Ackley: Nursing Diagnosis Handbook, 10th Edition
Clinical Reasoning and Critical Thinking: Use of the Nursing Process
Case Study - Mrs. Hill (Incontinence)
Case Studies
Case Scenario
“Oh, this is awful,” Jenny muttered to herself. She was sitting on the toilet with a pair of very wet panties and slacks around her ankles. Jenny never knew when it would hit―this need to urinate quickly. She would find herself running to the bathroom like a woman possessed and then usually not making it in time. “It also seems like I’m peeing all the time,” she said. “This is getting old really fast,” she thought, as she continued trying to squeeze the urine out of her panties using quantities of toilet paper.
Nursing Assessment Including
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Write a nursing diagnostic statement for one of the nursing diagnoses by combining the nursing diagnosis label with the “related to” (r/t) factors.
a. The label is the title of the nursing diagnosis as defined by the North American Nursing Diagnoses Association (NANDA).
b. An r/t statement describes the factors that may be contributing to or causing the problem that resulted in the nursing diagnosis.
(The information can be copied and pasted from the EVOLVE site into the areas below.)
NANDA label: Urge Incontinence; The state in which an individual experience involuntary passage of urine, occurring soon after strong sudden need to void.
Definition: Involuntary passage of urine occurring soon after a strong sense of urgency to void
Urge incontinence is defined within the context of overactive bladder syndrome. The overactive bladder is characterized by bothersome urgency (a sudden and strong desire to urinate that is not easily deferred) (Abrams et al, 2002). Overactive bladder is typically associated with frequent daytime voiding and nocturia, and approximately 37% will experience urge urinary incontinence (Stewart et al, 2003).
Related to (r/t) factors: frequent accidents after sudden urge to void, inability to delay urine with sudden urge and increasing urinary accidents over past year. Neurological disorders (brain disorders, including cerebrovascular accident, brain
By carrying out an assessment nurses can identify the causes of problems that require medical involvement. Nettina (2006)
D. Would the physician’s knowledge of the child’s condition serve as a defense against a claim of nursing negligence, particularly because the new graduate had spoken to the physician four times?
Incontinence is one of the major problems faced by the elderly. Nurses can play a significant role in discovering continence problems (Lea R.et.al.2007). Urinary incontinence is the unintentional passing of urine. It is a very common problem and is thought to affect more than 50 million people in the developed world.(NHS.UK). To identify the problem and provide necessary treatment at the early stage, a thorough physical assessment is necessary.
An r/t statement describes factors that may be contributing to or causing the problem that resulted in the nursing diagnosis.
May not introduce or define the topic, or may not describe its importance to professional nursing in a sufficient manner.
Write one nursing diagnosis that reflects a priority need for this person. Remember a wellness diagnosis is a possibility.
2011). Incontinence is defined as the complaint of any involuntary loss of urine (urine incontinence) or faecal material (faecal incontinence) or both (double incontinence) (Abrams et al. 2009). Incontinence is a widespread problem in all healthcare settings (Du Moulin et al. 2008; Macmillan et al. 2004). Figures produced by Macmillan et al. (2004) studies on the prevalence of incontinence varied but prevalence was estimated between 10% and 15% for faecal incontinence measured in community-dwelling adults and up to 46% for urinary incontinence measured in older, home-care patients in Du Moulin et al. (2008) studies results. This shows that there is a huge amount of patients at risk for IAD due to them having the risk factor of incontinence. Therefore the prevention of IAD should be paramount in the care of any patients or clients who are at risk for
Nursing care is focused on the assessment, nursing diagnoses, planning, implementation, and evaluation of patients. This nursing process can also be implemented in aspects outside of nursing and on the nursing field as a collective group. The nursing role is evolving, following the process the outcomes have to be evaluated and put into perspective. Research is being completed the conclusions are all the same, the higher education of nursing care the better the patient outcomes.
Discuss how an understanding of nursing-sensitive indicators could assist the nurses in this case in identifying issues that may interfere with patient care.
To further evaluate the usefulness of the 5 remaining articles, their abstracts were read to identify any relevant information. Information is data that has some meaning to it. Davenport and Prusak (1989) describes information as data that makes a difference to the receiver of the data. The data which is now aggregated into informational sentences and paragraphs (complete thoughts) reveal that the NANDA Nursing Diagnoses, the Iowa Nursing Interventions, and Iowa Nursing Outcomes Classification SNLs have been explored for use in Nurse Practitioner practice. This is information as it has context to the reason the literature search is being performed.
As a result of the introduction of computer technology and the combination of evidence-based practice in nursing; standardization of terminologies has become imperative in the classification of nursing diagnosis, interventions and expected outcomes. The most popular and successful systems are the North American Nursing Diagnosis Association International (NANDA-I), Nursing Outcomes Classification (NOC), and Nursing Intervention Classification (NIC) (de Lima Lopes, de Barros, & Marlene Michel, 2009). This paper aims to provide a brief outline of these standardized terminologies (STs) as they relate to a
Syndrome bladder overactive is a urologic condition defined by a set of symptoms - such as the urgent need to urinate - NOT depend on other diseases with similar events (including bladder tumors , infections or obstructive diseases of the urinary tract ).increased frequency of urination may be accompanied by incontinence and occur throughout the day (in this case one speaks of pollakiuria ) or only at night ( nocturia
Urinary Incontinence is the accidental or unwanted leakage of urine causes by a loss of bladder control. (www.womenhealthmatters.ca). The need
It is during the second phase that the nurse must establish a nursing diagnosis. Only diagnosis approved and listed through The North American Nursing Diagnosis Association (NANDA) may be used. Ineffective airway clearance, risk for impaired skin integrity, risk for infection and ineffective coping are just a few examples of NANDA approved diagnosis. A nursing diagnosis is a clinical judgment about actual or potential individual, family, or community experiences/responses to health problems/life processes. A nursing diagnosis provides the basis for selection of nursing interventions to achieve outcomes for which the nurse has accountability (Defining the Knowledge,” 2012).
The bladder and urinary tract depict the epitome of various old age associated conditions. Urinary incontinence otherwise known as loss of bladder control is a common problem associated with aging. Besides old age, diabetes and other conditions also contribute to incontinence. Other common conditions include menopause for women and enlarged prostate for men.