identify causes

[Medsport, LPN]

I'm working on the care plan section where you identify ineffective behaviors and identify causes. I'm haveing trouble deciding what to put down for the identify causes section. Say the client has urinary incontinence as the ineffective behavior, what would the identify cause be? There are several possibilities in my book. I noticed that Parkinsons and UTI are a couple my book had, If the client had both of those what would you put?

[Daytonite, BSN, RN]

this is why you need to know physiology and pathophysiology. did you look up incontinence in your nursing textbook? for purposes of a nursing diagnosis you will want to know or have an idea of what is the cause of the incontinence, not necessarily the disease causing it. there are actually several nursing diagnoses for urinary incontinence. briefly looking through their definitions and other information about them, here is a short list of what nanda accepts for us to use as causes for incontinence. see if you recognize any.

• delirium
  
• dementia
  
• mental retardation
  
• neuromuscular impairment
  
• physical barriers to getting to the bathroom
  
• spinal cord paralysis
  
• uterine prolapse
  
• urethral sphincter incompetence
  
• ectopia
  
• bladder outlet obstruction
  
• cystitis
  
• hyperreflexia
  
• depression

for a person with parkinson's disease the cause would most likely be neuromuscular impairment. with a uti the cause will be the cystitis (recall that the symptoms of any infection start with redness, swelling and heat. swelling in the area of the bladder presses on the tissues and structures of the bladder limiting the bladder space.). if the patient had both diseases and urinary incontinence, you would word your nursing diagnosis this way: total urinary incontinence r/t neuromuscular impairment and cystitis

[Medsport, LPN]

thanks, that helps, but i would just use the neuromuscular impairment and cystitis as causes in this section, but when i do the actual diagnosis (probly next week), i would put the r/t in between correct?

[Daytonite, BSN, RN]

You would write the nursing diagnosis exactly as I did:

• Total Urinary Incontinence R/T neuromuscular impairment and cystitis

  
  

If you write Total Urinary Incontinence R/T neuromuscular impairment and R/T cystitis which I think is what you are suggesting, you would be WRONG. You just add as many causes, or related factors, after the "R/T" part of your diagnostic statement as you have. Put commas between them and an "and" just before the last one. As an example, look at this nursing diagnostic statement:

• Self-Care Deficit: Bathing/Hygiene R/T pain, weakness, and lack of motivation.

All three causes are the reason for the self-care deficit so they are included in the statement, separated with commas.

Does that answer your question?