Impaired urinary elimination

Nursing Diagnosis Definition

The nursing diagnosis for impaired urinary elimination is defined as "difficulty or inability to empty the bladder completely." This diagnosis is relevant when a patient faces challenges in initiating or maintaining urine flow, leading to incomplete bladder emptying.

Defining Characteristics

Subjective

• Patient reports difficulty initiating or maintaining a urine flow: Subjective complaint indicating challenges in starting or sustaining urine elimination.
• Patient reports feeling of incomplete bladder emptying: Subjective observation of not being able to completely empty the bladder.
• Patient reports frequent urination: Subjective indication of more frequent than normal urination.
• Patient reports urgency or incontinence: Subjective complaints of a sudden need to urinate or involuntary urination.

Objective

• Patient has difficulty initiating or maintaining a urine flow as per examination and testing (such as urodynamic testing): Objective assessment confirming challenges in starting or sustaining urine elimination.
• Patient has feeling of incomplete bladder emptying as per examination and patient report: Objective assessment and patient confirmation of not fully emptying the bladder.
• Patient has frequent urination as per standards of normal urinary frequency: Objective measurement indicating urinary frequency outside the normal range.
• Patient has urgency or incontinence as per examination and patient report: Objective assessment and patient confirmation of a sudden urge to urinate or involuntary urination.

Related Factors

• Medical conditions (such as urinary tract infections, urinary incontinence, and prostate conditions): Underlying health issues affecting urinary elimination.
• Medications (such as diuretics, anticholinergics, and opioids): Pharmaceutical agents influencing urine production and bladder function.
• Obstruction (such as urinary tract stones or tumors): Physical blockages hindering normal urine flow.
• Neurological conditions (such as spinal cord injury, Parkinson's disease, and multiple sclerosis): Disorders affecting nerve signals involved in bladder control.
• Aging (as the muscles and nerves that control the bladder may become weaker over time): Age-related changes impacting bladder function.
• Surgeries (such as prostate or bladder surgery): Surgical procedures affecting the urinary system.
• Lifestyle factors (such as poor hydration, poor nutrition, and lack of physical activity): Personal habits and choices influencing urinary health.

Risk Population

• Individuals at risk for impaired urinary elimination include the elderly, those with certain medical conditions, those taking certain medications, and those who have decreased mobility or a history of pelvic surgery. Additionally, lifestyle factors such as poor hydration and nutrition may contribute to the risk.

Associated Problems

• Urinary tract infections: Infections affecting the urinary system.
• Urinary incontinence: Involuntary loss of urine.
• Bladder or kidney damage: Structural damage to the bladder or kidneys due to impaired urinary elimination.
• Skin irritation or breakdown from incontinence: Skin problems resulting from prolonged contact with urine.
• Social isolation or embarrassment: Emotional and social consequences of urinary issues.

Suggestions for Use

• Assess the patient's current urinary elimination patterns and any related symptoms: Conduct a thorough evaluation of the patient's urinary habits and associated symptoms.
• Identify any potential contributing factors, such as medications, medical conditions, and lifestyle habits: Investigate underlying causes that may be contributing to impaired urinary elimination.
• Implement interventions to improve urinary elimination, such as providing education on proper hydration, diet, and physical activity, and administering medications as prescribed: Take actions to enhance urinary function, including patient education and medication management.
• Monitor the patient's response to interventions and adjust as needed: Continuously evaluate the effectiveness of interventions and make necessary modifications.
• Consider referral to a healthcare provider for further evaluation and management if necessary: Involve healthcare professionals for additional assessment and intervention as required.

Suggested Alternative Diagnoses

• Urinary incontinence: Involuntary loss of urine.
• Impaired skin integrity: Compromised skin condition due to various factors, including incontinence.
• Ineffective health maintenance: Challenges in maintaining optimal health, including urinary function.

Usage Tips

• Be aware of the patient's current urinary elimination patterns and any related symptoms: Stay informed about the patient's urinary habits and associated signs and symptoms.
• Identify and address any potential contributing factors, such as medications, medical conditions, and lifestyle habits: Investigate and manage factors that may be influencing impaired urinary elimination.
• Implement interventions to improve urinary elimination, such as providing education on proper hydration, diet, and physical activity, and administering medications as prescribed: Apply strategies to enhance urinary function, including patient education and medication management.
• Monitor the patient's response to interventions and adjust as needed: Continuously assess the effectiveness of interventions and make necessary adjustments.
• Consider referral to a healthcare provider for further evaluation and management if necessary: Involve healthcare professionals for additional assessment and intervention as required.
• Provide education on bladder retraining and pelvic muscle exercises if appropriate: Offer guidance on techniques to improve bladder control and muscle function.
• Consider use of assistive devices such as catheters or urine collection bags if necessary: Explore the potential use of devices to assist with urinary elimination as needed.
• Encourage the patient to communicate any concerns or difficulties with urinary elimination: Promote open communication to address and manage any challenges the patient may be facing.

NOC Results

• Urinary Elimination: Continuous monitoring of the patient's ability to initiate and maintain a urine flow and empty the bladder completely will be performed, with interventions implemented to improve urinary elimination.
• Infection Control: The patient's risk of urinary tract infection will be monitored, and interventions will be implemented to prevent infection.
• Comfort: The patient's comfort will be monitored, and interventions will be implemented to alleviate any discomfort related to impaired urinary elimination.
• Skin Integrity: The patient's skin integrity will be monitored, and interventions will be implemented to prevent skin impairment related to incontinence.

NIC Interventions

• Bladder Retraining: Interventions will be implemented to teach the patient techniques for improving bladder control, such as timed voiding and pelvic muscle exercises.
• Medication Management: Interventions will be implemented to manage any medications that may contribute to impaired urinary elimination, such as adjusting dosages or switching to alternative medications as prescribed.
• Assistive Device Use: Interventions will be implemented to use assistive devices such as catheters or urine collection bags as needed.
• Infection Control Measures: Interventions will be implemented to prevent urinary tract infections, such as proper hygiene and catheter care.
• Comfort Measures: Interventions will be implemented to alleviate any discomfort related to impaired urinary elimination, such as heat therapy or pain medication as prescribed.
• Patient Education: The patient will be provided with education on proper hydration, diet, physical activity, and bladder retraining techniques to improve urinary elimination.