Nursing Care Plan for Urinary Incontinence
Urinary incontinence is one of the main complaints in patients with elderly person. As with complaints in a disease is not a diagnosis that is necessary to find the cause. (Brocklehurst et al, 1987)
Urinary incontinence is the elimination of urine from the bladder that is not controlled or occur outside of desire. (Brunner, Sudart. 2002: 1394)
Clinical Manifestations
Urinary incontinence can occur with various manifestations, among others :
- Impaired sphincter function causes the bladder to leak when coughing or sneezing. It could also be caused by abnormalities of the area around the urethra.
- Impaired brain function and result in large bladder contractions.
- Barriers occur with widening of urine bladder, urine in the bladder until a lot of excess capacity.
Along with increasing age, there are some changes in the anatomy and function of the urinary organs, among others : weakened pelvic floor muscles as a result of pregnancy many times, the ability to push the wrong, or chronic cough. This resulted in a person can not hold urine. Besides the contraction (movement) of abnormal bladder wall, so that even if a new bladder filled a little, it raises curiosity urination. Causes of urinary incontinence among others associated with disturbances in the lower urinary tract, the effect of drugs , increased urine production or their impaired ability / desire to toilet. Lower urinary tract disorders can be due to infection. If there is a urinary tract infection, antibiotic therapy is the treatment of. Behavioral therapy should be performed if the patient had undergone prostatectomy. And in case of faecal impaction, it must be eliminated for example with fiber-rich foods, mobility, care adequate fluid, or if necessary the use of laxatives. Urinary incontinence can also occur due to excessive urine production due to various reasons. For example, metabolic disorders, such as diabetes mellitus should still be monitored. Another cause is excessive fluid intake can be alleviated by reducing the intake of fluids that are diuretics like caffeine.
Nursing Diagnosis for Urinary Incontinence : Risk for infection related to incontinence, immobility in a long time.
Goal :
Urination with clear urine without discomfort, urinalysis within normal limits, urine culture showed no bacteria.
Nursing Intervention :
1. Provide perineal care with soapy water every shift. If the patient's incontinence, perineal washing area as soon as possible.
R / : To prevent contamination of the urethra.
2. If in pairs indwelling catheter, catheter care given 2x daily (part of a shower in the morning and at bedtime) and after defecation.
R / : Catheter give way to the bacteria to enter the bladder and into the urinary tract.
3. Follow universal precautions (wash hands before and after direct contact, wear gloves), when in contact with body fluids or blood that occurs (providing care perianal drainse bag emptying urine, urine specimens shelter). Maintain aseptic technique when doing catheterization , when taking a urine sample from indwelling catheters.
R / : To prevent cross-contamination.
4. Unless contraindicated, reposition the patient every 2 hours and encourage the input of at least 2400 ml / day. Help do ambulation as needed.
R / : To prevent urinary stasis.
5. Take action to maintain acidic urine.
Increase input berry juice.
Give medications, to improve the acidic urine.
R / : Acid urine hinder the growth of bacteria. Because the number of berry juice is needed to achieve and maintain the acidity of urine. Increasing fluid intake can affect fruit juice in the treatment of urinary tract infections.
