Urge urinary incontinence

Urge urinary incontinence

Domain 3. Elimination and exchange
Class 1. Urinary function
Diagnostic Code: 00019
Nanda label: Urge urinary incontinence
Diagnostic focus: Incontinence

Urge urinary incontinence (UUI) is a medical condition that affects the urinary system. It is a type of urinary incontinence in which a person experiences a sudden, strong need to go to the bathroom, but they are unable to control the bladder release until it is too late. UUI can be caused by various conditions and factors, including neurological disorders, a weakened pelvic floor, urinary tract infections, or simply age-related changes in the body. In order to determine an effective treatment plan, healthcare professionals must first identify and diagnose UUI.

NANDA Nursing Diagnosis Definition

Nursing professionals use the NANDA International standards to diagnose and treat patients with health care related problems. The definition of Urge Urinary Incontinence according to the NANDA standard is “The state in which a person experiences repeated, sudden, strong urges to void urine, but cannot postpone urination; resulting in involuntary leakage of urine.”

Defining Characteristics

Subjective Characteristics:

  • A frequent urgent need to urinate
  • A frequently decreased ability to inhibit micturition
  • A feeling of incomplete voiding
  • A feeling of urge despite absence of voiding

Objective Characteristics:

  • Difficulty postponing micturition
  • Uninterrupted urinary leakage
  • Frequent pauses while voiding
  • Short duration of voiding
  • Diminished sensation of bladder emptying

Related Factors

  • Diet: Foods and beverages high in caffeine, alcohol, and/or sugar can worsen UUI symptoms.
  • Interstitial Cystitis: This is a chronic condition caused by inflammation of the bladder, leading to increased urinary frequency and urgency.
  • Neurological Disorders: Marked changes in nerve function due to conditions such as stroke, multiple sclerosis, or Parkinson’s can cause overactive bladder and urinary urgency.
  • Post Menopausal Estrogen Deficiency: Estrogen deficiency leads to weakening of the muscles in the bladder, increasing the risk of UUI in postmenopausal women
  • Pregnancy: Changes in hormones, the uterus, and growing baby pushing against the bladder can all increase the risk of UUI during pregnancy.
  • Urinary Retention: Back-up of urine in the bladder causes an increased sensation of having to urinate, leading to episodes of UUI.

At Risk Populations

  • Elderly: Loss of bladder muscle strength and irritable bladder function that is common in older individuals can lead to urinary urgency and UUI.
  • Women: Pregnant women, post-menopausal women, and those taking certain medications (ie: birth control pills) are more likely to experience UUI.

Associated Conditions

  • Anxiety: Stress and anxiety can increase the likelihood of UUI symptoms.
  • Depression: Low self-confidence caused by depression can lead to episodes of UUI.
  • Pelvic Floor Weakness: Damage to the nerve supply to the bladder or weakened pelvic muscles can lead to increased UUI symptoms.
  • Urge Syndrome: Patients with urge syndrome experience difficulty initiating, delaying, and controlling the urinary release.

Suggestions of Use

  • Maintain good hydration: Avoid dehydration by drinking plenty of fluids, mainly water. Too much diuretic food and beverages can increase UUI symptoms.
  • Practice Pelvic Floor Exercises: Make sure your pelvic muscle are strong and healthy by engaging in Kegel exercises.
  • Identify Triggers: Keeping a voiding diary to identify triggering factors of UUI episodes can help when planning treatments.
  • Be Mindful of Restroom Frequency: Take small trips to the restroom to alleviate the feeling of urge.
  • Reduce Caffeine Intake: Avoid drinking large amounts of caffeine, as well as beverages with high sugar content, to reduce UUI symptoms.

Suggested alternative NANDA Nursing Diagnoses

  • Urinary Elimination: Stress Incontinence
  • Activity Intolerance
  • Risk for Injury
  • Ineffective Health Maintenance
  • Urinary Incontinence: Functional Incontinence
  • Knowledge Deficit
  • Dehydration
  • Constipation

Usage Tips

  • Ensure that you have a comprehensive knowledge and understanding of the condition before attempting to diagnose and treat it.
  • Thoroughly assess the patient and identify the risk factors associated with UUI in order to create an appropriate treatment plan.
  • Consider other diagnoses if the patient exhibits additional presenting symptoms along with the urge incontinence.
  • Always work closely with other healthcare professionals to determine the best course of action.

NOC Outcomes

  • Bladder Control: Ability to control micturition
  • Fluid Balance: Ability to maintain an optimal balance of bodily fluids
  • Hydration: Maintenance of an optimal level of hydration
  • Interventions Effectiveness: Ease of potential urinary symptoms
  • Pain Control: Management of discomfort from UUI
  • Sleep Pattern: Quality of sleep
  • Urination: Level of normal urinary functioning
  • Tissue Integrity: Prevention of tissue damage from UUI

Explanation

  • Bladder Control:Ability to recognize urinary sensations and then take appropriate action to delay or inhibit voiding.
  • Fluid Balance: The patient has an adequate intake of fluids and is able to balance this intake and output correctly.
  • Hydration: The individual is able to restore and retain adequate levels of bodily hydration.
  • Intervention Effectiveness: The effectiveness of treatments (such as medications, lifestyle changes, or physical therapy) within helping the patient better manage UUI symptoms.
  • Pain Control: The reduction of pain or discomfort due to UUI.
  • Sleep Pattern: The patient is able to achieve and maintain a typical sleeping pattern in spite of UUI symptoms.
  • Urination: The patient can control the voiding of urine and achieve a pattern of normal urination.
  • Tissue Integrity: The patient is able to maintain normal bladder wall and other tissue integrity, free of inflammation or infection caused by UUI.

Evaluation Objectives and Criteria

The goal of evaluation is to determine the effectiveness of the intervention. To do this, healthcare providers must assess the patient’s subjective responses, such as their perception of symptom improvement, as well as objective measures such as the frequency of urine leakage and amount of urine lost.

NIC Interventions

  • Medication Management: Prescribing and monitoring medications that can suppress urinary urgency and reduce the incidence of UUI episodes.
  • Fluid and Electrolyte Management: Providing instruction on proper hydration and monitoring the patient’s fluid balance.
  • Urologic Care: Referral to and integration with services of other healthcare providers, such as urologists for further assessments and possible surgery.
  • Pelvic Floor Strengthening: Advising to perform strengthening exercises to improve pelvic muscle function.
  • Emotional Support: Offering emotional support and counseling to help cope with stress, anxiety, and depression associated with UUI.
  • Continence Program: Implementing lifestyle changes and teaching techniques, such as fluid management and timed voiding, that work to eliminate the UUI symptoms.
  • Urge Suppression: Using cognitive-behavioral approaches to delay or reduce the feeling of urinary urge.

Explanation of Each

  • Medication Management: As part of treatment, medications may be prescribed that help relieve symptoms of UUI. Examples include anticholinergics, antidepressant drugs, and calcium channel blockers.
  • Fluid and Electrolyte Management: Encourage the patient to drink plenty of fluids, especially water.
  • Urologic Care: Referral to the services of other providers, such as urologists, to further assess the condition and explore additional treatment options.
  • Pelvic Floor Strengthening: Referral to a physical therapist for exercises to strengthen the pelvic floor and bladder muscles.
  • Emotional Support: Offering support and counseling to help cope with the symptoms of UUI.
  • Continence Program: Instruction on lifestyle habits that help control the UUI symptoms.
  • Urge Suppression: Cognitive-behavioral approaches to inhibit or delay the feeling of urinary urge.

Nursing Activities

  • Assess the patient for current symptoms of UUI, such as frequency of episodes, intensity of urge, and amount of urine lost.
  • Monitor patient’s response to treatments, such as medication and lifestyle habits.
  • Develop a comprehensive care plan, which also includes a discharge plan and follow-up instructions.
  • Provide education on UUI and available treatments.
  • Offer emotional support and counseling.
  • Develop strategies to prevent or reduce UUI triggers.
  • Referral to other healthcare providers, if needed.

Conclusion

Urge urinary incontinence is a common type of urinary incontinence that presents with symptoms such as a frequent urgent need to urinate and inability to inhibit micturition. The condition can be caused by various conditions and factors, including a weakened pelvic floor, urinary tract infections, neurological disorders, and age-related changes. In order to determine a successful treatment plan, healthcare professionals must first diagnose and identify the risk factors associated with UUI. Treatment of UUI typically involves lifestyle modifications, medications, pelvic floor strengthening exercises, and other interventions that are designed to reduce or eliminate symptoms.

FAQs

Q1. What is urge urinary incontinence?
A1. Urge urinary incontinence (UUIN) is a type of urinary incontinence in which a person experiences a sudden, strong need to go to the bathroom, but they are unable to control the bladder release until it is too late.

Q2. What are the defining characteristics of UUI?
A2. The defining characteristics of UUI include frequent urgent need to urinate, decreased ability to inhibit micturition, feeling of incomplete voiding, difficulty postponing micturition and uninterrupted urinary leakage.

Q3. What are some of the factors that can increase the risk of UUI?
A3. Some factors that can increase the risk of UUI include diet, interstitial cystitis, neurological disorders, post-menopausal estrogen deficiency, pregnancy, and urinary retention.

Q4. How is UUI diagnosed?
A4. UUI is typically diagnosed using the NANDA International standards. Healthcare professionals may also conduct a physical exam, urine tests, ultrasound, and/or cystoscopy to confirm the diagnosis and evaluate the severity of the condition.

Q5. What are some of the treatments for UUI?
A5. Common treatments for UUI include medications, lifestyle modifications, pelvic floor strengthening exercises, and referrals to other healthcare providers for additional assessments and treatment options.