OVERFLOW URINARY INCONTINENCE
Involuntary loss of urine associated with overdistention of the bladder
• Bladder distention
• High postvoid residual volume
• Reported and observed involuntary leakage of small volumes of
• Bladder outlet obstruction
• Severe pelvic prolapse
• Detrusor external sphincter
• Side effects of anticholinergic,
calcium channel blocker, or
• Detrusor hypocontractility
• Fecal impaction
• Urethral obstruction
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
• Physical regulation
The patient will
• Void 200–300 mL of clear, yellow urine every 3–4 hr while
• Have postvoid residual of less than 50 ml.
• Have reduction in urinary incontinence episodes or complete
absence of urinary incontinence.
• Experience relief of most bothersome aspect of urinary
• Remain clean and dry without urine odor.
• Express understanding of condition and activities to prevent/reduce
• Express improvement in quality of life.
SUGGESTED NOC OUTCOMES
Knowledge: Treatment Regimen; Urinary Continence
INTERVENTIONS AND RATIONALES
Determine: Monitor and record patient’s voiding patterns to
determine existence and extent of overﬂow incontinence.
Monitor and record patient’s intake and output to determine ﬂuid
Perform: Ask patient to keep a bladder diary of continent and incon-
tinent voids to promote understanding of the extent of the problem
of overﬂow incontinence. Discuss voiding and ﬂuid intake patterns.
Accurate understanding of patient’s pattern provides a baseline for
introducing new activities.
Provide privacy and adequate time to void to decrease anxiety
and promote relaxation of sphincter.
Assist patient to assume usual position for voiding. Some patients
are unable to void while lying in bed and may develop urinary
retention and overﬂow incontinence.
Massage (credé) the bladder area during urination to increase
pressure in the pelvic area to encourage drainage of urine from the
Institute indwelling or intermittent catheterization, as ordered.
Catheterization is used as a last resort to empty the bladder prevent-
ing overﬂow incontinence.
Assist with application of pads and protective garments (used only
as a last resort) to prevent skin breakdown and odor and to
promote social acceptance.
Inform: Teach patient and/or family to catheterize patient with
chronic overﬂow incontinence related to urinary retention using
clean technique to manage long-term overﬂow incontinence.
Teach stress management and relaxation techniques. Stress and
anxiety interfere with sphincter relaxation, causing urinary retention
and overﬂow incontinence.
Attend: Encourage patient to share feelings related to incontinence to
Encourage patient to drink six to eight glasses of noncaffeinated,
nonalcoholic, and noncarbonated liquid, preferably water, per day
(unless contraindicated). 1,500–2000 mL/day promotes optimal renal
function and ﬂushes bacteria and solutes from the urinary tract.
Caffeine and alcohol promote diuresis and may contribute to excess
ﬂuid loss and irritation of the bladder wall.
Encourage patient to respond to the urge to void in a timely man-
ner. Ignoring the urge to urinate may cause incontinence.
Encourage patient to participate in regular exercise, including
walking and modiﬁed sit-ups (unless contraindicated). Weak abdomi-
nal and perineal muscles weaken bladder and sphincter control.
Encourage patient to avoid anticholinergics, opioids, psychotrop-
ics, -adrenergic agonists, -adrenergic agonists, and calcium-
channel blockers (unless contraindicated), which inhibit relaxation of
the urinary sphincter and cause urinary retention.
Manage: Provide referrals for physical therapy or psychological
counseling as necessary to enhance success.
SUGGESTED NIC INTERVENTIONS
Urinary Incontinence Care; Urinary Retention Care
DuBeau, C. (2006). Clinical presentation and diagnosis of urinary
incontinence. Retrieved December 12, 2006, from http://www.uptodate.com