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Urinary incontinence is the involuntary loss of urine. Although abnormal, it is a common symptom that can seriously affect the physical, psychological, and social well-being of affected individuals of all ages. It has been estimated that 1 in 5 women develop urinary incontinence, but many are too embarrassed to discuss the condition with their health care providers. Some believe it’s a normal part of aging that they have to live with. The result can be isolation and depression when they limit their activities and social interactions because of embarrassment due to incontinence. Nurses can greatly improve the quality of life for these patients by assessing for incontinence in a sensitive manner and then providing patient education about methods to prevent and/or manage incontinence. Types of Urinary IncontinenceContinence is achieved through an interplay of the physiology of the bladder, urethra, sphincter, pelvic floor, and the nervous system coordinating these organs.[1] A disruption in any of these areas can cause several types of urinary incontinence.
It is important to understand the types of incontinence so that appropriate interventions can be targeted to the cause. Assessment of IncontinenceAssessment begins with screening questions during a health history, including questions such as, “Do you have any problems with the leakage or dribbling of urine? Do you ever have problems making it to the bathroom in time?” If a patient responds “Yes” to either of these questions, it is helpful to encourage them to start a voiding diary to record their urination habits and activities. The voiding diary should include the following:
The provider will review information from the voiding diary, perform a physical assessment, and likely order diagnostic testing, such as a urine dip to check for a urinary tract infection, and urodynamic diagnostic testing that includes a variety of tests about bladder function, including filling, urine storage, and emptying.[7] Individualized treatment will be based on the assessment and tests to assess any structural abnormalities and bladder function. InterventionsNurses should use therapeutic communication with patients experiencing urinary incontinence to help them feel comfortable in expressing their fears, worries, and embarrassment about incontinence and work toward improving their quality of life. Let them know they’re not alone and that urinary incontinence is not something they have to live with. Provide education about pelvic floor muscle training exercises, timed voiding, lifestyle modification, and incontinence products. Encourage them to learn more about their condition so they can optimally manage it and improve their quality of life.[8] Nurses play an important role in educating patients about bladder control training to prevent incontinence. Bladder control training includes several these techniques:
Teaching Pelvic Floor Exercises Kegel exercises are designed to make your pelvic floor muscles stronger. Your pelvic floor muscles hold up your bladder and prevent it from leaking urine.
View a YouTube video about Kegel Exercises[12] from Michigan Medicine. Patient education regarding other treatment options may be provided:
What is the nursing intervention for urinary incontinence?The most frequently used nursing interventions provided were counselling related to fluid and caffeine intake, pelvic muscle exercises (for stress incontinence and to suppress urinary urgency) and bladder training, using regular timed voiding. Over 90% of treatment subjects received all of these interventions.
What interventions can be done to help patients with incontinence?Options may include:. increased fluid intake of up to two litres a day.. high-fibre diet.. pelvic floor exercises.. bladder training.. training in good toilet habits.. medications, such as a short-term course of laxatives to treat constipation.. aids such as incontinence pads.. Which is the most appropriate interventions for a client experiencing urinary incontinence?Losing weight, drinking less caffeine (found in coffee, tea, and many sodas), preventing constipation, and avoiding lifting heavy objects may help with incontinence. Limiting fluid intake before bedtime and scheduling prescribed diuretic medication in the morning or early afternoon are also helpful.
What is transient urinary incontinence?Transient incontinence is urine leakage that is caused by a temporary (transient) situation such as an infection or new medicine. Once the cause is removed, the incontinence goes away. Bedwetting refers to urine leakage during sleep. This is most common in children, but adults can also have it.
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