When developing a plan of care for the client with stress incontinence, the nurse should take into consideration that stress incontinence is best defined as the involuntary loss of urine associated with:
A. A strong urge to urinate.
B. Overdistention of the bladder.
C. Activities that increase abdominal pressure.
D. Obstruction of the urethra.
Correct Answer: C. Activities that increase abdominal pressure
Stress incontinence is the involuntary loss of urine during such activities as coughing, sneezing, laughing, or physical exertion. These activities increase abdominal and detrusor pressure. Precipitating activities include coughing, laughing, sneezing, straining, or exercising. The patient may initially present with urinary complaints of dysuria, frequency, and urgency.
Option A: A strong urge to urinate is associated with urge incontinence. Urge incontinence is a type of urinary incontinence in adults, which involves sudden compelling urges to void and results in involuntary leakage of urine. This is a serious and debilitating condition and has a social stigma attached to it. To avoid the huge socioeconomic burden and high morbidity associated with this condition, early diagnosis, treatment, and referral concepts must be widely practiced among clinicians.
Option B: Overdistention of the bladder can lead to overflow incontinence. Overflow urinary incontinence is the involuntary leakage of urine from an overdistended bladder due to impaired detrusor contractility and/or bladder outlet obstruction. Neurologic diseases such as spinal cord injuries, multiple sclerosis, and diabetes can impair detrusor function.
Option D: Obstruction of the urethra can lead to urinary retention. Obstructive uropathy is a disorder of the urinary tract that occurs due to obstructed urinary flow and can be either structural or functional. The back-up of urine into the unilateral or bilateral kidneys, depending on the location of the obstruction, causes hydronephrosis.
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