteristics of mixed urinary incontinence include subjective symptoms like urgency, frequency, leakage of small amounts of urine and involuntary contraction of the pelvic floor muscles. Objective symptoms include involuntary contraction of the external sphincter muscles and involuntary loss of urine.

Related Factors

There are several underlying factors that may predispose individuals to mixed urinary incontinence, such as physical conditions, neurological dysfunction, anatomical abnormalities, medications, and pregnancy. Physical conditions could include pelvic organ prolapse, which is when the uterus or other organs slip into the vagina; or obstructive uropathy, which is obstruction of the urinary tract due to blockage of the urethra or other tissues. Neurological dysfunction could include spinal cord injury resulting in disruption of neural pathways between the brain and bladder control centers, or neurogenic bladder due to nerve or muscle damage. Anatomical abnormalities include prostate enlargement or bladder outlet obstruction caused by bony or soft tissue structures pathology. Similarly, medications affecting bladder control or causing damage to the bladder wall can also affect normal bladder functioning. Lastly, pregnancy and childbirth can cause bladder trauma, such as tears in the bladder neck, or weak pelvic floor muscles.

At Risk Population

Individuals at risk for developing mixed urinary incontinence include pregnant women, post-menopausal women, people with physical conditions that affect normal bladder functioning, people with neurological disorders that disrupt the neural pathways between the brain and the bladder control centers, men with enlarged prostates or bladder outlet obstruction, and those taking medications associated with urinary incontinence.

Associated Conditions

There are several associated conditions associated with mixed urinary incontinence. These conditions may include decreased physical activity and exercise, which could lead to weakened pelvic floor muscles; higher body mass index, which can contribute to increased intra-abdominal pressure; and psychological distress, which can lead to anxiety or fear of leaving the house due to concern about leakage.

Suggestions of Use

Mixed urinary incontinence can be managed through dietary modifications, medications, pelvic floor muscle training, and lifestyle modifications. avoiding certain beverages and foods (e.g., caffeine, alcohol, and spicy food) can help decrease the symptoms of mixed urinary incontinence. Pelvic floor muscle training can help strengthen the muscles in the pelvis and improve bladder control, as well as reduce other symptoms like overactive bladder and urinary frequency. Lifestyle modifications, such as timed urination and avoiding holding urine for long periods of time, can also help manage mixed urinary incontinence.

Suggested Alternative NANDA Nursing Diagnoses

Other NANDA nursing diagnoses related to mixed urinary incontinence include urinary retention, stress urinary incontinence, functional urinary incontinence, and urge urinary incontinence. Urinary retention refers to difficulty or inability to pass urine, while stress urinary incontinence involves leakage of urine associated with physical exertion, such as coughing, laughing, or sneezing. Functional urinary incontinence refers to difficulty in timed voiding and is mainly due to cognitive impairments, while urge incontinence refers to sudden, strong need to urinate and sudden leakage of smaller amounts of urine.

Usage Tips

When diagnosing patients with mixed urinary incontinence, it is important to obtain a thorough medical history, assess the patient’s current symptoms and physical findings, and consider any other related factors that may be contribuiting to the condition. It is also important to talk to the patient about lifestyle changes they can make to help manage their incontinence, such as timed urination and pelvic floor muscle training. Additionally, it is important to consider pharmacological management of the condition and follow-up with return visits as needed to assess progress and ongoing management of the condition.

NOC Outcomes

NOC outcomes related to mixed urinary incontinence include urinary control, bladder capacity, activity tolerance, and physical mobility. Urinary control refers to the ability to initiate and maintain bladder emptying without leakage. Bladder capacity measures the total amount of urine that can be stored in the bladder before emptying is necessary. Activity tolerance measures the individual’s ability to remain physically active with minimal discomfort, while physical mobility measures the ability to move around with ease.

Evaluation Objectives and Criteria

Evaluation objectives for mixed urinary incontinence include determining the underlying causes of the condition, assessing and addressing any co-morbid conditions, and monitoring for response to interventions. Evaluation criteria includes assessing the patient’s ability to control urine loss, the amount of urine lost, quality of life, and any changes in activity level or mobility.

NIC Interventions

NIC interventions related to mixed urinary incontinence include bladder training, lifestyle modifications, pharmacotherapy, and surgery. Bladder training involves strategies such as scheduled toileting and timing voiding intervals, while lifestyle modifications involve changes in diet, activity level, and habit reeducation. Pharmacotherapy involves the use of medications to manage incontinence, while surgery involves procedures such as bladder augmentation or sling procedures.

Nursing Activities

Nursing activities related to mixed urinary incontinence include assessing and monitoring for signs and symptoms, providing patient and family education, and initiating interventions as appropriate. Assessing and monitoring for signs and symptoms includes doing a physical assessment, obtaining a medical history, and asking the patient about lifestyle factors that might be contributing to incontinence. Patient and family education includes teaching the patient about diet and lifestyle modifications and helping them develop a plan for managing incontinence. Interventions may include bladder training, lifestyle modification, pharmacotherapy, and/or surgery.

Conclusion

Mixed urinary incontinence is a common condition that can affect individuals of all ages. Different underlying causes, such as physical conditions, neurological disorders, and medications can contribute to mixed urinary incontinence. Treatment options include lifestyle modifications, bladder training, pharmacotherapy, and surgery. Nursing activities related to mixed urinary incontinence include assessing and monitoring for signs and symptoms, providing patient and family education, and initiating interventions as appropriate.

FAQs

  • What is mixed urinary incontinence? Mixed urinary incontinence is a condition that involves the unintentional loss of urine and this condition affects people of all ages. It may occur due to physical conditions, neurological disorders, or pregnancy. People who suffer from this condition may experience leakage of urine from different directions, such as from urine flow suddenly stops or from pressure on the bladder.
  • Who is at risk for mixed urinary incontinence? Individuals at risk for developing mixed urinary incontinence include pregnant women, post-menopausal women, people with physical conditions that affect normal bladder functioning, people with neurological disorders that disrupt the neural pathways between the brain and the bladder control centers, men with enlarged prostates or bladder outlet obstruction, and those taking medications associated with urinary incontinence.
  • What are some treatment options for mixed urinary incontinence? Treatment options for mixed urinary incontinence include dietary modifications, medications, pelvic floor muscle training, and lifestyle modifications.
  • What are some nursing activities related to mixed urinary incontinence? Nursing activities related to mixed urinary incontinence include assessing and monitoring for signs and symptoms, providing patient and family education, and initiating interventions as appropriate.
  • Which NANDA Nursing Diagnoses are related to mixed urinary incontinence? Other NANDA nursing diagnoses related to mixed urinary incontinence include urinary retention, stress urinary incontinence, functional urinary incontinence, and urge urinary incontinence.

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