Domain 3. Elimination and exchange
Class 1. Urinary function
Diagnostic Code: 00017
Nanda label: Stress urinary incontinence
Diagnostic focus: Incontinence
Stress urinary incontinence (SUI) is a form of urinary incontinence. It occurs when the patient has a sudden urge to urinate, normally due to physical stress on the bladder, leading to the inability to contain urine. This type of incontinence can have a serious effect on the quality of life of those living with it. Its assessment and diagnosis by nurses are key to effective treatment and management.
NANDA Nursing Diagnosis Definition
According to the NANDA-International Nursing diagnoses , SUI is a “state in which involuntary leakage of urine occurs in response to intra-abdominal pressure that is increased by coughing, sneezing, laughing, bending, or lifting”. The patient’s symptom(s) of SUI must be severe enough to produce a significant impact on the patient’s daily activities and social interactions.
Subjective SUI defining characteristics include feelings of wetness or leakage of urine. The patient may also experience a sudden urge to urinate, particularly when engaging in physical activities such as bending, lifting, or jumping.
Objective defining characteristics of SUI include observation of urine leakage during physical activities (as described above). Other objective diagnostic data may include laboratory or other tests such as imaging exams, or analysis of urine samples to assess the cause of the incontinence.
Nurses should be aware of various factors which might contribute to SUI, including age, sex, obesity, bladder contractions, excessive caffeine consumption, smoking, pregnancy, childbirth, surgery, and disease processes (such as arthritis). Certain medications, including diuretics, anticholinergics, and alpha-blockers can contribute to SUI. Emotional stress can also lead to SUI, although it is more difficult to diagnose and treat.
At Risk Population
Those most commonly at risk for SUI include menopausal women, pregnant women, women who have had multiple vaginal deliveries, people with neurological conditions, and those with a history of pelvic or abdominal surgery.
SUI is often associated with other medical conditions such as overactive bladder (OAB) and urge incontinence, urinary tract infections (UTIs), cystocele and rectocele. It can also be a symptom of neurological conditions such as multiple sclerosis or Parkinson’s disease.
Nursing care plans for SUI should involve strategies to reduce the risk and severity of symptoms, as well as lifestyle changes. Self-care measures such as doing Kegel exercises, avoiding bladder irritants, minimizing fluid and caffeine intake, and reducing stress can be suggested to the patient. Medication adjustments may also help reduce SUI.
Suggested Alternative NANDA Nursing Diagnoses
In addition to SUI, possible alternative nursing diagnoses may include Overactive Bladder, Urge Incontinence, Impaired Urinary Elimination, and Urinary Retention.
When diagnosing SUI, it is important to rule out other relevant conditions, especially since some of them (such as OAB and urge incontinence) have similar symptoms. It is advisable to have the patient keep a symptom log to note down their experiences (such as times & situations when leakage occurs) before and during treatment, as this can help with the treatment.
The following Nursing Outcomes Classification (NOC) outcomes should be set for patients being treated for SUI: Urine Continence, Quality of Life, and Executive Function.
Urine Continence: This outcome measures the patient’s ability to maintain bladder control, and will be assessed based on how well the patient is able to manage their leaks/involuntary urination.
Quality of Life: Quality of life of those living with SUI can be significantly affected. This outcome measure assesses the patient’s contentment with their daily activities and their overall life satisfaction.
Executive Function: Self-care management and adherence to prescribed treatments relies on adequate executive function. This outcome focuses on the patient’s ability to make decisions, plan ahead, and adhere to treatment recommendations.
Evaluation Objectives and Criteria
Successful evaluation of treatment for SUI should consider the following criteria: reduction of frequency and volume of urine leakage, improved bladder control and emptying, improved quality of life, and improved executive functioning.
The following Nursing Interventions Classification (NIC) interventions should be included in a care plan for SUI: Education, Health Promotion, Management of Care, Physical Assessment, and Monitoring.
Education: This intervention involves teaching the patient information about SUI and its management, including lifestyle modifications and self-care measures, as well as risks associated with medication and its side effects.
Health Promotion: This intervention focuses on helping the patient optimize their physical and mental health through proper nutrition, exercise, relaxation techniques, and other related activities.
Management of Care: This intervention involves evaluating the patient’s situation to ensure that the best treatment modality is pursued.
Physical Assessment: This intervention comprises the ongoing physical assessment of the patient in order to determine any changes in condition, including evaluating the use of medications, urine output, and bloating.
Monitoring: This intervention monitors the patient’s response to treatment and ensures that any adverse effects are dealt with swiftly.
When providing nursing care to patients with SUI, nurses should focus on the assessment, diagnosis, and implementation of treatment plans. Nurses should assess the patient’s symptoms, current condition, and risk factors. They should then diagnose the patient’s condition and develop an appropriate care plan based on the patient’s needs and preferences. Finally, they should implement the care plan and monitor the patient’s progress.
SUI can cause significant impacts on quality of life, so proper assessment, diagnosis, and management are crucial for patients. Nurses play an important role in patient’s response to treatment, and should monitor and intervene accordingly.
- What is Stress Urinary Incontinence?
- Stress Urinary Incontinence (SUI) is a form of urinary incontinence. It occurs when the patient has a sudden urge to urinate, normally due to physical stress on the bladder, leading to the bladder not being able to contain urine.
- What are the risk factors for SUI?
- Risk factors associated with SUI include age, sex, obesity, bladder contractions, excessive caffeine consumption, smoking, pregnancy, childbirth, surgery, certain medications, and certain diseases. Additionally, emotional stress may also play a role in SUI, though it is more difficult to diagnose and treat.
- Who is most at risk for suffering from SUI?
- Those most at risk for SUI include menopausal women, pregnant women, women who have had multiple vaginal deliveries, people with neurological conditions, and those with a history of pelvic or abdominal surgery.
- What are the NOC outcomes for SUI?
- The NOC outcomes for SUI include Urine Continence, Quality of Life, and Executive Function.
- What kind of nursing interventions are used for managing SUI?
- NIC interventions used for managing SUI include Education, Health Promotion, Management of Care, Physical Assessment, and Monitoring.