Acute UI Interventions

Acute urinary incontinence (UI) is an involuntary loss of urine that begins suddenly and resolves in less than 6 months. Chronic UI continues for more than 6 months.
Nursing interventions for the management of acute UI will focus on:

• Screening at risk individuals; UI remains significantly under reported.
  
• Identifying the type of UI, i.e., urge, stress, functional, overflow.
  
• Identifying reversible causes of UI, i.e., DIAPPERS (see below).
  
• Support the expectation of continence through patient/caregiver education.
  
• Coordinating multidisciplinary patient-centered care to optimize continence and independence.

"CORRECT THE OBVIOUS and COLLABORATE"

• Track voiding pattern with I/O or voiding diary
• UTI - primary care consult
  
• Constipation or impaction - primary care consult
  
• Enlarged prostate - urology consult
  
• Adjust medications - primary care, pharmacy consult
  
• Delirium - primary care, pharmacy consult
  
• Correct fluid problems, whether too much or too little.
  
• Impaired mobility - occupational/physical therapy consult
• Avoid bladder irritants:
  • Alcoholic beverages
  • Apples and apple juice
  • Artificial sweeteners, saccharin, aspartame, corn sweeteners, honey, fructose, sucrose, lactose
  • Beverages with caffeine: coffee, tea, decaffeinated coffee, etc.
    
  • Carbonated drinks
  • Chocolate
  • Fruit: Cantaloupe, Citrus juice & citrus fruit, Cranberries and Cranberry juice, Grapes, Guava, Peaches, Pineapple, Plums, Strawberries, Tomatoes and tomato products
    
  • Milk Products: milk, cheese, cottage cheese, yogurt, ice cream
    
  • Medications with caffeine
  • Sugar especially artificial sweeteners,
  • Very spicy foods
• Scheduled or prompted toileting when appropriate
• Teach Kegel exercises (10 repetitions, three to five times per day)

"DIAPPERS" mnemonic acronym to quickly remember potentially reversible causes of urinary incontinence.

Delirium/confusional states
Infection-urinary (symptomatic)
Atrophic urethritis/vaginitis
Pharmaceuticals
Psychological, especially depression
Excessive excretion (i.e., CHF, hyperglycemia)
Restricted mobility
Stool impaction (Resnick & Yalla, 1985)