Enuresis
Involuntary urination, often nighttime bed-wetting in children
Definition
Enuresis is involuntary voiding at an age when bladder control is expected (≥5 years). Primary enuresis: never achieved control. Secondary: after ≥6 months of dryness. Nocturnal (nighttime) is most common.
Causes and Contributors
- Developmental immaturity (small bladder capacity)
- Deep sleep arousal issues
- Low nighttime ADH production
- Family history (strong genetic component)
- Emotional stress (new sibling, school changes)
- Medical causes: UTI, diabetes, constipation, sleep apnea
Nursing Interventions
Reassure parents that most children outgrow enuresis. Avoid punishment or shaming. Behavioral strategies: limit fluids 2 hours before bed, empty bladder before sleep, positive reinforcement, bed-wetting alarms (most effective). Medications (desmopressin, imipramine) as last resort. Rule out medical causes with urinalysis.
NCLEX Relevance
Teach parents non-punitive approach. Bed-wetting alarm is the most effective behavioral treatment.