RISK FOR URGE URINARY INCONTINENCE
At risk for involuntary loss of urine associated with a sudden,
strong sensation or urinary urgency
• Effects of medication, caffeine,
• Detrusor muscle instability
with impaired contractility
• Detrusor hyperreﬂexia from
• Ineffective toileting habits
cystitis, urethritis, tumors,
renal calculi, central nervous
system disorders above
pontine micturation center
• Involuntary sphincter
• Small bladder capacity
ASSESSMENT FOCUS (Refer to comprehensive assessment parameters.)
• Fluid and electrolytes
• Physical regulation
The patient will
• State ability to anticipate if incontinence is likely to occur.
• State understanding of potential causes of urge incontinence and
• Avoid or minimize complications of urge incontinence.
• Discuss potential effects of urologic dysfunction on self and family
• Demonstrate skill in managing incontinence.
• Identify community resources to cope with alterations in urinary
SUGGESTED NOC OUTCOMES
Knowledge: Treatment Regimen; Urinary Continence; Urinary Elimi-
INTERVENTIONS AND RATIONALES
Determine: Observe patient’s voiding pattern, and document intake
and output to ensure correct ﬂuid replacement therapy and provide
information about the patient’s ability to void adequately.
Determine patient’s premorbid elimination status to ensure that inter-
ventions are realistic and based on the patient’s health status and goals.
Assess patient’s ability to sense and communicate elimination
needs to maximize self-care.
Perform: Unless contraindicated, provide 21⁄2 to 3 qt (2.5–3 L) of
ﬂuid daily to moisten mucous membranes and ensure adequate
hydration. Space out ﬂuid intake through the day and limit it to
150 ml after supper to reduce the need to void at night.
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.
Have patient wear easily removed articles of clothing (a gown
instead of pajamas, Velcro fasteners instead of buttons or zippers)
to facilitate the removal of clothing and foster independence.
Have patient keep a diary recording episodes of incontinence to
use as a basis for planning bladder training interventions; interven-
tions may include voiding every 2 hr, avoiding high ﬂuid intake,
maintaining proper hygiene, or notifying a healthcare professional if
urge incontinence occurs frequently. Individualized interventions help
promote self-care, foster motivation, and avoid incontinence.
Incorporate patient’s suggestions for managing incontinent
episodes into a care plan to foster motivation.
Inform: Explain urge incontinence to patient and family members,
especially preventive measures and potential underlying causes, to
Instruct patient to stop and take a deep breath if he or she expe-
riences an intense urge to urinate before he can reach a bathroom.
Anxiety and rushing may increase bladder contraction.
Attend: Encourage patient to express feelings about incontinence to
provide emotional support and identify needed areas for further
Manage: Use an interdisciplinary approach to caring for incontinence.
Incorporate recommendations from a urologist, urology nurse special-
ist, other healthcare providers, and the patient. Monitor progress and
report the patient’s response to interventions. An interdisciplinary
approach helps ensure that the patient receives adequate care. Encour-
aging patient participation on the team will help foster motivation.
Note if patient expresses concern about the effect of incontinence
on sexuality. If appropriate, refer him to a sex therapist to promote
Refer patient and family members to community resources such as
support groups, as appropriate, to help ensure continuity of care.
SUGGESTED NIC INTERVENTIONS
Fluid Monitoring; Urinary Elimination Management; Urinary Habit
Training; Urinary Incontinence Care
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.