Nursing Care Plan and Nursing Diagnosis for Impaired Urinary
Page Contents
Elimination
Impaired urinary elimination is a term that refers to urinary elimination dysfunction. It is defined as an alteration in the pattern of urine elimination. Although impaired urinary elimination is an overly broad diagnosis for effective clinical use, it is clinically useful when sufficient data is obtained.
With additional data, a nurse can view and, if possible, diagnose a specific condition such as stress urinary incontinence. In general, a nurse can write an impaired urinary elimination associated with an unknown aetiology when the aetiology of incontinence is unknown.
The documents that comprise the impaired urinary elimination care plan detail the process of identifying, assessing, treating, diagnosing, and monitoring the impaired urinary elimination. Whether you are a student or a practicing nurse who requires help writing an impaired urinary elimination care plan, it may be prudent to seek quality nursing care plans with consistent follow-up guidelines.
Types of Urinary Incontinence
- Impaired Urinary Elimination: This term refers to urinary elimination dysfunction.
- Functional Urinary Incontinence: A typically affluent individual cannot reach the toilet in time to avoid unintentional urine loss.
- Stress Urinary Incontinence: Affects individuals who engage in activities that increase intra-abdominal pressure.
- Reflex Urinary Incontinence: Refers to the involuntary loss of urine at predictable intervals after reaching a certain bladder volume.
- Urge Urinary Incontinence: The involuntary passage of urine that occurs immediately following a strong sense of urgency to avoid.
Factors Related to Impaired Urinary Elimination
Several factors that are strongly associated with impaired urinary elimination include the following:
- Bladder outlet obstruction
- Bladder atony
- Diminished bladder cues
- Decreased bladder capacity
- Disruption in bladder innervation
- Environmental barriers
- Multiple causalities
- Small bladder
- Sensory-motor impairment
- Incompetent bladder
- Impaired Urinary Elimination Care Plan Diagnosis
A comprehensive care plan should include instructions on how to detect the presence of impaired urinary elimination. One or more of these signs and symptoms indicate impaired urinary elimination.
- Bladder distention
- Enuresis
- Frequency
- Nocturia
- Dribbling
- Incontinence
- Hesitancy
- Dysuria
- Retention of urine (large residual volumes)
- Urgency to urinate
Impaired Urinary Elimination Care Plan Goals and Outcomes
A nurse will create a care plan tailored to the unique needs of patients with impaired urinary elimination. Their care plan should direct them toward the following objectives and outcomes. The patient should:
- Urinate frequently and without retention
- Urinate freely and without dilating the bladder
- Determine the source of incontinence
- Achieve a urine residue volume of less than 50ml without overflowing
- Comprehend the situation
- Maintain clear, odorless urine
- Develop techniques and behaviors to prevent urine retention/urinary infection
- Prevents or eliminates urine leakage
Nursing Care Plan for Impaired Urinary Elimination
When developing a care plan, it is critical to first assess the patient to ascertain whether the impaired urinary elimination results from chronic neural, genitourinary, or acute conditions. However, a nurse or caregiver can glean information about the underlying cause from these assessments.
- Urine frequency and amount (voiding pattern) assessment: By comparing the patient’s fluid intake and urine output, the nurse should determine the effectiveness of the renal bladder’s emptying and fluid balance functions.
- Take note of reports of incontinence, burning, urgency, nocturia, the size of the stream, and urinary frequency force: The nurse can determine the degree to which these factors are interfering with urine removal by making these observations. After a void, fullness over the bladder indicates retention or inadequacy to eliminate, indicating a bladder infection that requires intervention.
- Drug prescription review: Certain medications, such as OTC antispasmodics, narcotic analgesics, antidepressants, and recreational drugs such as cannabis, may impair bladder emptying.
- Determine the availability and nature of toileting facilities: Some patients may require a bedside commode if their mobility is restricted.
- Determine the patient’s typical urination pattern and frequency of incontinence: Most patients are incontinent only in the early morning hours when the bladder frequently stores a large volume of urine during sleep.
Nursing Interventions for Impaired Urinary Elimination
The following nursing interventions are therapeutic for impaired urinary elimination:
- When appropriate, bladder retraining according to the protocol: The timing and nature of the bladder program are determined by the type of injury – upper or lower neuron involvement.
- Promote adequate fluid intake – 2–4 liters per day: Adequate body hydration increases urinary output and aids in infection prevention. If the patient is taking sulfa medications, adequate fluids are required to ensure adequate drug excretion while minimizing the risk of cumulative effects.
- Look for cloudy or bloody urine and a foul odor: Multistrip dipsticks can quickly determine the pH, nitrate, and leukocyte esterase levels, all of which indicate the presence of infection.
- Cleanse and dry the perineal area: Good perineal hygiene reduces the risk of skin irritation or breakdown and the development of ascending infection.
- Advise patients to practice proper handwashing and perineal care: Proper handwashing and perineal care help prevent skin irritation and the risk of ascending infection.
- Refer to a urinary continence specialist as necessary: Collaborating with specialists enables the development of an individualized plan of care tailored to the patient’s unique needs using the most advanced techniques and continence products.
- Catheterization may be necessary for evaluation or treatment when a patient retains urine or cannot empty the bladder.
- Continued mobility is encouraged.
- Teach Kegel exercises: These exercises strengthen the pelvic floor muscles and sphincter of the ureterovesical junction.
- Initially, deflate the bladder with an indwelling catheter: During the acute phase, an indwelling catheter is used to prevent urinary retention and monitor output. Intermittent catheterization may be used to avoid complications frequently associated with prolonged indwelling catheter use.
A nurse or caregiver caring for a patient who consumes caffeine or alcohol should inform the patient about the risks associated with these substances contributing to excessive activity and triggering bladder irritation.
Impaired Urinary Elimination Nursing Diagnosis Writing Help Services
Developing a concise nursing care plan for impaired urinary elimination can be difficult for students and professional nurses on duty. As a result, nurses and caregivers frequently seek help with Impaired Urinary Elimination interventions writing. If you require help with care plan writing, we are here to help you create unique, structural, and well-detailed documents that will guide you in assessing and treating patients.
