Urinary retention

Domain 3. Elimination and exchange
Class 1. Urinary function
Diagnostic Code: 00023
Nanda label: Urinary retention
Diagnostic focus: Retention

Nursing diagnosis is an important part of patient care. In order to best assess and treat any medical condition, it is important that nurse practitioners and other healthcare professionals can properly identify and diagnose a particular ailment. For example, urinary retention is a medical condition wherein a patient has difficulty urinating, or does not urinate at all. By properly diagnosing this condition, a medical professional can develop a treatment plan that will alleviate the symptoms associated with this condition.

NANDA Nursing Diagnosis Definition

The NANDA nursing diagnosis for urinary retention is defined as an impaired voiding. This diagnosis is based on an individual's inability to empty their bladder completely. It is considered more of a symptom than an actual condition and can affect both men and women of various age groups. This symptom is caused by a variety of factors, including decreased bladder capacity or flow, obstruction of the bladder, or a narrowing of the urethra.

Defining Characteristics

The defining characteristics of urinary retention vary depending on the individual. Subjectively, some people may experience difficulty initiated voiding, interrupted flow, diminished force of stream, or decreased amount of urine. Objectively, there may be increased abdominal girth, discomfort upon urination, enuresis, overflow incontinence, or bladder distention.

Related Factors

A variety of factors can contribute to urinary retention, such as an obstructed bladder or narrowed urethra. Other neurological conditions such as diabetes or multiple sclerosis can also contribute to urinary retention. Fever, childbirth, and prostate enlargement can also cause this symptom. Finally, side effects from medications can also inhibit bladder function.

At-Risk Population

Certain populations are more at risk for developing urinary retention than others. These populations include elderly individuals, those who have had surgery to the bladder or reproductive system, those who take medications that inhibit bladder function, and those who have neurological conditions such as diabetes or multiple sclerosis. Women are more likely to experience this symptom, particularly after childbirth or after menopause.

Associated Conditions

There are a few conditions that are related to urinary retention. These include an overactive bladder, pelvic organ prolapse, weak bladder muscles, and bladder stones. In addition, certain conditions such as enlarged prostate, obesity, constipation, or alcohol and drug abuse can also cause this symptom.

Suggestions of Use

For those who experience urinary retention, there are many forms of treatment available. A doctor can prescribe medications to help reduce spasms and improve muscle strength. In some cases, surgery may be necessary to remove an obstruction or repair a defect. In addition, physical therapy can help improve overall bladder function.

Suggested Alternative NANDA Nursing Diagnosis:

There are a few alternative NANDA nursing diagnoses that are related to urinary retention. These include activity intolerance, confusion, and altered urinary elimination. Activity intolerance occurs when a person is unable to participate in physical activities due to decreased energy. Confusion occurs when a person experiences difficulty understanding what is happening in their environment. Altered urinary elimination occurs when a person has difficulty carrying out normal activities related to urination and voiding.

Usage Tips

When diagnosing a patient with urinary retention, it is important to consider the various contributing factors. A doctor must take into account the patient’s medical history, current medications, and lifestyle habits in order to determine the best form of treatment for the condition. Additionally, nurses should be aware of the various signs and symptoms, as well as the associated conditions, that are related to urinary retention.

NOC Outcomes

Below is a NOC Outcomes related to urinary retention. Each outcome is followed by a brief explanation of how it relates to urinary retention:

• Urinary Elimination: A patient's ability to empty the bladder adequately.
• Urinary Control: A patient's ability to inhibit uncontrolled elimination and maintain continence.
• Comfort Level: A patient's level of comfort related to voiding.
• Self-Care: A patient's ability to independently care for their urinary needs.
• Safety Status: A patient's safety level related to urinary prevention of complications.

Evaluation Objectives and Criteria

When evaluating a patient for urinary retention, the objective is to obtain a comprehensive understanding of the contributing factors. The criteria used to evaluate a patient include the presence of symptoms such as urge incontinence, diminished force of stream, or decreased amount of urine; the level of comfort upon urination; a review of the patient’s medical history and current medications; and a physical evaluation of the abdomen.

NIC Interventions

Below is a NIC Interventions related to urinary retention. Each intervention is followed by a brief explanation of how it relates to urinary retention:

• Medication Management: Administering or monitoring medications to relieve symptoms of urinary retention and improve overall bladder function.
• Phone Call Follow Up: Contacting a patient to assess their urinary symptoms, continuing progress, and follow up care.
• Patient Teaching: Educating a patient on lifestyle modifications and bladder-strengthening exercises.
• Flushing Bladder Instructions: Coaching a patient on the proper way to perform self-catheterization.
• Safety Advice: Providing a patient with safety advice related to UTI prevention.

Nursing Activities

When caring for a patient with urinary retention, certain nursing activities should be performed to ensure proper diagnosis and management. These activities include obtaining a thorough health history; scheduling urine tests; monitoring a patient’s voiding patterns, comfort level, and continence; and providing instructions on lifestyle modifications and bladder-strengthening exercises. Additionally, nurses should ensure that the patient has access to adaptive equipment if necessary and educate them about the importance of following up with their healthcare provider for ongoing care.

Conclusion

Urinary retention is a common and treatable medical condition that affects men and women of all age groups. In order to properly diagnose and manage this symptom, it is important that healthcare professionals accurately identify the underlying causes. With proper evaluation and treatment, individuals can lead a healthier and more comfortable life.

FAQs

• What is urinary retention? Urinary retention is a medical condition wherein a patient has difficulty urinating, or does not urinate at all.
• What is the NANDA nursing diagnosis for urinary retention? The NANDA nursing diagnosis for urinary retention is defined as an impaired voiding.
• What are the associated conditions of urinary retention? There are a few conditions that are related to urinary retention, including an overactive bladder, pelvic organ prolapse, weak bladder muscles, and bladder stones.
• What are the recommended treatments for urinary retention? For those who experience urinary retention, there are many forms of treatment available. A doctor can prescribe medications to help reduce spasms and improve muscle strength. In some cases, surgery may be necessary to remove an obstruction or repair a defect. In addition, physical therapy can help improve overall bladder function.
• Who is most at risk of developing urinary retention? Certain populations are more at risk for developing urinary retention than others. These populations include elderly individuals, those who have had surgery to the bladder or reproductive system, those who take medications that inhibit bladder function, and those who have neurological conditions such as diabetes or multiple sclerosis. Women are more likely to experience this symptom, particularly after childbirth or after menopause.