Nurse's Pocket Guide

Use condom catheter or other external device if tolerated
during the day and absorptive pads during the night if
external device is not tolerated.
Implement intermittent or continuous catheterization
appropriate to client’s condition (may be short- or longterm).
Refer to NDs functional, stress, urge, reflex, overflow Urinary
Incontinence for related interventions.
Administer medications, as indicated.
• Discuss/prepare for surgical intervention depending on underlying
cause (e.g., to treat urethral hypermobility, to suspend
bladder, repair vaginal walls, remove obstruction, provide artificial
sphinter or bladder reservoir).
NURSING PRIORITY NO.4.To promote wellness (Teaching/Discharge
Considerations):
• Assist client/caregiver to identify regular time for bladder program
to establish a predictable elimination program.
• Suggest use of incontinence pads/adult briefs, as indicated
(e.g., during social contacts), for extra protection and to
enhance confidence.
• Stress importance of pericare after each voiding (using alcoholfree
products) and application of oil-based emollient to protect
the skin from irritation.
• Instruct in proper care of catheter and cleaning technique to
prevent infection.
• Recommend use of silicone catheter when long-term/continuous
placement is indicated after other measures/bladder
training have failed.
• Encourage self-monitoring of catheter patency and avoidance
of reflux of urine. Reduces risk of infection.
• Suggest intake of acidifying juices to discourage bacterial
growth/reduce incidence of infection.
Documentation Focus
ASSESSMENT/REASSESSMENT
• Current elimination pattern.
• Assessment findings including effect on lifestyle and selfesteem.
PLANNING
• Plan of care/interventions, including who is involved in planning.
• Teaching plan.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
Diagnostic Studies Pediatric/Geriatric/Lifespan Medications 747
total URINARY INCONTINENCE