RNSG 1412 (Ob/Pedi) - Exam 3, PPT & Learning Guide: PEDI GU dx|Pediatric Urinary Disorders, Enuresis, Nocturnal Diurnal Incontinence, Primary Secondary Bedwetting, Behavioral Training, Desmopressin, Oxybutynin, Vesicoureteral Reflux, Ureteral Malformation

RNSG 1412 (Ob/Pedi) - Exam 3, PPT & Learning Guide: PEDI GU dx|Pediatric Urinary Disorders, Enuresis, Nocturnal Diurnal Incontinence, Primary Secondary Bedwetting, Behavioral Training, Desmopressin, Oxybutynin, Vesicoureteral Reflux, Ureteral Malformation, VCUG, Antibiotic Prophylaxis, Surgical Reimplantation, Cryptorchidism, Orchidopexy, Hypospadias, Epispadias, Bladder Exstrophy, Ambiguous Genitalia, Congenital Adrenal Hyperplasia, Multidisciplinary Care, Acute Poststreptococcal Glomerulonephritis, Hematuria, Proteinuria, Hypertension, Renal Insufficiency, Nephrotic Syndrome, Hypoalbuminemia, Edema, Prednisone Therapy, Diuretics, Albumin Infusion, Nursing Care, Fluid Management, Patient/Parent Education Exam Questions Verified and Provided with Complete A+ Graded Rationales Latest Updated 2026 Enuresis •Difficulty with urine control •Nocturnal enuresis - at night = bed wetting •Diurnal enuresis - during the day •Primary enuresis = never exp. period of dryness •Secondary enuresis = exp. 6-12 mos dryness, then wets self again kidneys mature to adult func. lvl abt 6 mos, control of bladder 4-5 yrs Enuresis Diagnosis •History and clinical symptoms •Rule out other conditions •Assess child's social and emotional status •Ultrasound Enuresis Treatment •Reassurance to child/family •Limit fluid intake after dinner •Void prior to bedtime •Avoid sugar and caffeine after 4pm •Imagery •Keep record of progress •Rewards - depends on child/situation •Behavioral training •Desmopressin acetate (DDAVP) = anti-diuretic •Oxybutynin chloride Enuresis Nursing Care •Assess for dimple or hair tuft on lower spine = SB acolta •Assess for signs of sexual abuse •Patient/parent teaching •Follow up to assess effectiveness of treatment •Provide reassurance Vesicoureteral Reflux •Defect causing urine to flow back •Congenital anomaly •Bacteria in the bladder can travel back up to the kidney causing pyelonephritis and renal damage •Graded on scale I - V with V being the most severe defective valve or the way ureter (s) implanted into bladder watch for s/s UTI Vesicoureteral Reflux Diagnosis & Treatment •Diagnosis •Voiding cystourethrogram (VCUG) •Radionuclide cystography (RNC) = requires sedation/not used often •Treatment •Antibiotics prophylactic •Surgical intervention •Endoscopic injections •Reimplantation of ureter Grade I to V, V= most severe •**Grade I through III often have spontaneous resolution** Vesicoureteral RefluxNursing Care Monitor and record intake and output Assess comfort level Monitor vital signs