Domain 11. Safety-protection
Class 2. Physical injury
Diagnostic Code: 00250
Nanda label: Risk for urinary tract injury
Diagnostic focus: Injury
Introduction To Nursing Diagnosis Risk for Urinary Tract Injury
Nursing diagnosis is an integral part of nursing care and assessment. It provides nurses with a way to identify the underlying causes of an ailment or condition. When assessing a patient, it is important for nurses to take into consideration both physical and psychological health. Risk for urinary tract injury is a nursing diagnosis that takes into account a patient’s risk of developing such an injury due to factors beyond the patient’s control.
NANDA Nursing Diagnosis Definition
The NANDA International, otherwise known as the North American Nursing Diagnosis Association, is a professional organization formed in 1982 to support the use of standardized nursing language. According to the NANDA International, risk for urinary tract injury is defined as “the state in which an individual is at risk of developing a urinary system related injury due to physical, psychological or environmental stressors.”
Risk Factors
Risk for urinary tract injury has been associated with a variety of factors. These include physical trauma, inadequate nutrition, psychological stress, dehydration, age, infection, and surgical complications.
At Risk Population
Various populations can be at risk for urinary tract injuries, including preterm infants, the elderly, post-partum women, those with chronic medical conditions, and those who are physically immobilized. Preterm infants may be at risk because they typically have underdeveloped organ systems and immature reflexes. Elderly patients may be at risk due to weakened immune systems. Post-partum women are at risk due to hormonal changes, while those with chronic medical conditions are at risk simply due to a weakened immune system or the effect of certain medications. Finally, those who are physically confined to a bed or chair may also be at risk for urinary tract injuries.
Associated Conditions
Urinary tract injuries may also be associated with serious conditions such as renal artery stenosis, pyelo-vascular tension syndrome, sepsis, acute renal failure, and gliomatosis. In addition, some medications are known to increase the risk for urinary tract injuries. These medications include some antiseizure agents and calcium channel blockers.
Suggestions For Use
When assessing a patient for risk of urinary tract injury, it is important to review the patient’s risk factors. It is also important to assess any associated conditions, as well as any medication the patient may be taking. Moreover, physical examination and urine analysis may be important to establish the patient’s baseline data.
Suggested Alternative NANDA Nursing Diagnoses
In addition to the NANDA nursing diagnosis of risk for urinary tract injury, there are several other related nursing diagnosis that should be considered. These include acute pain related to tissue damage, disrupted sleep patterns related to nocturia, and impaired physical mobility related to immobility. Moreover, vulnerable for tissue integrity can indicate a patient’s need to be monitored for risk of urinary tract injury.
Usage Tips
When assessing for risk for urinary tract injury, it is important to review the patient’s site of injury, any associated signs or symptoms, past medical history, lab results, and any medications. It is also important to determine the patient’s level of risk and the potential for prevention or intervention.
NOC Outcomes
The NOC, or Nursing Outcomes Classification, offers a number of outcomes that can be used to measure progress towards successful outcomes. These include pain control, skin integrity, urinary elimination, activity intolerance, urinary tract infection, and self-care.
Explanation Of Each
Pain control is one outcome that would be measured in order to ensure that the patient is not experiencing any pain associated with their urinary tract injury. Skin integrity would be measured to ensure that the infection is not spreading beyond the injured area. Urinary elimination is important to ensure that the patient is emptying and replenishing their bladder regularly. Activity intolerance would be measured to ensure that the patient is not engaging in too much physical activity that could put undue strain on their system. Urinary tract infections would be checked for to ensure that the infection is not getting worse or spreading. Finally, self-care would be assessed to ensure that the patient is following all necessary safety measures to protect them from risking further injury or infection.
Evaluation Objectives And Criteria
When assessing a patient for risk for urinary tract injury, the evaluation objectives should be the alleviation of any potential symptoms and the prevention of further complications or infection. The criteria to be assessed would include the patient’s physical exam, lab results, diagnostic tests, and any associated medical history.
NIC Interventions
The NIC, or Nursing Interventions Classification, outlines several interventions that can be taken to ensure that a patient is being cared for properly and that their risk of urinary tract injury is minimized. These include bladder training, pressure relief interventions, pain management, nutrition support, fluid balance monitoring, and urinary diversion.
Explanation Of Each
Bladder training is a form of treatment designed to help individuals regain control of their bladder. Pressure relief interventions are aimed at reducing any painful symptoms associated with urinary tract injury. Pain management is focused on alleviating any discomfort associated with the injury. Nutrition support is used to ensure that the patient is receiving adequate nutrition and hydration. Fluid balance monitoring is important to ensure that the patient is not retaining excess fluids that may lead to further complications. Finally, urinary diversion techniques can be used to reduce the risk of infection.
Nursing Activities
When caring for a patient with risk for urinary tract injury, nurses should ensure that the patient is properly informed of their risks, provide appropriate patient education, maintain consistent follow-up, and communicate any identified changes in symptoms. Nurses should also provide comfort and support to the patient and modify activity levels so as to reduce any further risk of injury or infection.
Conclusion
Risk for urinary tract injury is a real concern for many patients and can affect individuals of all ages. Early detection of risk factors and prompt management of associated conditions can help to minimize the risk of this potentially devastating condition. By understanding the risk factors, evaluating the patient’s current status, and intervening with appropriate nursing activities, nurses can ensure that a patient’s risk of injury is minimized.
5 FAQs
- What is risk for urinary tract injury? Risk for urinary tract injury is a nursing diagnosis that takes into consideration a patient’s risk of developing such an injury due to factors beyond the patient’s control.
- Who is at risk for urinary tract injury? Various populations can be at risk for urinary tract injuries, including preterm infants, the elderly, post-partum women, those with chronic medical conditions, and those who are physically immobilized.
- What are some associated conditions of risk for urinary tract injury? Urinary tract injuries may also be associated with serious conditions such as renal artery stenosis, pyelo-vascular tension syndrome, sepsis, acute renal failure, and gliomatosis. In addition, some medications are known to increase the risk for urinary tract injuries.
- How can risk for urinary tract injury be prevented? When assessing a patient for risk of urinary tract injury, it is important to review the patient’s risk factors. It is also important to assess any associated conditions, as well as any medication the patient may be taking. Moreover, physical examination and urine analysis may be important to establish the patient’s baseline data.
- What are some nursing interventions for risk for urinary tract injury? When caring for a patient with risk for urinary tract injury, nurses should ensure that the patient is properly informed of their risks, provide appropriate patient education, maintain consistent follow-up, and communicate any identified changes in symptoms. Nurses should also provide comfort and support to the patient and modify activity levels so as to reduce any further risk of injury or infection.
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