Reflex Urinary Incontinence, Nursing Assessment for Reflex Urinary Incontinence, Nursing Interventions for Reflex Urinary Incontinence, Treatment Options for Reflex Urinary Incontinence, and 5 Nursing Diagnoses & Care Plan Examples for Reflex Urinary Incontinence.

Reflex Urinary Incontinence, Nursing Assessment for Reflex Urinary Incontinence, Nursing Interventions for Reflex Urinary Incontinence, Treatment Options for Reflex Urinary Incontinence, and 5 Nursing Diagnosis & Care Plan Examples for Reflex Urinary Incontinence.

This study guide is about reflex urinary incontinence, nursing assessment for reflex urinary incontinence, nursing interventions for reflex urinary incontinence, treatment options for reflex urinary incontinence, and 5 nursing diagnoses & care plan examples for reflex urinary incontinence. Use it to develop educational nursing care plans for reflex urinary incontinence.

Reflex Urinary Incontinence

What is reflex urinary incontinence?

Reflex Urinary Incontinence, Nursing Assessment for Reflex Urinary Incontinence, Nursing Interventions for Reflex Urinary Incontinence, Treatment Options for Reflex Urinary Incontinence, and 5 Nursing Diagnoses & Care Plan Examples for Reflex Urinary Incontinence.
Reflex Urinary Incontinence

Urinary incontinence is the involuntary loss of urine as a result of problems controlling the bladder. Reflex Urinary Incontinence involves dysfunction of the normal neurological control mechanisms for coordination of detrusor contraction and sphincter relaxation. This is most often caused by a problem in the central nervous system.

What are the causes of reflex urinary incontinence?

Reflex incontinence can occur as a result of:

  • Stroke.
  • Parkinson’s disease.
  • Brain tumors.
  • Spinal cord injuries.
  • Multiple sclerosis.

The patient with reflex incontinence experiences periodic urination without an awareness of needing to void. Urination is constant throughout the day and night. Urine volume is consistent with each voiding. Residual urine volumes are usually less than 50 mL. Urodynamic studies will indicate detrusor contraction when bladder volume reaches a particular amount.

What are the risk factors for reflex urinary incontinence?

Factors that increase your risk of developing reflex urinary incontinence include:

  • Age. As you get older, the muscles in your bladder and urethra lose some of their strength. Changes with age reduce how much your bladder can hold and increase the chances of involuntary urine release.
  • Being overweight. Extra weight increases pressure on your bladder and surrounding muscles, which weakens them and allows urine to leak out when you cough or sneeze.
  • Smoking. Tobacco use may increase your risk of urinary incontinence.
  • Family history. If a close family member has urinary incontinence, especially urge incontinence, your risk of developing the condition is higher.
  • Some diseases. Neurological disease or diabetes may increase your risk of incontinence.

Nursing Assessment for Reflex Urinary Incontinence

How do you access whether a patient has reflex urinary incontinence?

Reflex Urinary Incontinence, Nursing Assessment for Reflex Urinary Incontinence, Nursing Interventions for Reflex Urinary Incontinence, Treatment Options for Reflex Urinary Incontinence, and 5 Nursing Diagnoses & Care Plan Examples for Reflex Urinary Incontinence.
Nursing Assessment for Reflex Urinary Incontinence

The following are the comprehensive assessments for Reflex Urinary Incontinence:

Assessment Rationales
Ascertain the patient’s recognition of the need to urinate. Patients with neurological impairments may have damaged sensory fibers, and may not have the sensation of the need to void.
Measure and record urine volume with each voiding. Urine volumes are usually consistent with reflex incontinence.
Review the results of urodynamic studies. A cystometrogram will measure bladder pressures and fluid volumes during filling, storage, and urination. Electromyography will record detrusor activity during voiding. Test results will indicate the point of coordination between detrusor muscle and sphincter activity.
Allow the patient to maintain a “bladder diary.” Data about fluid intake and voiding patterns provide a basis for planning bladder management techniques.

Nursing Interventions for Reflex Urinary Incontinence

What are the interventions for reflex urinary incontinence?

The following are the therapeutic nursing interventions for Reflex Urinary Incontinence:

Interventions Rationales
Tell the patient to limit fluid intake 2 to 3 hours prior to bedtime and to void just before going to bed. Restricting fluid intake and voiding before going to bed reduces the need to interrupt sleep for voiding.
Allow voiding at scheduled intervals before predictable urination. Voiding at regular intervals, based on knowledge of the patient’s voiding pattern, lowers the possibility of uncontrolled incontinence.
For the male patient, acknowledge the application of an external catheter. An external catheter attached to a gravity drainage device enables the patient to remain dry.
If spontaneous voiding is not possible, catheterize the patient at regular intervals. Emptying the bladder at regular intervals will reduce incontinence episodes. The risk for infection is noteworthy with indwelling catheters.
Explain the importance of absorbent pads in social situations. Absorbent pads will preserve clothing when the patient is in public. The patient needs to learn about replacing the pads at regular intervals to prevent skin irritation from exposure to urine and moisture.
Demonstrate to patient or caregiver intermittent catheterization. This method drains the bladder at particular periods.
Work with the patient and family to establish a reasonable, manageable voiding program. Participation in the plan of care promotes additional knowledge and appropriate management.

Treatment Options for Reflex Urinary Incontinence

What are the treatment options for a patient suffering from reflex urinary incontinence?

Reflex Urinary Incontinence, Nursing Assessment for Reflex Urinary Incontinence, Nursing Interventions for Reflex Urinary Incontinence, Treatment Options for Reflex Urinary Incontinence, and 5 Nursing Diagnoses & Care Plan Examples for Reflex Urinary Incontinence.
Treatment Options for Reflex Urinary Incontinence

If you suffer from reflex urinary incontinence, there are a number of urinary treatment options available today that can help you return to a normal lifestyle. Depending on the cause of your incontinence, there are surgery and drug options available, but there are also non-invasive treatments and lifestyle changes that are proven to work just as effectively. It’s typical to see that a combination of treatments may be needed to fully treat your bladder incontinence.

The urinary incontinence doctors with the Incontinence Institute offer a variety of treatment options designed to help you start living a better life.

  • Botox
    Injected into the bladder muscle by a specialized instrument called a cystoscope. The procedure takes 15 minutes or less and can be done under general anesthesia, or on an outpatient basis so you don’t have to be admitted to a hospital.
  • Sacral Nerve Stimulation
    Sacral nerve stimulation (SNS) or sacral neuromodulation (SNM) devices work by helping the brain communicate normally with the bladder or bowel to prevent certain types of incontinence. Designed to help you improve bladder and/or bowel control, a small device is implanted using a minimally invasive procedure that typically lasts about one hour.
  • Medication
    Medication for urinary incontinence treatment can include oral medications, patches, or creams. Common medications that a doctor will prescribe include Anticholinergics, Estrogen, Imipramine, and Desmopressin.
  • Physical Therapy & Biofeedback
    Generally used alongside other treatment options, physical therapy is a painless treatment method that can help strengthen weak muscles and damaged nerves that are causing incontinence. Biofeedback, also a painless treatment method, allows you to receive on-the-spot feedback about a specific function in your body. Biofeedback is often used if you have pelvic floor muscle dysfunction, urgency or frequent urination, difficulty emptying the bladder, or pelvic pain.
  • Urethral Sling
    Typically used to treat stress incontinence, bladder slings/urethral slings treat urinary incontinence in both men and women. Urethral sling surgeries are designed to treat urinary incontinence by placing a sling around the urethra to lift it back into a normal position and to apply pressure on the urethra to assist with urine retention.

5 Nursing Diagnoses & Care Plan Examples for Reflex Urinary Incontinence

What are some of the available nursing care plans for reflex urinary incontinence?

Nursing Care Plan 1

Stroke

Nursing Diagnosis: Reflex Urinary Incontinence related to loss of bladder control secondary to stroke as evidenced by leakage of urine and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

Intervention Rationale
Advise the patient to only consume fluids 2 to 3 hours before going to bed and mainly urinate before getting some sleep. Having a limited fluid intake before bedtime reduces the need to disturb a patient’s sleep to urinate. It also reduces the chances of accidentally urinating while one is in bed.
Set a toileting schedule with the patient in intervals that will be doable to allow predictable urination. If a patient has a toileting schedule designed with their usual urinating pattern as the baseline, he/she will have reduced chances of having uncontrollable urination.
If the patient has a pad or diaper, check for the need to change on a regular basis (for example, every 2 hours during the day and every 4 hours during night time). To ensure that the patient maintains good hygiene and to prevent skin breakdown.
If the set toileting schedule is not feasible for the patient, catheterizing the patient at regular intervals can also be an alternative method. Having the patient’s bladder on a scheduled basis through catheters can also be done to reduce the episodes of one’s incontinence. However, it is worth noting that there are some risks for infections with indwelling catheters.

Nursing Care Plan 2

Parkinson’s Disease

Nursing Diagnosis: Reflex Urinary Incontinence related to loss of bladder control secondary to Parkinson’s’ disease as evidenced by leakage of urine, sudden urges to urinate, and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

Intervention Rationale
Absorbent pads can be a good measure in helping the patient with Parkinson’s disease Absorbent pads can be very helpful for a patient with Parkinson’s disease. They would need to learn about pad replacement at set intervals to prevent irritating the skin from exposure to moisture and urine.
Demonstrate to the patient or their caregiver on how to perform intermittent catheterization as indicated by the physician. Intermittent catheterization is a method that could help drain the bladder at specific periods.
Try to work with the patient and their families to create a feasible and manageable voiding or urinating program. This helps the patient manage their condition and helps the people surrounding them understand what they are suffering from. Coordinating with their families can promote and add substantial knowledge that could enable them to help the patient in their reasonable ways.
Create a toileting schedule for the patient. A toileting schedule can help reduce a patient’s sudden urge to urinate as it has already been allocated and designated a specific time to do so, thus lessening incontinence episodes.
Explain in thorough but understandable detail the necessity for void and toilet schedules and the need to follow them strictly and accordingly. Consistency and discipline are some of the prime requirements in achieving the ultimate goal of toilet schedules. To achieve these, the nurse must explain the rationale and reasoning behind a toileting schedule to understand why it has been followed.

Nursing Care Plan 3

Multiple Sclerosis

Nursing Diagnosis: Reflex Urinary Incontinence related to loss of bladder control secondary to multiple sclerosis as evidenced by leakage of urine and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

Intervention Rationale
Create an environment that helps the patient deal with incontinence with methods such as but not limited to removing loose rugs on the floor and improving the lighting in their hallways and bathrooms. Loose rugs and poor lighting can be unhelpful and may pose an additional challenge for patients suffering from incontinence.
Place an appropriate and hygienic urinary receptacle for the patient if toilet and bathroom access is hindered by immobility and distance. Make sure to provide privacy when doing so. There must be an alternative measure to help the patient get to the toilet in no time, and some environmental factors may pose a challenge.
Help the patient through assistance in changing and choosing their clothing that could help them gain easier access for toilet use. Loose-fitting clothes with stretchable waistbands are highly preferred over buttoned and zippered clothes. Clothing, though minimal, can also be a huge barrier for people suffering from incontinence. If the clothing is not as indicated in the intervention notes on the opposite of this cell, the patient may have a hard time removing them as they use the toilet.
Educate the patient and the care provider about the wide benefits of using reusable and disposable pads, pad-pant systems, and replacement underwear that were specifically created for the usage of incontinence patients. Some of the absorbent products used by community-dwelling elderly people were not designed to absorb urine, prevent bad odor and protection from perineal skin infection. Products specifically designed for incontinence patients are more cost-effective in the long run.

Nursing Care Plan 4

Urinary Tract Infection

Nursing Diagnosis: Reflex Urinary Incontinence related to loss of bladder control secondary to urinary tract infection as evidenced by leakage of urine and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

Intervention Rationale
Perform a dipstick analysis of the urine and observe for a foul odor and its appearance if it looks cloudy or bloody. By performing a dipstick analysis, signs of the urinary tract and kidney infection may be observed. Multistrip dipsticks can provide details of the patient’s pH, nitrite, and leukocyte esterase, indicating the said infections.
Educate the patient of the benefits of continued mobility and pelvic exercises. Through physical activity, the risk of developing infections in the urinary tract can be significantly decreased.
Promote good hygiene practices such as regularly cleaning the perineal area, keeping it free from moisture, good handwashing techniques, and overall proper perineal care. Educating a patient of these easy measures to help their urinary incontinence in terms of reducing adverse risks for skin irritation and breakdown.
If the patient is suffering from an existing perineal skin problem along with the UTI, help and teach the patient to manage them by recommending vitamin-enriched creams and a moisture barrier. By recommending medical and dermatological measures, the patient will have protection for their skin from the leaking urine.

Nursing Care Plan 5

Recurrent cystitis

Nursing Diagnosis: Reflex Urinary Incontinence related to loss of bladder control secondary to recurrent cystitis as evidenced by leakage of urine and increase in urine frequency

Desired Outcome: The patient will be able to cope with urinary incontinence while preventing any complications such as poor hygiene, skin breakdown, or feelings of shame and embarrassment.

Intervention Rationale
Teach the patient on how to perform self-catheterization (if able) and instruct on the proper care of indwelling catheter. This measure can help promote the patient’s independence and autonomy and promote convenience and less hassle towards their nurses and caregivers. Some patients may require an indwelling catheter though it would entirely depend on their abilities and the severity of their incontinence.
If the patient is of an advanced age, anticipate that he/or she is at high risk for dehydration. Monitor the oral fluid intake to prevent such dehydration from happening. Urine loss, acute confusion, and the increase of the dangers of morbidity and mortality may be intensified when dehydration does occur and is especially dangerous to elderly patients who may have compromised immune system.
Instruct the patient on how to perform Kegel exercises. Kegel exercises can help improve and strengthen pelvic floor muscle tone and as well as ureterovesical junction sphincter tone.
If incontinence gets worse, refer the patient to a bladder specialist. A bladder specialist can create a more detailed and specific plan carefully curated to fit the patient’s needs will be met, along with educating them on the latest techniques and products that could help lessen the worst effects of their condition.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier.

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.

 

 

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