Holly, a 4-year-old female patient, has started wetting the bed again after being dry at night for the last 5 months.
Holly, a 4-year-old female patient, has started wetting the bed again after being dry at night for the last 5 months. Her mother reports she is crabby & tired all the time and when she urinates, she cries. This has happened before when Holly has a urinary tract infection. A urine sample is obtained revealing cystitis for which the APRN-NP prescribes an antibiotic. A referral is made to a urologist, as the NP is concerned that Holly may have vesicoureteral reflux since she has had previous urinary tract infections within the past year or so.
In this discussion:
1. Describe the findings of the urine sample that would indicate cystitis. If the urine sample did not indicate a urinary tract infection, what might be other causes for nocturnal enuresis?
2. Describe the pathophysiological reasons leading patients with urinary tract infections to develop nocturnal enuresis.
3. Describe vesicoureteral reflux and its relationship with a urinary tract infection.
4. Discuss any patient teaching and health promotion activities you would provide for this family.
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