Nursing Assistant Monthly Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Urinary Incontinence: prevention and care August 2009

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 2 Why worry about urinary incontinence?  Urinary incontinence can lead to: –skin irritation –skin breakdown Therefore good skin care is essential! continues

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 3 Why worry about urinary incontinence? (cont.) Emotional effects  Urinary incontinence can lead to: –depression –avoidance of social activities –isolation from others

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 4 Preventing urinary incontinence  Make sure residents drink enough liquids –especially water and non-caffeinated beverages –some residents may be on a fluid restriction; ask the nurse for advice  Assist with regular toileting –every 2 or 3 hours  Report signs of constipation –constipation can interfere with bladder functioning  Assist with proper hygiene –wiping front to back after bowel movements helps prevent urinary tract infection that can lead to incontinence from bladder irritation

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 5 Helping residents with urinary incontinence Residents with urinary incontinence can usually be helped through proper:  assessment  treatment Nursing assistants can help with both of these

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 6 Assessment: your role You are the nurse’s eyes and ears Observe residents for:  sudden urine leakage with a cough or sneeze –could be stress incontinence, often due to weak pelvic muscles continues

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 7 Assessment: your role (cont’d) Observe residents for:  urine leakage, even soon after toileting –could be overflow incontinence –bladder is not emptying completely when voiding –often due to a blockage (example: enlarged prostate in men) continues

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 8 Assessment: your role (cont’d) Observe residents for:  inability to “make it to the bathroom” –could be urge incontinence –often due to urinary tract infection Some people have a combination of the above types of urinary incontinence

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 9 Possible treatments and your role  Regular toileting –assist resident as needed  Bladder exercises –remind resident to do them  Bladder retraining –usually involves gradually increasing time between voidings –follow the toileting schedule as ordered

Copyright © 2009 Delmar, Cengage Learning. All rights reserved. August 2009Urinary incontinence 10 Bladder scanning devices  Detect how much urine is in the bladder  Typically used before and after voiding  Can help determine if urinary incontinence is due to stress, urge, or a blockage  Nursing assistants can be taught to operate a bladder scanner  If your facility uses bladder scanners, follow established policies