This nursing care plan is designed for patients who have urinary retention. Urinary retention can occur for a variety of reasons. Some of these reasons include naming a few, strictures, prostate enlargement, adverse drug events, diabetic neuropathy, and ureterocele.
Patients with urinary retention are unable to empty their bladders of urine. Patients frequently tell nurses that they feel there is still urine in their bladder and that they need to urinate even though they have already done so. Urinary retention makes the patient feel uneasy. Some patients are ashamed of this and may not discuss it with the nurse. The nurse must evaluate patients’ urinary habits and ensure they empty their bladders.
What is impaired urinary elimination?
Impaired urinary elimination refers to urinary elimination dysfunction. It is defined as a disruption in the sequence of urine elimination. Impaired urinary elimination is too broad a diagnosis for efficient medical use, but it can be clinically helpful when enough data is collected.
With more data, a nurse can view and determine a specific diagnosis, such as stress urinary incontinence. When the factors contributing to incontinence have yet to be identified, a midwife can write an impaired urinary elimination connected to an unknown etiology.
The documents containing the impaired urinary elimination care plan detail the identification, assessment, treatment, diagnosis, and monitoring of the impaired urinary elimination. Suppose you are a student or a professional nurse needing impaired urinary elimination care plan writing assistance. In that case, you should look for high-quality nursing care plans with coherent follow-up guidelines.
Nursing care plan for impaired urinary elimination
This nursing care plan for urinary tract infections focuses on nursing actions to relieve pain and discomfort, increase client knowledge of prevention methods and treatment regimens, and manage possible problems. Here are four nursing care plans and nursing diagnosis and treatment for urinary tract infection patients (UTI):
- Severe Pain
- Urinary Elimination Impairment
- Hyperthermia
- Lack of Knowledge
- Alternative nursing care plans
Impaired urinary elimination care plan
Urinary retention is when a person cannot empty their bladder of urine. It can be an acute, sudden change or a chronic condition in which the personalized experience loses the ability to empty the bladder fully over time.
Signs and symptoms
The signs and symptoms of urinary incontinence can differ depending on whether the urinary retention is acute or chronic. Both types’ signs and symptoms are listed below.
Urinary retention acute
- Urinary incontinence
- Lower abdominal discomfort (usually severe)
- scanty urination
- Lower abdominal swelling
Chronic urinary retention
- Inability to deserted the bladder while urinating
- Frequent, small quantities of urination
- Reticence (difficulty initiating urination)
- Slow urine stream
- Urge to urinate with very little success
- Need to urinate immediately after urinating
It’s also worth noting that some people with chronic urinary retention don’t show any signs or symptoms.
Causes
Urinary retention could be caused by a variety of factors, including:
- Urethral blockage or narrowing
- Medications (e.g., antihistamines, opiates, antispasmodics)
- Nerve diseases/conditions (e.g., stroke, diabetes, multiple sclerosis, spine or pelvic trauma)
- Infections
- Surgery
- Weakening bladder muscles
Complications
Urinary retention, if left untreated, can lead to other health problems for the individual. Among the possible complications are the following:
- Increased risk of urinary infections
- Bladder damage is caused by stretching the bladder too far or for much too long periods
- Renal damage
- Urinary incontinence
Expected results
- A patient will be able to nullify sufficient amounts of urine
- The patient will be free of any perceptible bladder distention
- The patient will be independent of any post-void royalties greater than 100mL.
- The patient will be free of any abdominal discomfort caused by urinary retention.
Pathophysiology
The balance of urethral closure and detrusor muscular activity is required for continence and micturition. When urethral pressure exceeds bladder pressure, urine remains in the bladder. The pelvis contains both the anterior urethra and the bladder. Increases in intraabdominal pressure (due to coughing and sneezing) are equally transmitted to the urethra and bladder, leaving the differential pressure unchanged and resulting in continence. Changes in both pressure factors cause normal voiding: urethral pressure falls and bladder powerful force.
Impaired urinary elimination nursing diagnosis
Nursing diagnosis of impaired urinary elimination must be referred to a urologist specializing in this area. Urologists are experts in the urinary tract, and some are also experts in the female urinary tract. A urogynecologist is a gynecologist who specializes in female urological problems. Family doctors and internists see patients for various reasons and are well-educated to identify and treat this common problem. If necessary, these primary healthcare specialists can make referrals to urology specialists.
A thorough history is required, particularly in nullifying urine leakage, indicating the type of incontinence encountered. Other considerations include strain, discomfort, drug use, labrum surgery, and illness. The physical exam will look for signs of medical conditions that cause incontinence, such as tumors that block the urethra, stool obstruction, and poor reflexes or senses, which may indicate a nerve-related cause.
The measurement of bladder ability and residual urine for proof of poorly fully operational bladder muscles is a standard test. Other tests include:
- The patient helps to relax, then wheezes vigorously while the doctor monitors for urine loss.
- Urinalysis – urine is tested for symptoms of infection, urinary stones, or other factors.
- Blood tests – blood is drawn, sent to a research lab, and analyzed for substances linked to incontinence causes.
- Ultrasound – using sound waves to envision the kidneys, ureters, urethra, and urethra.
- Cystoscopy entails inserting a thin tube containing a tiny camera into the urethra and viewing the inside of the bladder and urethra.
- Urodynamics – various techniques for measuring bladder pressure and urine flow.
Patients are frequently ordered to keep a diary daily or more, up to a week, to record their voiding pattern, noting times and amounts of urine produced.
Types of urinary incontinence
- Decreased urine output: This term refers to urinary elimination dysfunction.
- Functional Urinary Incontinence: A person’s inability to achieve the toilet in time to avoid unintended urine loss.
- Stress Urinary Incontinence: Acute leakage of urine caused by activities that raise intra-abdominal pressure.
- Reflex Urinary Incontinence: This term refers to the unconscious loss of urine at regular intervals when a specific bladder volume is reached.
- Urge Urinary Incontinence: The unconscious passage of urine that occurs immediately after a powerful sense of urgency to avoid.
Risk factors of nursing care plan for impaired urinary elimination
Some of the variables that are closely linked to impaired urinary eradication are as follows:
- Bladder outlet obstruction
- Bladder atony
- Diminished bladder cues
- Decreased bladder capacity
- Disruption in urethra innervation
- Environmental barriers
A suitable care plan should include instructions on how to detect the existence of impaired urinary elimination. Even one of these signs and symptoms indicates impaired urinary elimination.
- Bladder distention
- Enuresis
- Frequency
- Nocturia
- Dribble
Goals and outcomes of the impaired urinary elimination care plan
A nurse will create a care plan tailored to patients with impaired urinary elimination. The care plan should direct them toward the following objectives and outcomes. The patient should:
- Urinate without retaining
- Urinate smoothly and without bladder distention
- Identify the cause of incontinence
- Maintain urine residues of less than 50ml without overflow
- Understand the condition
- Maintain clear urine without odor
- Develop techniques and behavior to prevent urine retention/urinary infection
Impaired urinary elimination care plan assessment
The patient assessment must be prioritized when developing a care plan to determine whether the impaired urinary elimination is due to chronic neural, genitourinary, or acute conditions. These assessments, however, can provide a nurse or caregiver with information about the underlying cause.
· Evaluating urine frequency and amount (voiding pattern)
The nurse should be able to positively determine the efficiency of the renal bladder function of discharging and fluid balance by comparing the patient’s fluid intake and urine output.
· Take note of reports of incontinence, burning, urgency, nocturia, stream size, and urinary frequency force
By making these observations, the nurse can determine the degree of interference with urine removal. Fullness over the bladder following a void suggests retention or lack of adequate to eliminate, indicating a bladder infection that requires treatment.
· Examine the drug prescription
Some over-the-counter medications, anti-inflammatories, narcotic analgesics, antidepressants, and drugs, such as cannabis, may affect your bladder emptying.
Impaired urinary elimination interventions
Treatment plans for impaired urinary elimination include:
- When necessary, bladder retraining according to the protocol
The type and timing of the bladder program are determined by the type of injury – either upper or lower neuron participation.
- Encourage appropriate hydration intake (2 – 4 liters per day)
Adequate body hydration promotes urinary output and aids in infection prevention. If the patient takes sulfa drugs, sufficient fluids are required to ensure the proper drug excretion while lowering the likelihood of cumulative impact.
- Look for cloudy or bloody urine and a foul odor
Multistrip dipsticks can quickly determine pH, nitrate, and monocyte esterase levels, indicating the presence of infection.
- Cleanse and dry the perineal area
Perineal hygiene reduces the likelihood of skin irritation or breakdown and the development of harmful bacteria.
A nurse or caregiver caring for a patient who drinks caffeine or alcohol should inform patients about the risks of these drugs in increasing overactivity and causing bladder irritation.
Bottom line
It may be difficult for students or professional nurses to develop a clear care plan for impaired urinary elimination. Nurses and caregivers frequently seek impaired urinary elimination care plan writing assistance. If you require care plan writing assistance, we are here to assist you in creating unique, structural, and well-detailed files to guide you in evaluating and treating patients.
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