week 4, response 2

Case Scenario 3: Mark is a 5-year-old male who was brought into the clinic today for a

well-child exam. His mother reports that she is concerned that Mark wets his bed at

night 3 to 4 times per week. She is at her wit’s end and does not know what to do.

What does the APRN need to know about Mark’s condition? There are a few questions that must be asked about Mark’s condition to get a better

understanding about it, such as the voiding characteristics if there is urgency, dysuria,

or dribbling. The APRN should question what time of the day Mark drinking fluids is and

if there has been a family history of enuresis. If there is a family history, then the APRN

should question what treatment was started and how long it took to resolve. They

should also question how the parents are handling the current situation and what they

have tried to treat Mark with. Mark should also be asked about sleep patterns and if

there is anything abnormal that has happened recently.

What are some of the possible causes for Mark’s condition? There are many different causes for enuresis in children. The most common cause for

enuresis is a urinary tract infection. Another common reason is due to diabetes mellitus.

If the patient has a high blood sugar, this will lead to more sugar being leaked into the

patient’s urine. Therefore, the kidneys will produce more urine in order to excrete the

excess sugar. Other reasons for enuresis can also be a structural abnormality, sleep

apnea, psychiatric problems, or pinworms.

What strategies should the APRN share with Mark’s mother to help him stay dry

at night? A few strategies to help Mark stay dry at night include removing any guilt associated

with enuresis, having a schedule for regular voidings, regular drinking habits, and

having a correct voiding position (Nevéus, 2022). The focus for keeping Mark dry at

night is behavioral modification. By getting the patient used to voiding regularly during

the day, he will than have a better chance of avoiding enuresis. Furthermore, the patient

should be treated for any underlying condition before correcting enuresis, such as

urinary dysfunction or constipation. Drug therapy, such as desmopressin, can also be

used but only has a short term success rate and can cause many side effects in

children.

References Maaks, D.L. G., Starr, N., & Gaylord, N. (2019). Burns' Pediatric Primary Care (7th ed.).

Elsevier - Evolve. https://online.vitalsource.com/books/9780323581967Links to an

external site.

Nevéus, T. (2022). Problems with enuresis management—A personal view. Frontiers in

pediatrics, 10, 1044302. https://doi.org/10.3389/fped.2022.1044302Links to an external

site.