URGE URINARY INCONTINENCE
Involuntary passage of urine occurring shortly after a strong sense
of urgency to void
• Bladder contraction or spasm
• Increased or decreased volume
• Inability to reach toilet in time
• Alcohol intake
• Decreased bladder capacity
• Atrophic urethritis
• Detrusor hyperactivity with
• Atrophic vaginitis
impaired bladder contractility
• Bladder infection
• Fecal impaction
• Caffeine intake
• Use of diuretics
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
• Physical regulation
The patient will
• Have fewer episodes of incontinence.
• State increased comfort.
• State understanding of treatment.
• Have minimal, if any, complications.
• Discuss impact of disorder on himself and family members.
• Demonstrate skill in managing incontinence.
SUGGESTED NOC OUTCOMES
Tissue Integrity: Skin & Mucous Membranes; Urinary Continence;
INTERVENTIONS AND RATIONALES
Determine: Observe voiding pattern; document intake and output.
This ensures correct ﬂuid replacement therapy and provides informa-
tion about patient’s ability to void adequately.
Perform: Provide appropriate care for patient’s urologic condition,
monitor progress, and report patient’s responses to treatment.
Patient should receive adequate care and take part in decisions
about care as much as possible.
Assist with speciﬁc bladder elimination procedures, such as the
bladder training—place patient on commode every 2 hr while
awake and once during night, provide privacy, and gradually
increase intervals between toileting (these measures aim to restore a
regular voiding pattern). As well as rigid toilet regimen—place
patient on toilet at speciﬁc times (to aid adaptation to routine
physiologic function), and keep baseline micturition record for
3–7 days (to monitor toileting effectiveness).
Administer pain medication; discuss effectiveness with patient to
reinforce that pain can be alleviated, which reduces tension and anxiety.
Place commode next to bed, or assign patient bed next to
bathroom. A bedside commode or convenient bathroom requires less
energy expenditure than bedpan. If using commode, keep bed and
commode at same level to facilitate patient’s movements. If using
bathroom, provide good lighting from bed to bathroom to reduce
sensory misinterpretation; remove all obstacles between bed and bath-
room to reduce chance of falling. Prepare pleasant toilet environment
that is warm, clean, and free from odors to promote continence.
Provide a clock to help patient maintain voiding schedule through
Unless contraindicated, maintain ﬂuids to 3,000 ml daily to mois-
ten mucous membranes and ensure hydration; limit patient to 150
ml after dinner to reduce need to void at night.
Have patient wear easily removable clothes (gown instead of paja-
mas and Velcro fasteners instead of buttons or zippers) to reduce
frustration and delay in voiding routine.
If patient loses control on way to bathroom, instruct patient to
stop and take a deep breath. Anxiety and rushing may strengthen
Inform: Explain urologic condition to patient and family members;
include instructions on preventive measures and established bladder
schedule. Patient education begins with educational assessment and
depends on establishing a therapeutic relationship with patient and
family. Prepare patient for discharge according to individual needs to
allow patient to practice under supervision.
Instruct patient and family members on continence techniques for
home use. This reduces fear and anxiety resulting from lack of knowl-
edge of patient’s condition and reassures patient of continuing care.
Attend: Encourage patient to express feelings and concerns related to
his or her urologic problem to identify patient’s fears.
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
Fluid Monitoring; Perineal Care; Self-Care Assistance: Toileting; Uri-
nary Elimination Management; Urinary Habit Training; Urinary
Dingwall, L., & McLafferty, E. (2006, October). Do nurses promote urinary
continence in hospitalized older people?: An exploratory study. Journal of
Clinical Nursing, 15(10), 1276–1286.