Urinary incontinence care (NIC 0610)

Set of activities performed by the nurse aimed at promoting urinary continence and maintaining the integrity of the perineal skin.

Objectives:

– Implement health education program to reduce urinary incontinence. – Maintain the integrity of the skin in the perineal region. – Raise awareness of the patient and family that incontinence is not a disease but a health problem. – Promote the physical and psychological well-being of the patient.

Equipment:

– Wedge or basin. – Towels

Material:

– Disposable incontinence pads. – Non-sterile gauze. – Swabs. – Diaper-braga. – Non-sterile gloves. – Dirty linen bag. – Sponge. – Neutral soap. – Soap and antiseptic solution. – Nursing records.

Procedure:

– Take urinary history and other related health events: urinary history, duration of urinary incontinence, severity, number of leaks, nocturia, frequency of daytime incontinence, presence of urinary tract infection, previous treatments, surgery (evidence I and III). – Provide privacy for voiding. – Explain to the patient the etiology of the problem and the basis of the care to be provided. – Periodically monitor urinary elimination, including frequency, consistency, odor, volume and color. – Modify clothing to facilitate access to the toilet. – Assist in selecting disposable incontinence pads for short-term management. – Provide protective clothing. – Clean genital dermal area at regular intervals. – Show a positive response to any decrease in incontinence episodes. (Grade of recommendation C). – Limit fluids for 2-3 hours before bedtime. – Teach the patient to record urinary output and pattern. – Limit intake of bladder irritants (colas, coffee, tea and chocolate).

Carry out a urinary bladder training program (Recommendation grade A):

1. Determine the ability to recognize the urge to void. 2. Maintain a continence specification record for 3 days to establish elimination schedule. 3. Establish an initial time interval for toileting based on the elimination schedule. This technique is referred to as timed voiding (Grade of recommendation C). The toilet interval should be: – Leaks > 1 hour interval should be scheduled for hourly voiding. – Leaks < 1 hour, voiding every 30 minutes. 4. Provide privacy. 5. Take the patient to the toilet if necessary. 6. Decrease toileting interval by 30 minutes if more than 3 episodes of incontinence occur in 24 hours. 7. Increase the toilet interval by one hour if the patient has no incontinence episodes for 3 days. 8. Perform Kegel exercises. – Explain the double voiding technique to the patient, which consists of keeping the patient standing after voiding if the patient is male and sitting if the patient is female in order to encourage him/her to try to void again after voiding.

– Record in the nursing documentation the care performed, reason, date and time, incidents, and patient’s response.[/et_pb_text][/et_pb_column][/et_pb_row][/et_pb_section]