urinary incontinence 
definition
in ability to control urine
clinical manifestation
pressure in pelvic area, causing strong urge to urinate
going to the bathroom more than 8 times a day or more than two times at night
urinating while asleep
causes
being overweight
this put pressure on the bladder which weakens bladder muscle
constipation
straining during deification put pressure on bladder and weakens the muscle
nerve damage
surgery
types
urge incontinence
intense urge to urinate
caused by overactive bladder (OAB)
stress incontinence
leaking urine during activities
e.g. laughing, cough or sneeze, jump or lift things
overflow incontinence
this is when the bladder doesn't empty completely as it should
mixed incontinence
combination of several problem that all lead to leakage issues
this affects bladder control
diagnostic test
physical exam
do pelvic exam to woman and size of the prostate to man
urine sample
test for infection and blood
ultrasound
to look at the contents of bladder
to assess the emptying ability of the bladder
stress test
ask the patient to cough to see if urine leaks during this action
cystoscopy
this is inserted to urethra and bladder to get a closer look of urinary tract
urodynamic testing
to check how much the bladder can hold
to check how well the urethral sphincter muscles is working
pharmacological management
oxybutynin
to relax the muscles of the bladder
to control the release of pee
tolterodine
to treat symptoms of an overactive bladder
health education
empty the bladder on regular schedule
empty the bladder before doing activities
avoid lifting heavy objects
do Kegel exercises to strengthens the pelvic floor muscles
avoid drinking caffeine and lot of fluids at night and before starting an activity
maintain body weight
add lot of vegetables and fruits as well as fiber in diet
nursing care plan
if the pelvic floor muscles are damaged , bladder may not work as it should
pathophysiology
this occurs when there is failure of the storage function of lower urinary tract , due to inappropriate activity of the bladder muscle
nursing diagnosis
altered elimination pattern due to frequency of pelvic floor muscles
expected outcome
patient remain continent of urine
nursing intervention
reassure patient to allay embarrassment and anxiety
encourage patient to urinate at 2 hourly, to reduce overflow
maintain hygiene of the patient to reduce risk of skin irritation and infection
encourage diet that is non irritating to the bowel like spices and diet high in fiber to prevent constipation
monitor and record input and output on fluid chart
evaluation
continence of urine maintained
or incompetence of the continence maintaining mechanism