STRESS URINARY INCONTINENCE
Sudden leakage of urine with activities that increase intra-abdominal
• Dribbling with increased abdominal pressure
• Degenerative changes in pelvic
• Intrinsic urethral sphincter
• High intra-abdominal pressure
• Weak pelvic muscles
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
• Physical regulation
The patient will
• Maintain continence.
• State increased comfort.
• State understanding of treatment.
• State understanding of surgical procedure.
• Demonstrate skill in managing urinary elimination problems.
• Identify resources to assist with care following discharge.
SUGGESTED NOC OUTCOMES
Tissue Integrity: Skin & Mucous Membranes; Urinary Continence;
INTERVENTIONS AND RATIONALES
Determine: Observe patient’s voiding patterns, time of voiding,
amount voided, and whether voiding is provoked by stimuli. Accu-
rate, thorough assessment forms basis of an effective treatment plan.
Perform: Provide appropriate care for patient’s urologic condition,
monitor progress, and report patient’s responses to treatment.
Patient expects to receive adequate care and to participate in
decisions regarding care.
Help patient to strengthen pelvic ﬂoor muscles by Kegel exercises
for sphincter control. Exercises increase muscle tone and restore cor-
Promote patient’s awareness of condition through education to
help patient understand illness as well as treatment.
Help patient reduce intra-abdominal pressure by losing weight,
avoiding heavy lifting, and avoiding chairs or beds that are too high
or too low. These measures reduce intra-abdominal pressure and
Provide supportive measures:
– Respond to call bell quickly, assign patient to bed next to bath-
room, put night-light in bathroom, and have patient wear easily
removable clothing (gown rather than pajamas and Velcro fasteners
rather than buttons or zippers). Early recognition of problems pro-
motes continence; easily removed clothing reduces patient frustration
and helps achieve continence.
– Provide privacy during toileting to reduce anxiety and promote
– Have patient empty bladder before meals, at bedtime, and
before leaving accessible bathroom area to promote elimination,
avoid accidents, and help relieve intra-abdominal pressure.
– Limit ﬂuids to 150 ml after dinner to reduce need to void at
– Encourage high ﬂuid intake, unless contraindicated, to moisten
mucous membranes and maintain hydration.
– Suggest patient eat increased amount of salty food before going
on a long trip (unless contraindicated). Increased sodium decreases
– Make protective pads available for patient’s undergarments, if
needed, to absorb urine, protect skin, and control odors.
If surgery is scheduled, give attentive, appropriate preoperative
and postoperative instructions and care to reduce patient’s anxiety
and build trust in caregivers.
Inform: Alert patient and family members about need for toilet
schedule. Prepare for discharge according to individual needs to
ensure that patient will receive proper care.
Attend: Encourage patient to express feelings and concerns related to
urologic problems. This helps patient focus on speciﬁc problem.
Manage: Refer patient and family members to psychiatric liaison
nurse, support group, or other resources, as appropriate.
Community resources typically provide healthcare not available from
other healthcare agencies.
SUGGESTED NIC INTERVENTIONS
Pelvic Muscle Exercise; Teaching: Individual; Urinary Elimination
Management; Urinary Habit Training; Urinary Incontinence Care
Anders, K. (2006, May). Recent developments in stress urinary incontinence in
women. Nursing Standard, 20(35), 48–54.