Urge Urinary Incontinence is caused by abnormal bladder contractions. Usually, strong muscles termed as sphincters regulate the flow of urine from the bladder. With urge incontinence, the muscles of an “overactive” bladder contract with enough force to override the sphincter muscles of the urethra, which is the tube that takes urine out of the body. Urge incontinence may develop as a result of spinal cord lesions or following pelvic surgery. Central nervous system disorders such as Alzheimer’s disease, multiple sclerosis, and Parkinson’s disease may contribute to urge incontinence. Overactivity of the detrusor may be the result of interstitial cystitis, urinary tract infection, or pelvic radiation. Extreme alcohol or caffeine consumption may stimulate urge incontinence. The person may have changes in body image and self-concept following the person’s feelings of shame and embarrassment with loss of control of urinary elimination. This alteration may affect a person’s social interaction and work performance.
The following are the comprehensive assessments for Urge Urinary Incontinence:
|Determine the patient’s episodes of incontinence.||Urge incontinence happens when the bladder muscle abruptly contracts. The patient may report feeling the need suddenly to urinate but being unable to get to the bathroom in time.|
|Tell patient to keep a daily diary indicating voiding frequency and patterns.||This information enables the nurse to recognize patterns in voiding. This information will allow for an individualized treatment plan. The patient may be voiding as often as every 2 hours.|
|Take a specimen of urine for culture.||Bladder infection can result in a strong urge to urinate; successful management of a urinary tract infection may reduce or improve incontinence.|
|Observe the results of cystometry.||Diagnostic testing is used to measure bladder pressures and fluid volume during filling, storage, and urination. The results of this test may show the underlying problem leading to urge incontinence.|
The following are the therapeutic nursing interventions for Urge Urinary Incontinence:
|Promote access to toilet facilities, and instruct patient to make scheduled trips to the bathroom.||Scheduled voiding allows for frequent bladder emptying.|
|Give or encourage the use of medications as ordered:
||Anticholinergics lessen or block detrusor contractions, thereby reducing occurrence of incontinence. The tricyclics increase serotonin or norepinephrine, which results in relaxation of the bladder wall and increased bladder capacity.|
|Educate the patient about the effects of extreme alcohol and caffeine intake.||These chemicals are known to be bladder irritants. they can increase detrusor overactivity.|
|Aid the patient with developing a bladder training program that includes voiding at scheduled intervals, gradually increasing the time between voidings.||A bladder training program helps increase bladder capacity through regulation of fluid intake, pelvic exercises, and scheduled voiding. A regular schedule of voiding helps decrease detrusor overactivity and increase bladder fluid volume capacity.|
|Educate patient about Kegel exercises.||Kegel exercises are done to strengthen the muscles of the pelvic floor and can be followed with a minimum of exertion. The repetitious tightening and relaxation of these muscles (10 repetitions four or five times per day) aid some patients regain continence.|
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