Analysis Of Primary Nocturnal Enuresis
Enuresis is the involuntary passage of urine past the age when a child should be expected to have attained bladder control (Pillitteri, 2014, p. 1358). Jorge is a nine-year-old boy who should have established bladder control by now. His mother states that he wets the bed every night and has no accidents during this day. I have come to the conclusion that Jorge has primary nocturnal enuresis form the information provided by his mother. According to our textbook, primary nocturnal enuresis is bedwetting in a child who has not achieved consistent dryness at night (Treas & Wilkinson, 2014, p. 1015).
The RN should collect assessment data so that the patient’s problem can be evaluated more in depth. Two pieces of assessment data the RN should
collect is how the mother tried to correct this problem and identify if there are any stresses in the family. Stresses can include the parent wanting a more mature behavior more than the child can manage, divorce, new brother or sister, or an uncomfortable school situation such as bullying (Pillitteri, 2014, p. 1359).
The RN will use the assessment data collected to plan the patient nursing care. This information can be used to identify any stress factors contributing to this problem and if so can they be eliminated and how. It can also help to determine where the most nursing care is needed and how extensive it needs to be. From the assessment, the nurse will be able to identify if this is more of a problem for Jorge or his mother. If it is more of an issue for his mother, it may be harder to correct if Jorge is not concerned about it.
One physiological and one psychosocial intervention that could help Jorge and his mother deal with this problem would be: Physiological- Restrict Jorge’s fluid intake after dinner and encourage voiding before bed (Pillitteri, 2014). This will keep a decreased volume of urine in the bladder giving Jorge a better chance of not wetting the bed because he would have voided it out prior. Psychosocial- Place alarm bells on his bed that ring when he wets the bed at night (Thurber, 2016). The sensors with register the wetness and the bells will ring waking him up, and he will stop voiding and proceed to the bathroom (Pillitteri, 2014). It is important for the nurse and Jorge’s mother to understand that correcting this problem may take time and that they need to be patient with him.
The RN should collect assessment data so that the patient’s problem can be evaluated more in depth. Two pieces of assessment data the RN should
collect is how the mother tried to correct this problem and identify if there are any stresses in the family. Stresses can include the parent wanting a more mature behavior more than the child can manage, divorce, new brother or sister, or an uncomfortable school situation such as bullying (Pillitteri, 2014, p. 1359).
The RN will use the assessment data collected to plan the patient nursing care. This information can be used to identify any stress factors contributing to this problem and if so can they be eliminated and how. It can also help to determine where the most nursing care is needed and how extensive it needs to be. From the assessment, the nurse will be able to identify if this is more of a problem for Jorge or his mother. If it is more of an issue for his mother, it may be harder to correct if Jorge is not concerned about it.
One physiological and one psychosocial intervention that could help Jorge and his mother deal with this problem would be: Physiological- Restrict Jorge’s fluid intake after dinner and encourage voiding before bed (Pillitteri, 2014). This will keep a decreased volume of urine in the bladder giving Jorge a better chance of not wetting the bed because he would have voided it out prior. Psychosocial- Place alarm bells on his bed that ring when he wets the bed at night (Thurber, 2016). The sensors with register the wetness and the bells will ring waking him up, and he will stop voiding and proceed to the bathroom (Pillitteri, 2014). It is important for the nurse and Jorge’s mother to understand that correcting this problem may take time and that they need to be patient with him.